Delayed Reduction of Pure Medial Blowout Fracture of the Orbital Wall

Background and Objectives：The timing of surgery is an important consideration point in the management of blowout fracture (BOF) of the orbit. This study aimed to compare the surgical outcome of early and delayed reduction and to suggest the best timing of surgery in the pure medial BOF of the orbit. Subjects and Method：Fifty-two patients who had endoscopic endonasal reduction of medial BOF were studied retrospectively. Patients were divided into an early group (N=42) who had surgery within one month after the trauma and a delayed group (N=10) who had surgery after one month from the trauma. Surgical indications, results of the surgery, and complications were compared between the two groups. Results：The surgical indications in the early group were persistent diplopia, large defect expecting later enophthalmos and limitation of EOM, whereas the delayed group complained mainly of enophthalmos and diplopia. There were no significant differences in surgical outcomes and the rate of complications between the two groups. Conclusion：When patients with pure medial BOF have large defects without any persistent diplopia and limitation of EOM, surgery would be safely deferred until significant enophthalmos occurs. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:796-9)