Management of Zygomatic-Maxillary-Orbital Fracture Using Transcutaneous Approaches Versus Retroseptal Transconjunctival Approach

Abstract

This study was performed to evaluate mainly the esthetic outcome and complications of the transcutaneous versus transconjunctival approach in the repair of orbital floor fractures reconstructed by plates and titanium mesh. The study was conducted on 21 patients with orbital floor fractures indicated for repair and the mean age of the patients was 30. The included patients were randomly divided in three equal groups (7 patients in each group). Group 1 transconjunctival approach, group 2 subtarsal approach, group 3 subciliary were performed to expose, reduce and reconstruct the orbital floor and walls with titanium mesh and plates. Clinical assessment included modified Vancouver scar scale, epiphora, asymmetry, pain, wound dehiscence and sensory deficit. The study results indicates that the transconjunctival approach is associated with lower rates of complications and pain in comparison with the subciliary and the subtarsal approaches. There is statistical significance between the transconjunctival and subciliary, but there is no statistically significant difference between the subtarsal and the other two approaches. Therefore, this study advocates the use of transconjunctival incision for orbital fractur, although you can’t go wrong with any one of them.