Abstract

Background: The current study headed to assess the safety and effectiveness of endoscopy in fractures of zygomatic arch, orbit and frontal sinus as well as sub condylar fractures to extend endoscopic approach in relevant surgeries in some referral centers over our country.

Methods: Through a clinical trial we evaluated three types of facial fractures in terms of their outcome, hardness and satisfactory rate when was corrected using endoscopy. Patients with frontal, zygomatic and orbital fractures who referred to Amir-Aalam and Vali-Asr hospitals in Tehran between October 2015 and September 2016 enrolled the study. Fractures of orbital base, isolated inverted fractures of the anterior table of frontal sinus, simple zygomatic fractures and fractures of mandibular condyle with insufficient occlusion were the cases to be recruited by the current study.

Result: The most common cause of fractures was accident (61.5%) followed by falling (23.1%), assault and sport trauma. All the cases with frontal fracture obtained good results (100% rate) and orbit fractures were the next successful cases with 66.7% good results but zygomatic fracture had the most rate of fair outcome (60%). Overall rate of good results was 64.7% whilst 35.3% fair response to endoscopic technique of surgery. Only one of the total fractures had a hard procedure, 12 (70%) experienced easy procedure and 4 (23.5%) moderate severity of surgery. Frontal cases reported the most rate of satisfaction (9.00) followed by orbit (8.11) and zygomatic (7.40) with no significant difference and surgeon was also satisfied mostly with frontal cases (8.67) and then orbit (8.11) and zygomatic ones (7.60).

Conclusion: The current trial confirmed the advantages of endoscopic approach in maxillofacial fractures chiefly due to perfect expose of the site of surgery. There was neither complication like ectropion, neural injury, and/or facial scars which one usually seen in transcutaneous approach.

Keywords: Facial fracture; Endoscopic approach; Frontal; Orbit; Zigoma; Difficulty; Satisfaction; Outcome