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Updated: Jul 7, 2026
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
A different approach to orbital blow out fractures: microscope-assisted reconstruction of the orbital floor
1Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of Utah, School of Medicine, Salt Lake City, UT 84132, United States. pcapark@ihc.com
Abstract:
To describe a different surgical approach to treat pediatric orbital floor fractures. We report the case of a 14-year-old boy who underwent a microscope-assisted repair of his orbital floor fracture 6 weeks after his injury. The microscope provided excellent visualization of the entire orbital floor defect and facilitated placement of a polyethylene implant. The repair was achieved without complications, and follow-up examinations demonstrated improvement in patient's enophthalmos and diplopia. We noted significant advantages with a microscope-assisted repair over an endoscopic technique for this condition. The operating microscope allows for two-handed surgery, does not require withdraw of the endoscope for cleaning, and provides depth of field. A larger patient population and longer follow-up are needed to better assess the clinical efficacy of this technique.
Insights
Microscope-assisted surgery offers a novel approach for pediatric orbital floor fractures, improving enophthalmos and diplopia. This technique provides superior visualization and surgical control compared to endoscopic methods.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Microsurgery
Background:
- Orbital floor fractures in children present unique surgical challenges.
- Traditional endoscopic techniques may have limitations in visualization and manipulation.
- A novel microscope-assisted approach is explored for pediatric orbital fracture repair.
Observation:
- A 14-year-old male with a complex orbital floor fracture underwent delayed repair (6 weeks post-injury).
- Microscope-assisted surgery provided enhanced visualization of the orbital floor defect.
- A polyethylene implant was successfully placed using the microscope-assisted technique.
Findings:
- The microscope-assisted repair resulted in successful fracture closure without complications.
- Post-operative follow-up showed significant improvement in the patient's enophthalmos and diplopia.
- Key advantages include two-handed surgical capability, continuous visualization without endoscope removal, and superior depth perception.
Implications:
- Microscope-assisted surgery may be a valuable alternative for treating pediatric orbital floor fractures.
- This technique offers potential benefits over endoscopic approaches for complex cases.
- Further research with larger patient cohorts and extended follow-up is warranted to confirm clinical efficacy.
