Blow out fracture Endoscopic repair

BY

Dr. T. Balasubramanian  

Introduction:

Blow out fracture is defined as fractures involving the walls of the orbit with an intact orbital rim.

Details regarding the etiopathogenesis, clinical features can be accessed from

here: http://www.drtbalu.co.in/blow_out.html

 

30 years old patient came with h/o injury right orbit. He was hit by a cricket ball.

 

Clincial photograph of the patient

 

On examination the patient presented with:

Enophthalmos

Diplopia

Pain in the eye

Forced duction test was positive

The patient gave history of propensity to keloid formation. Hence facial incisions were avoided in him.

A combined caldwel luc and endoscopic guided reduction of the fractured fragments was performed. The reduced fragments were stabilised using a foleys catheter which was introduced into the maxillary sinus via an inferior meatal antrostomy.

 

CT scan showing blow out fracture

As a first step caldwel luc procedure was performed through a sublabial incision.

Sublabial skin incision

Figure showing transantral reduction of fracture


.

Foleys catheter introduced into the antrum via inferior meatal antrostomy

Balloon of foley's catheter inflated with air. This holds the fractured fragments in position

Video clipping showing the surgical procedure

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