The combination of the transorbital and endoscopic transnasal approach for the reconstruction of orbital wall fractures has been modified to be less invasive after the introduction of functional endoscopic sinus… Click to show full abstract
The combination of the transorbital and endoscopic transnasal approach for the reconstruction of orbital wall fractures has been modified to be less invasive after the introduction of functional endoscopic sinus surgery. Artificial materials or iliac bone was used as graft material in past studies [1-3]. Instead, we use nasal septal cartilage as the graft material; herein, we describe its usefulness with a representative case. A 25-year-old woman had a blunt orbital injury. Restriction of upward and downward movement of the left eyeball was accompanied by double vision. Computed tomography (CT) revealed herniated orbital tissue due to inferior and medial wall fractures (Fig. 1). Under general anesthesia, nasal septal cartilage was first harvested via endoscopy (Fig. 2). The orbital wall fractures were examined via an endoscopic transnasal and transconjunctival approach (Fig. 3). The herniated tissue was repositioned back into the orbit, and the bony defects were covered with the graft (Fig. 4). Postoperative eye movements were normal and double vision disappeared. An optimal cosmetic result was obtained without scarring or enophthalmos. Postoperative CT Pediatric/Craniomaxillofacial/Head&Neck Image
               
Click one of the above tabs to view related content.