Reconstruction of orbital floor defects assisted by transantral endoscopy

Abstract

Purpose: The goal of orbital reconstruction is to restore anatomy, volume, and function. In extensive orbital floor defects, the visualization of the posterior area is limited through inferior eyelid incisions. The use of endoscope may improve the treatment; however, it is a high-sensitivity technique. The aim of this case series is to describe the combination of inferior eyelid incision with transantral endoscopy for treatment of extensive orbital floor defects. Methods: Three patients were submitted to orbital reconstruction, and the postoperative CT scans were evaluated to analyze the orbital volume and anteroposterior globe position. Surgical treatment was performed using subciliary inferior palpebral approach to explore the orbital floor and placement of the titanium mesh and an intraoral antrostomy for endoscopy to magnification of the surgical field and adaptation of the mesh. Results: Postoperative CT scan analysis shows that all treatments restored orbital volume and globe position without compression or damage of the optical nerve. Conclusion: The use of endoscope allowed the precise visualization of the posterior region of the orbit and adaptation of the titanium mesh.