Efficacy of Endoscopic Transantral versus Transorbital Surgical Approaches in the Repair of Orbital BlowOut Fractures-(Randomized Clinical Trial).

Abstract

The present study was designed to compare the postoperative results of open reduction versus endoscopically controlled reconstructions of orbital floor fractures.

A total of twelve male patients with unilateral pure blowout fractures (with an average age of 9-33years were selected from the outpatient clinic of Oculo- Plastic Surgery Department, Faculty of Medicine, Cairo University and Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University. All patients were randomized into two equal groups:  Study group (Group A): six patients managed with transantral endoscopic approach and reconstructed with reinforced collagen membrane.  Control group (Group B): six patients managed with transconjunctival approach and reconstructed with Titanium mesh.

The patients were recalled at the intervals , 2nd day after surgery, 1 week, 1, 3, and 6 months postoperatively for follow up visits and photos were taken for postoperative evaluation. Patients were evaluated at 3 months for subjective and ophthalmogical assessments of complete diplopia resolution and enophthalmos correction.. Also, patients were evaluated at 6 months for radiological assessment of bony fracture healing. A significantly better outcome, regarding enophthalmos and diplopia improvement, was found in the endoscopically controlled group. Endoscopically controlled reconstruction of orbital floor fractures seems to be a more accurate and successful treatment. Endoscopic repair appears to be a safe and effective technique for the treatment of BOF of the orbit.