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Transantral endoscopic orbital floor exploration: a cadaver and clinical study
C J Saunders1, T P Whetzel, R B Stokes
1Division of Plastic and Reconstructive Surgery, University of California Medical Center, Davis, USA.
Plastic and Reconstructive Surgery
|September 1, 1997
Summary
Transantral endoscopy precisely diagnoses orbital floor fractures, assessing size and entrapped tissue. This minimally invasive technique aids fracture repair and implant placement, offering a valuable alternative to traditional approaches.
Area of Science:
- Ophthalmology
- Maxillofacial Surgery
- Endoscopic Surgery
Background:
- Orbital floor fractures present diagnostic and therapeutic challenges.
- Traditional approaches may have limitations in visualizing fracture details and entrapped tissues.
Purpose of the Study:
- To evaluate the utility of transantral endoscopy in diagnosing and treating orbital floor fractures.
- To assess the accuracy of endoscopic assessment of fracture size, location, and tissue entrapment.
Main Methods:
- A cadaver study involving endoscopic dissection of orbital floors.
- Clinical application in nine patients with various orbital floor fractures undergoing endoscopic repair.
- Utilized a 30-degree, 4-mm endoscope through a 1 cm2 antrotomy.
Main Results:
- Cadaver dissection confirmed easy identification of the orbital floor and infraorbital nerve, establishing reference zones.
- Endoscopy accurately determined fracture size in nine patients, identifying seven larger (>2 cm2) and two smaller (<2 cm2) fractures.
- Successfully reduced entrapped periorbital tissue in an isolated blowout fracture and assisted in precise implant placement for complex fractures.
Conclusions:
- Transantral endoscopy precisely determines orbital floor fracture size, location, and entrapped tissue, aiding surgical planning and potentially avoiding unnecessary procedures.
- The technique facilitates reduction of complex fractures and accurate identification of the posterior ledge for optimal implant placement.
- Transantral endoscopic methods effectively reduce entrapped periorbital tissue in trapdoor fractures.