A different approach to orbital blow out fractures: microscope-assisted reconstruction of the orbital floor.

To describe a different surgical approach to treat pediatric orbital floor fractures. We report the case of a 14-year-old boy who underwent a microscope-assisted repair of his orbital floor fracture 6 weeks after his injury. The microscope provided excellent visualization of the entire orbital floor defect and facilitated placement of a polyethylene implant. The repair was achieved without complications, and follow-up examinations demonstrated improvement in patient's enophthalmos and diplopia. We noted significant advantages with a microscope-assisted repair over an endoscopic technique for this condition. The operating microscope allows for two-handed surgery, does not require withdraw of the endoscope for cleaning, and provides depth of field. A larger patient population and longer follow-up are needed to better assess the clinical efficacy of this technique.