Facial plast Surg 2009; 25(1): 017-022
DOI: 10.1055/s-0028-1112227
© Thieme Medical Publishers

Endoscopic Endonasal Management of Medial Orbital Blowout Fractures

Yasuyuki Hinohira1 , Hirotaka Takahashi1 , Masahiro Komori2 , Atsushi Shiraishi3
  • 1Department of Otolaryngology, Ehime University School of Medicine, Ehime, Japan
  • 2Department of Otolaryngology, Takanoko Hospital, Ehime, Japan
  • 3Department of Ophthalmology, Ehime University School of Medicine, Ehime, Japan
Further Information

Publication History

Publication Date:
10 February 2009 (online)


This study demonstrated that endoscopic endonasal sinus surgery is a successful technique for reducing medial orbital blowout fractures and does not cause complications. Twenty-three patients with isolated medial blowout fractures that did not involve the inferior wall underwent reduction surgery using the endoscopic endonasal approach. Surgery was indicated if the patient experienced persistent diplopia, ocular motility limitation, or enophthalmos. Septoplasty and submucous resection of the inferior turbinate bone were performed to access the fracture site safely in 3 and 15 patients, respectively. The bone fragments entrapping the orbital content or adhesions between the orbital contents and the sinus mucosa were dissected carefully from the fracture site. An ophthalmologist used the eye traction test to verify improvement in ocular motility. A temporary Silastic sheet was applied in three patients, but no permanent supporting material was used in any patient. No surgical or late complications were seen. Preoperative symptoms were resolved in 22 of the 23 (95.5%) patients 6 months after surgery. We concluded that the endoscopic endonasal reduction based on endoscopic endonasal sinus surgery techniques is safe, accurate, and an appropriate surgical intervention for medial orbital blowout fractures.