International Journal of Anatomy and Physiology

International Journal of Anatomy and Physiology Vol. 1 (1), pp. 006-010, December, 2012. © International Scholars Journals

Full Length Research Paper

Transmaxilar access for treatment of blow-out orbital fracture with titanium mesh 

Edson Martins de Oliveira Junior1*, Fernando Elias Melhem1,2, Antonio Carlos Campos1,b, Marcia Maria de Gouveia1, and Carlos Augusto Alves Ferreira1

1Department of Dentistry - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.

2Department of Surgery - Prosthesis and Maxillofacial Trauma - Faculdade de Odontologia - Universidade de São Paulo, São Paulo/SP - Brazil.

*Corresponding author. E-mail:

Received 04 September, 2012; Accepted 23 December, 2012 


Orbital fractures blow-out type result from traumatic force applied directly to the eye, often associated fracture of the medial orbital wall, without involvement of adjacent bones. This type of fracture results in prolapse of the orbital contents into the maxillary and/or ethmoid sinus. Diplopia, enophthalmos, hiposfagma, periorbital edema and ecchymosis are the major clinical findings. The Computerized Tomography (CT) scan of the orbits is the gold standard in accurate diagnosis of these fractures in order to determine the degree of prolapse orbital structuresinto thesinus, oriented their treatment. About the surgical access to these fractures is classically done by extra-oral way, through subciliar and transconjunctivalaccesses, which sometimes result in undesirable local complications such as scar, ectropion or entropion. This paper aims to report a case of blow-out fracture for which we chose to access via the maxillary sinus, by Caldwell-Luc  access, with reduction of the fracture and deserniation of orbital content through titanium mesh fixed on the superior and medial walls of the maxillary sinus.

Key words: Orbital, trauma, fracture, maxillary sinus, titanium mesh.