Treatment for Blowout Fracture. Repair of Orbital Floor with Hydroxyapatite Plate.

Two patients with broad orbital blowout fractures were treated surgically by the following method. After repair of the orbital floor fractures through a transmaxillary and an orbital approach under general anesthesia, a hydroxyapatite plate was inserted into the maxillary sinus and attached to the orbital floor with human fibrin glue. Furthermore, fixation of the plate was reinforced with a balloon inserted through the counter opening of the maxillary medial wall for about ten days. Satisfactory results were obtained in both cases.Autogenous bone or alloplastic materials utilized as grafts for reconstruction of blowout fractures have been previously reported, and most of them were inserted into the orbit. It is possible that insertion of the plate into the orbit causes adhesion to intraorbital tissues or that the thickness of the plate results in disturbances of ocular movements. Therefore, the authors conclude that the method described in this paper is useful in the treatment of orbital floor fractures.