Endoscopically assisted reconstruction of orbital medial wall fractures

Chien Tzung Chen, Yu Ray Chen, Tung Chain Tung, Jui Ping Lai, Rod J. Rohrich

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Traditional surgical approaches to orbital medial wall fractures are either direct extraocular skin incisions or indirect bicoronal flap. However, these methods can leave remarkable orbital scars or scalp alopecia with the possible associated complications. A minimally invasive endoscopic technique with the assistance of a 2.7-mm, 30-degree telescope through a medial transconjunctival incision has been successfully used to reconstruct the orbital medial wall fractures. This technique was applied to four patients who had orbital medial wall fractures. Three patients also had concomitant orbital floor fractures. The other had associated superior orbital fissure syndrome. All patients were presented with limited eye movement, positive forced duction test, horizontal diplopia, and enophthalmos (3 mm to 6 ram) preoperatively. The entrapped periorbital tissues in the ethmoid sinus were completely reduced endoscopically. The bone defect of orbital medial wall was reconstructed with autogenous rib bone grafts under endoscopic control. The patients were followed up for 8 to 16 months with an average of 11 months. Three patients recovered completely without any residual eye symptoms after intervention. Clinically significant residual enophthalmos of 3 mm occurred in the patient with the superior orbital fissure syndrome. His eye movement limitation caused by entrapment of medial rectus muscle was relieved postoperatively. There was no donor-site morbidity or any complications related to the endoscopically assisted procedure. Endoscopically assisted medial transconjunctival approach to the orbital medial wall fractures is an excellent adjunct for the exposure and complete reduction of herniated periorbital tissue and bony reconstruction of the medial orbital wall.

Original languageEnglish (US)
Pages (from-to)714-721
Number of pages8
JournalPlastic and Reconstructive Surgery
Volume103
Issue number2
DOIs
StatePublished - Feb 1999

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Enophthalmos
Eye Movements
Ethmoid Sinus
Telescopes
Orbital Fractures
Bone and Bones
Diplopia
Alopecia
Ribs
Scalp
Cicatrix
Tissue Donors
Morbidity
Transplants
Muscles
Skin

ASJC Scopus subject areas

  • Surgery

Cite this

Endoscopically assisted reconstruction of orbital medial wall fractures. / Chen, Chien Tzung; Chen, Yu Ray; Tung, Tung Chain; Lai, Jui Ping; Rohrich, Rod J.

In: Plastic and Reconstructive Surgery, Vol. 103, No. 2, 02.1999, p. 714-721.

Research output: Contribution to journalArticle

Chen, Chien Tzung ; Chen, Yu Ray ; Tung, Tung Chain ; Lai, Jui Ping ; Rohrich, Rod J. / Endoscopically assisted reconstruction of orbital medial wall fractures. In: Plastic and Reconstructive Surgery. 1999 ; Vol. 103, No. 2. pp. 714-721.
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