Orbital inferior and medial wall repair via the paranasal sinus: A case report
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Orbital floor and medial wall fractures often require surgery but conventional extraoral approaches can cause scarring, eyelid malposition, and sensory changes. We report a 19-year-old male with left orbital floor, medial wall, and nasal bone fractures after a fall. The medial wall was repaired endoscopically via the ethmoid sinus, and the orbital floor was reconstructed through an intraoral transantral approach using titanium miniplates and screws. The nasal bone fracture underwent closed reduction. Postoperative CT confirmed accurate anatomical restoration. The patient achieved full recovery of ocular motility and symmetry without diplopia or enophthal-mos, experiencing only transient infraorbital hypoesthesia. This case illustrates that combining intraoral trans-antral and endoscopic transnasal approaches provides precise, minimally invasive reconstruction for complex orbital fractures while reducing soft-tissue trauma, scarring, and postoperative complications.
Abstract
Orbital floor and medial wall fractures often require surgery but conventional extraoral approaches can cause scarring, eyelid malposition, and sensory changes. We report a 19-year-old male with left orbital floor, medial wall, and nasal bone fractures after a fall. The medial wall was repaired endoscopically via the ethmoid sinus, and the orbital floor was reconstructed through an intraoral transantral approach using titanium miniplates and screws. The nasal bone fracture underwent closed reduction. Postoperative CT confirmed accurate anatomical restoration. The patient achieved full recovery of ocular motility and symmetry without diplopia or enophthal-mos, experiencing only transient infraorbital hypoesthesia. This case illustrates that combining intraoral trans-antral and endoscopic transnasal approaches provides precise, minimally invasive reconstruction for complex orbital fractures while reducing soft-tissue trauma, scarring, and postoperative complications.