Sinuscopy for the diagnosis of blow-out fractures

Between 1973 and 1976 thirty-one patients with the symptoms of a blow-out fracture underwent sinuscopy. In all these cases a precise diagnosis was not possible from the clinical and x-ray findings alone without exploratory surgery. In 28 cases an exact diagnosis could be made using sinuscopy; 21 patients with blow-out fractures underwent reconstructive surgery to the orbital floor. In the remaining 7 cases fracture of the orbital floor was ruled out and the patients were spared more extensive diagnostic procedures. In 3 cases the diagnosis of a fracture could not be definitely established. Exploratory surgery of the orbital floor showed blow-out fractures which needed treatment. These findings were photographed; 5 typical photographs of fractures are presented. Sinuscopy provides a simple and sure method in the diagnosis of blow-out fractures. Its early application is recommended in cases of suspected fractures of the orbital floor, since reconstructive surgery of blow-out fractures yields the best functional results when performed within 2 weeks after the accident.