Endoscopic Transantral Orbital Floor Repair With Antral Bone Grafts

• Published in: Archives of otolaryngology--head & neck surgery Vol. 131; no. 10; pp. 911 - 915
• Main Authors: Nishiike, Suetaka, Nagai, Miki, Nakagawa, Aya, Konishi, Masaki, Kato, Takashi, Sakata, Yoshiharu, Yasukura, Tohru, Harada, Tamotsu
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Medical Association 01-10-2005
• Subjects: Adolescent; Adult; Biological and medical sciences; Bone Transplantation; Child; Endoscopy; Eyes & eyesight; Female; Humans; Male; Maxilla - transplantation; Medical sciences; Ophthalmologic Surgical Procedures - methods; Orbit - surgery; Orbital Fractures - diagnostic imaging; Orbital Fractures - surgery; Otorhinolaryngology. Stomatology; Plastic surgery; Retrospective Studies; Tomography, X-Ray Computed; Human; Floor of the orbit; Endoscopy; Stomatology; Bone graft
• ISSN: 0886-4470; 2168-6181; 1538-361X; 2168-619X
• DOI: 10.1001/archotol.131.10.911

OBJECTIVE To evaluate the endoscopic transantral insertion of antral bone grafts into the orbit for repair of orbital floor defects. DESIGN A retrospective analysis with a mean follow-up of 5.3 months. PATIENTS Eleven patients who underwent surgical repair of orbital floor fractures. SETTING Municipal hospital. MAIN OUTCOME MEASURES Preoperative and postoperative Hess screen tests and the presence of diplopia, enophthalmos, donor site complications, cosmetic deformity, infection, and graft extrusion. RESULTS Subjectively, 3 patients with diplopia had complete resolution of their symptoms after surgery, and 8 patients had improvement of their symptoms. Objectively, 11 patients had significant improvement in the postoperative Hess area ratio compared with the preoperative Hess area ratio. In 1 patient with a floor defect measuring 2.5 cm, enophthalmos existed after surgery, but reoperation was not performed in this case because diplopia was improved. There were no donor site complications, cosmetic deformity, infection, or graft extrusion. CONCLUSIONS The endoscopic transantral insertion of antral bone grafts through the floor defect into the orbit is an effective technique that prevents injury to the lower eyelid, carries minimal donor site morbidity, and provides an optimal support function for the globe. It merits consideration in cases of orbital defects less than 2 cm in diameter.Arch Otolaryngol Head Neck Surg. 2005;131:911-915-->