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AIM: To assess the feasibility and the outcome of endoscopically assisted repair of zygomatico-maxillary complex orbital fractures in a tertiary care hospital. MATERIALS AND METHODS: A descriptive study was carried out over a period of 2 years (01. 11. 2014–31. 10. 2016). 0°–4 mm endoscopes were used for intra-operative endoscopic exploration. Regular armamentarium for management of maxillofacial trauma along with standard plating systems was used. Commercially available medical grade titanium meshes were utilised for orbital floor reconstruction. RESULTS: Fifty-seven of hundred and twelve surgically managed zygomatico-maxillary complex fractures required orbital exploration. Twenty-one of these had reconstruction of the orbital floor. Endoscopically assisted exploration was performed in 10 of the 21; trans-nasally in three cases, the Caldwell–Luc approach was used in three cases, and in another three, the existing fracture in the anterior wall of the maxilla was utilised. In addition, an endoscopic trans-nasal–sphenoidal approach was opted for to access the orbital apex to manage fractured bone fragments that were impinging on the optic nerve in one of the patients. CONCLUSION: Endoscopes serve as the primary tool in minimally invasive procedures. They are yet to evolve as a major role player in the maxillofacial arena. The authors conclude that endoscopes are truly beneficial as an adjunct to existing techniques. They hold much promise for the future.

Traumatic optic neuropathy (TON) is uncommon, yet a serious sequela to a facial injury. The American Medical Association equates the total loss of vision in one eye to a 24% impairment of a whole man. Literature from the late 90s state, the occurrence of some 55 million eye injuries globally per day. Poor visual perception in 3% of maxillofacial trauma cases was evident in Indian studies carried out in 2011. This has been attributed in most cases to TON resulting from indirect injury to the optic nerve. Clinical diagnosis of TON is made on the basis of a specific constellation of history and physical examination findings. Magnetic resonance imaging with its inherent superior soft tissue contrast resolution has helped identify this problem early to a certain extent. However, the clinical situations characteristic of this type of injury makes a diagnosis and early surgical intervention difficult. Its management remains controversial, and data in literature does not indicate anyone to be superior to the other. Here, we present our experience with a case which fell into this much-disputed category.