Intranasal Reconstruction of the Blowout Fracture of the Medial Orbital Wall

The reconstruction of the blowout fracture of the medial orbital wall has been performed by the transorbital approach with the external ethmoidectomy incision.
Recently, the endoscopic endonasal reconstruction of the blowout fracture of medial orbital wall without external incision was introduced with good results and cosmetic advantages.
Eight cases were treated with the intranasal reconstruction of the blowout fracture of medial orbital wall under the operating microscope. Ethmoid air cells were resected, fractured bones were removed, and orbital content was identified and pushed back into the orbit. Ethmoidectyomy was completed, a thin silastic sheet was inserted in inverted U-shape to cover the lamina papyracea and ethmoidectomy cavity, Merocel packing was placed and soaked with broad spectrum antibiotic solution. Seven patients recovered completely without any residual eye symptoms or complications, and postoperative CT revealed reconstructed medial orbital wall in proper position of the orbit.
In conclusion, the microscopic intranasal reconstruction of the blowout fracture of medial orbital wall is another surgical alternative with good results and cosmetic advantages.