ترميم شكستگي كف اربيت به روش آندسكوپيك ترانس نازال

TRANSNASAL ENDOSCOPIC REPAIR OF ORBITAL BLOW OUT FRACTURE

Orbital blowout fracture by definition is fracture of one of the orbital walls without orbital rim involvement. It is more common in the orbital floor. Prolapse of orbital contents into maxillary sinus can cause ophthalmic complaints. Clinical signs of orbital blowout fracture include eyelid echymosis, diplopia, restriction of eye movements , enophthalmia, and occasionally, sensory deficits in infraorbital nerve territory. Here, we describe a case of orbital blowout fracture with involvement of orbital floor after trauma who presented with eyelid ecchymosis, diplopia, exophthalmous and impairment of upward gaze. Corona] high resolution CTScan showed fracture of orbital floor with prolapse of orbital contents into maxillary sinus without fracture of lamina papyracea. Under general anesthesia with transnasal endoscopic approach, a wide middle meatal antrostomy was created and after remorval of bony fragments, orbital contents were released from periphery and returned into orbit. A Foleys catheter was introduced into the maxillary sinus and inflated to support the repaired area. It remained in place for 2 weeks. After operation, all signs of fracture improved and post operative CTScan approved clinical improvement. It seems that transnasal endoscepic approach is better than transorbital or transantral methods as there is better visualization, less bleeding and no need for foreign materials such as silastic.