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Updated: Jun 18, 2026
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Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
A Systematic Review Comparing Endoscopic and Open Approaches in Orbital Fracture Surgery.
Gustavo Magalhães Albuquerque1, Hana Shah2,3, Sara E Munkwitz3
1Department of Medicine, Pernambuco School of Health Sciences, Recife, PE, Brazil.
The Journal of Craniofacial Surgery
|June 17, 2026
Summary
Endoscopic orbital floor fracture repair shows fewer cases of double vision (diplopia) and sunken eyes (enophthalmos) post-surgery compared to open surgery. This minimally invasive approach may be a good option for suitable patients.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Trauma Surgery
Background:
- Orbital floor fractures are common facial injuries.
- Open repair offers exposure but risks scarring and eyelid issues.
- Comparative data on minimally invasive outcomes are limited.
Purpose of the Study:
- To systematically review and compare postoperative outcomes of open versus endoscopic orbital floor fracture repair.
- Specifically evaluate enophthalmos and diplopia rates.
Main Methods:
- Systematic review following PRISMA guidelines.
- Searched PubMed/MEDLINE, Embase, ClinicalTrials.gov, Cochrane Library (2000-2025).
- Included RCTs and observational studies comparing open vs. endoscopic repair in adults.
Main Results:
- Seven studies (538 patients) met criteria.
- Endoscopic repair had significantly lower rates of postoperative diplopia (OR=0.31, p=0.0008).
- Endoscopic repair also showed significantly lower rates of postoperative enophthalmos (OR=0.32, p=0.01).
Conclusions:
- Endoscopic orbital floor fracture repair demonstrates superior outcomes regarding diplopia and enophthalmos compared to open approaches.
- Clinicians may consider endoscopic techniques for appropriate candidates.
- Further research is needed due to limited data on secondary outcomes.
