안와내벽골절의 내시경적 정복술의 유용성

Objectives: Conventionally, reconstruction of blowout fractures of the medial orbital wall has been performed by the transorbital approach. Advanced high resolution endoscopes currently provide surgeons with excellent visualization and access the medial orbital wall without external incision. We studied the clinical results and effectiveness of endoscopic endonasal approach that allows the repair of blowout fractures of the medial orbital wall. Materials and Methods: Fifteen patients with blowout fractures of the medial orbital wall treated by endoscopic endonasal reconstruction were studied retrospectively. The area of fracture site and the volume of herniated orbital tissue were measured in computed tomographic scans. Operative results and the relationship between ophthalmic symptoms and signs and measured value were analyzed. Results: All patients showed a complete improvement of their symptoms. There was no intraoperative or postoperative complications. The average area of fracture site and volume of herniated tissue were 1.96 cm² and 0.65 ml, respectively. Fracture area over 2 cm² was significant correlated with diplopia. Enophthalmos over 2 mm could be expected with large defect area and herniated volume. Conclusion: Endoscopic endonasal reconstruction of blowout fractures of the medial orbital wall without an external incision has provided good functional and cosmetic results. (J Clinical Otolaryngol 2006;17:114-119)