Utility of Endoscope-Assisted Orbital Fracture Repair for Atraumatic Reduction of Entrapped Muscle Tissue and Surgical Education.

Trapdoor fractures can result in extraocular muscle entrapment with resultant pain, diplopia, bradycardia, nausea, and vomiting. Urgent repair is required to minimize the risk of permanent muscle injury and long-term diplopia. Complete fracture visualization is imperative to ensure adequate reduction of the herniated tissue and accurate implant placement when necessary. Orbital floor angulation and prolapsed orbital fat can make visualization of the posterior orbit challenging. Inadequate reduction can lead to reoperation in up to 18% of cases. Because the narrow field of view makes visualization difficult, teaching the surgical technique can be very challenging. We demonstrate the reduction of an entrapped inferior rectus muscle using an endoscope-assisted transconjunctival approach, highlighting its advantages in fracture visualization and surgical training.