- Purpose This article describes a new endoscopic approach for orbital floor fractures, reduction, and fixation and reports the clinical results. Patients and Methods Ten patients who sustained either a comminuted or trap door orbital floor fracture were treated in 2 medical centers following the same surgical protocol. The indications for orbital reconstruction were limited eye movement, diplopia, and significant enophthalmos. The new approach is discussed in detail. Results All patients healed uneventfully. No major complications were noted in the postoperative period, and good functional and esthetic results were obtained. Conclusions Our results demonstrate that endoscopic intraoral plating is a safe and effective procedure for treating orbital floor fractures.