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Microsurgical Intranasal Reconstruction of Isolated Blowout Fractures of the Medial Orbital Wall

The middle meatus is opened using a long Killian speculum. The uncinate process is resected with a knife, and the bulla and ethmoidal air cells are resected using forceps. Fractured bones of the lamina papyracea and herniated orbital contents are identified behind the resected air cells. Fractured lamina papyracea is removed. Orbital contents are separated from air cell mucosa and pushed back laterally with the long blade of a Killian speculum.