Blow out fracture endoscopic reduction
By
Dr. T. Balasubramanian M.S. D.L.O.
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.
Clinical 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