Transnasal endoscopic approach in medial blow out orbit fractures

ABSTRACT

Objective: The purprose of this study is to present the team experience and the method efficacy in transnasal endoscopic approach of medial orbital blow out fracture using septum graft. Method: This approach was used in 14 patients with an isolated medial orbital wall fracture between June 2005 and June 2006. A computed tomographic scan was taken before and after surgery. The ocular motility and enophthalmos were checked before and after surgery. The endoscopic transnasal approach provided the appropriete surgical exposure in all cases. Patients were followed up for a mean of 8,2 months (range, 5-14 months) after repairing the orbital wall fracture. Hertel exophthalmometry was performed in all patients. Results: Hertel exophthalmometry showed that among 14 patients 13 patients showed no enophthalmos. The enophthalmos ranged from 0.5-1 mm in 12 patients and 1.5 mm enphthalmos was noted in 2 patients. A clinically significant enophthalmos =2mm was not found postoperatively. Preoperatively, 2 (15%) patients had a diplopia in the primary position of the gaze and 12 (75%) patients had a diplopia within 30º of the gaze. Postoperatively, all patients had an orthotropia in the primary position but 1(7%) patient had a residual diplopia. Conclusion: The transnasal endoscopic approach using septal graft provides a minimally invasive, effective, and cosmetically pleasing surgical approach for managing an isolated medial wall fracture.