2022 Volume 65 Issue 2 Pages 62-67
Surgical treatment of orbital wall fractures includes transnasal, transmaxillary sinus, and transorbital methods, and the transnasal method has been the main method performed in our department. We report a case of L-shaped fracture of the inferior orbital wall in which the fracture extended from medial to lateral along the anterior wall, and then from the anterior wall to the lateral part of the posterior wall. We used a combined transorbital and intranasal approach to treat the fracture. The transnasal approach consisted of endoscopic modified medial maxillectomy, and the transorbital approach was by means of a transconjunctival incision. Traditionally, the intranasal approach has been effective in treating fractures of the posterior infraorbital wall, but it has been difficult to repair anterior fractures, while the transorbital approach is effective for treating fractures of the anterior infraorbital wall, but it has been difficult to repair posterior fractures. The fracture in our patient extended from the anterior to the posterior infraorbital wall. We believe that the combined approach is useful in the treatment of extensive orbital wall fractures and that it is important to select the most appropriate procedure in each case.
