Endoscopic endonasal reduction surgery for diplopia caused by orbital roof fractures

Orbital roof fractures (ORF) frequently occur together with frontal bone fractures, and can cause diplopia as a sequela. However, ORF have never been treated using endoscopic endonasal reduction surgery.

A 22-year-old woman was injured in a traffic accident and diagnosed with right ORF along with frontal bone fractures. She was referred to us for diplopia 2 weeks after the initial trauma. No facial deformation was seen. Endoscopic endonasal reduction surgery was performed under general anaesthesia. Ethmoidectomy was performed and, subsequently, the anterior superior portion of the medial orbital bone was removed. During the procedure, an ophthalmologist performed eye traction tests until definitive ocular motility improvement was observed.

Postoperatively, diplopia disappeared and no enophthalmos was seen. From both a functional and an aesthetic point of view, the endoscopic endonasal reduction surgery resulted in a satisfactory outcome without having to use any extranasal approaches in this case.