Endoscopic Transantral Orbital Floor Repair With Antral Bone Grafts | Ophthalmology | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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Original Article
October 2005

Endoscopic Transantral Orbital Floor Repair With Antral Bone Grafts

Author Affiliations

Author Affiliations: Department of Otolaryngology, Kawasaki Medical School, Kurashiki, Japan (Drs Nishiike and Harada); and Departments of Otolaryngology (Drs Nishiike, Nagai, Nakagawa, Konishi, Kato, and Sakata) and Ophthalmology (Dr Yasukura), Suita Municipal Hospital, Suita, Japan.

Arch Otolaryngol Head Neck Surg. 2005;131(10):911-915. doi:10.1001/archotol.131.10.911
Abstract

Objective  To evaluate the endoscopic transantral insertion of antral bone grafts into the orbit for repair of orbital floor defects.

Design  A retrospective analysis with a mean follow-up of 5.3 months.

Patients  Eleven patients who underwent surgical repair of orbital floor fractures.

Setting  Municipal hospital.

Main Outcome Measures  Preoperative and postoperative Hess screen tests and the presence of diplopia, enophthalmos, donor site complications, cosmetic deformity, infection, and graft extrusion.

Results  Subjectively, 3 patients with diplopia had complete resolution of their symptoms after surgery, and 8 patients had improvement of their symptoms. Objectively, 11 patients had significant improvement in the postoperative Hess area ratio compared with the preoperative Hess area ratio. In 1 patient with a floor defect measuring 2.5 cm, enophthalmos existed after surgery, but reoperation was not performed in this case because diplopia was improved. There were no donor site complications, cosmetic deformity, infection, or graft extrusion.

Conclusions  The endoscopic transantral insertion of antral bone grafts through the floor defect into the orbit is an effective technique that prevents injury to the lower eyelid, carries minimal donor site morbidity, and provides an optimal support function for the globe. It merits consideration in cases of orbital defects less than 2 cm in diameter.

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