Endoscopic repair of orbital floor fractures

A variety of surgical approaches to orbital floor fractures have been described. These approaches include the subciliary, transconjunctival, transmaxillary, endonasal, and, recently, the endoscopic transmaxillary approach. As in other surgical specialties, technological advances continue to be used for the betterment of patients with facial trauma. The treatment of orbital fractures has benefited from these advances, particularly in the endoscopic arena. Currently, most orbital floor fractures are repaired with either a transcutaneous or transconjunctival eyelid approach. The use of endoscopy can easily be added to these approaches to enhance the surgeon's visualization, particularly deep in the orbital cavity. Endoscopy also can be used in a minimally invasive, transmaxillary approach to the orbital floor that eliminates complications associated with eyelid incisions (ie external scarring, eyelid edema, ectropion, entropion, and granuloma formation). In this article, we review the technique for transmaxillary, endoscopic repair of orbital blow-out fractures.