Verstraete Laurence, Schillemans Paulien, Meeus Jan, Vuylsteke Philippe, Willaert Robin
Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, BE-3000 Leuven,
Department of Oral and Maxillofacial Surgery, AZ Delta, Deltalaan 1, BE-8800 Roeselare, Belgium.
Craniomaxillofac Trauma Reconstr. 2025 Sep 22;18(3):41. doi: 10.3390/cmtr18030041. eCollection 2025 Sep.
This study aims to evaluate the use of the endoscopic transorbital approach for reducing frontal sinus fractures and compare its outcomes with the traditional bicoronal approach.
A retrospective comparative analysis of case studies including all patients with frontal sinus fractures treated at our institution between January 2013 and December 2023 was conducted. Patients were categorized based on treatment approach (through traumatic laceration, bicoronal, or endoscopic transorbital). For the comparative analysis, cases with associated maxillofacial fractures or cerebrospinal fluid (CSF) leakage were excluded.
Out of 133 patients, 35 underwent surgery, with 6 patients treated using the endoscopic transorbital approach. This group of patients treated with the transorbital endoscopic approach demonstrated significantly shorter operative times compared to the bicoronal approach (mean 102 vs. 168 min, = 0.021). They also had only minor complications, including temporary hypoesthesia and one transient ptosis. One patient had a minimal residual defect. The technique has been concluded to require endoscopic expertise.
The endoscopic transorbital approach is a safe, minimally invasive alternative to the bicoronal approach for selected anterior wall frontal sinus fractures. Proper patient selection and surgical experience are essential to achieving favorable outcomes. Studies with longer follow-up are required to assess potential late complications, such as the development of mucoceles.
本研究旨在评估经眶内镜入路在治疗额窦骨折中的应用，并将其结果与传统双冠状入路进行比较。
对2013年1月至2023年12月在本机构接受治疗的所有额窦骨折患者的病例研究进行回顾性比较分析。患者根据治疗方法（经创伤性撕裂伤、双冠状或经眶内镜）进行分类。为进行比较分析，排除伴有颌面骨折或脑脊液（CSF）漏的病例。
133例患者中，35例接受了手术，其中6例采用经眶内镜入路治疗。与双冠状入路相比，经眶内镜入路治疗的这组患者手术时间明显更短（平均102分钟对168分钟，P = 0.021）。他们也仅有轻微并发症，包括暂时性感觉减退和1例短暂性上睑下垂。1例患者有极小的残余缺损。已得出结论，该技术需要内镜专业知识。
对于选定的前壁额窦骨折，经眶内镜入路是双冠状入路的一种安全、微创替代方法。正确的患者选择和手术经验对于取得良好结果至关重要。需要进行更长时间随访的研究来评估潜在的晚期并发症，如黏液囊肿的形成。
