Management of Orbital Medial Wall Fracture With Endonasal Balloon

Medial wall fracture of the orbit is a condition that requires surgical correction should the patient presents a series of signs and symptoms such as diplopia and enophthalmos. The classical external approaches for exposure like the transconjunctival or transcutaneous approach have been replaced in specific cases by endoscopic approaches as they are less invasive and they eliminate any risk of potential scarring. Larger defects where the medial wall is comminuted or bony fragments are missing could be reconstructed with permanent autogenous or alloplastic materials. When bony fragments are present, a reduction of the fracture can be performed instead, with only a temporary alloplastic material for support. In this study, the authors discuss our experience regarding the management of orbital medial wall fractures by endoscopic endonasal balloon in 14 patients and describe its indications and contraindications. The authors concluded that the balloon achieves satisfactory mechanical support for the fracture to heal and it can be easily removed on an outpatient basis.