Neuronavigation-Guided Endoscopic Decompression of Superior Orbital Fissure Fracture

We present a rare case of an isolated superior orbital fissure fracture resulting from blunt injury to the face and presenting with a selective palsy of the inferior oculomotor division. The patient was surgically treated with an endoscopic approach assisted by neuronavigation. The anatomy of the superior orbital fissure is detailed and the peculiarities of the surgical approach described. A review of the existing literature reveals this is the first reported case of a neuronavigation-assisted endoscopic approach used in the extraction of a superior orbital fracture fragment with resolution of neurological deficits. Current guidelines for endoscopic approach in orbital trauma are reviewed and pertinent literature is discussed.