Reconstruction Using a Combined Approach for Orbital Floor Fractures

Abstract

　　For orbital floor fractures, surgical procedures are performed via a transorbital, transmaxillary, or endoscopic intranasal approach. Otolaryngologists mainly perform intranasal and transmaxillary procedures. Although the intranasal approach has an advantage of being minimally invasive, operations in front and outside of the orbital floor are limited. The endoscopic modified medial maxillectomy（EMMM）approach, a new technique for intranasal maxillary surgery, improved the operability and visibility. By applying EMMM to the reduction of fractures of the orbital floor, it is possible to manipulate a wide range of the orbital floor. Although intranasal surgery has expanded the range of surgical procedures, it still does not cover the entire area of the orbital floor. This approach combined with the transorbital method was useful in cases in which the fracture extended to a wide area of the orbital floor and to the anterior region.