The orbital restitution through double approaches of the ethmoid sinus under nasal endoscope and the subciliary incision in orbital blowout fracture

Objective To evaluate the therapeutic effects of the double approaches of the ethmoid sinus under nasal endoscope and the subciliary incision on orbital blowout fracture.Methods 31 cases with orbital blowout fracture who received the orbital restitution through double approaches of the ethmoid sinus under nasal endoscope and the subciliary incision were analyzed.Results Diplopia of the 31 cases were all diminished within 2 weeks after operation and disappeared in 27 cases at 1 5～8 months after operation.The mobility of the globes recovered completely in 27 cases and was improved partially in 4 cases.The degree of the ocular proptosis gained 10 5～14 5mm and was 13 3mm averagely at 7～10 days after operation.The difference of proptosis between the healthy eye and the suffering eye remained +1 5～-2 0mm and averagely was +0 9mm postoperatively.They recovered with no complications in a 3 months′ to 3 years′ follow-up.Conclusions The approach is characterized by its safety and reliability,slight scar on the skin,mild wound to the patient,clear field intraoperatively,no harm to the optic nerve and suborbital nerve,simple work during the process,and low possibility of complications postoperatively.It has positive therapeutic effects on enophthalmos and diplopia caused by trauma and matches the needs of facial appearance.Therefore,it is an ideal approaches for the orbital blowout fracture.