Comparison of various approaches for exposure of infraorbital rim fractures of zygoma |
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Authors: | Balanand Subramanian Srimathy Krishnamurthy P Suresh Kumar B Saravanan M Padhmanabhan |
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Institution: | (1) Dept. of Oral and Maxillofacial Surgery, Tamilnadu Government Dental College and Hospital, Chennai, India;(2) 10/279, Raman Street, Sokkanathanpet, Pondicherry, 605009, India |
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Abstract: | Objective The aim of this study was to randomly compare four incisionssubciliary, subtarsal, infraorbital and transconjunctival with
lateral canthotomy for treatment of orbital rim or floor fractures.
Methods 40 patients with zygomatic complex fractures either isolated or in association with pan facial fractures, were selected for
the study. They were divided into four groups of 10 patients each, Group I-Transconjunctival with lateral canthotomy, Group
II-Subciliary single eyelid incision], Group III-Subtarsal incision, and Group IV-Infraorbital incision. The following parameters
were compared a) The average time from incision to fracture exposure b) The amount of exposure of the site provided c) The
aesthetic appearance of the ‘scar’ d) Complications e) Factor of ‘time’ — its effect on scar and complications.
Results The study revealed that all four incisions provided adequate exposure of fracture site and transconjunctival (22 minutes)
required the maximum time for exposure. The complications included ectropion in group I and prolonged edema in group IV. Group
II and III patients had relatively lesser number of complications. Group IV patients had visible scar as compared to no scar
in group I patients.
Conclusion We conclude by saying that transconjunctival approach provides an excellent aesthetic result when done meticulously. However
the subciliary and the subtarsal incisions provide a more rapid, direct approach to the orbital floor and infraorbital rim
with minimal morbidity and an aesthetically acceptable scar. The infraorbital incision is the least acceptable aesthetically. |
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Keywords: | Transconjunctival Superciliary Infraorbital Subtarsal approach |
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