We prefer the direct approach through the eyelid to the floor of the orbit rather than the canine fossa-maxillary sinus approach in managing cases of blowout fractures and orbital rim and floor fractures associated with zygomatic and maxillary fractures, because direct visualization of the orbital floor permits entrapped tissues to be freed and an orbital floor substitute to be inserted if needed. The skin-muscle flap technique for approaching the orbital floor is fast and simple, easy to use and teach, provides wide exposure of the orbital floor, and yields excellent physiologic and cosmetic results.
Strahan RW, Dischell W, Williams D. Skin-Muscle Flap for Orbital Floor Fractures. Arch Otolaryngol. 1970;92(6):539–542. doi:10.1001/archotol.1970.04310060011004
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