Abstract: Objective: To explore the possibility of transnasal endoscopic management of septal cartilage augmentation in repairing medial orbital wall fracture. Methods: Eleven patients (11 eyes) with medial orbital wall fracture were enrolled in this study. Before surgery, all the patients had more or less enophthalmos, diplopia and hypopsia. Eye socket CT examination showed that ocular contents were herniated into the ethmoid sinus accompanied with hydrocele. Among them, 6 patients had medial rectus swelling. Under endoscopy, ethmoid sinus was opened via the nasal cavity, the ethmoid cells were extirpated to uncover the fractured lamina, herniated contents were returned back to the eye socket, and the fracture zone was overlaid with septal cartilage. Results: All were cured after surgery. The exophthalmos of both eyes was less than 1mm (with a mean of 0.11mm). The eyesight of the patients showed no change or was slightly improved. Nasal endoscopy showed epithelization of nasal and sinus cavities and un-shift augmented septal cartilage. There was no infection or rejection. Conclusion: Transnasal endoscopic management of septal cartilage augmentation in repairing medial orbital wall fracture is simple, quick and has a high success rate. Autogenous septal cartilage has no rejection response.

Key words: Orbital fracture, Endoscopic surgical procedures, operative, Cribellum, Septal cartilage