Endoscopic exploration of the orbital floor: a technique for transantral grafting of floor blowout fractures.

A cadaveric study was conducted with a twofold purpose--to perform diagnostic transantral endoscopy in pure blowout fractures of the orbital floor and to attempt restoration of bony defects in the orbital floor using the endoscope. Endoscopic visual access of the orbital floor allows precise determination of the fracture size and the presence and extent of entrapped periorbital fasciae. A bony defect was created surgically in the orbital floor of 6 fresh cadaver heads, and a split-thickness calvarial bone graft and an alloplast were used to repair the orbital floor. Grafting of the orbital floor with endoscopic visual access was successful, and the potential risks associated with the traditional eyelid incisions were minimized. The anatomic course of the infraorbital nerve was observed and protected. The study confirmed that endoscopy could be used successfully in obtaining visual access to the orbital floor.