Outcomes of transconjunctival approach and its modifications for the treatment of orbito-zygomatic complex fractures: A pilot study

Abstract

Background and Objectives: Transconjunctival incision is used to access the floor of orbit and infraorbital rim; however, when continued with lateral canthotomy, it becomes a versatile approach to treat various types of zygomaticomaxillary fractures. The aim of this study was to evaluate the outcomes of transconjunctival approach and its modifications in terms of accessibility, esthetic outcome, and postoperative complications for the treatment of patients of orbito-zygomaticomaxillary complex fractures. Methods: In the hospital, a total of five cases of zygomatic complex fractures were operated from October 2019 to December 2019. The transconjunctival approach was assessed on the following criteria: adequacy and ease of exposure, time required for exposure of fracture site, accuracy of reduction of fracture, esthetic outcome, and postoperative complications (e.g., ectropion, entropion, chemosis, infection, and scarring). The patients were kept on follow-up for 6 weeks. Results: The average age of the patients was 26 years. The average time required for exposure of fracture site was 25.2 min. Exposure obtained in all the cases was adequate according to the operating surgeon. During postoperative follow-up, all the patients were evaluated for ectropion, entropion, chemosis, and infection. None of the patients reported with any complications, and the postoperative esthetic results were satisfactory (according to the patient). Conclusion: The transconjunctival approach is an efficient approach to gain surgical access to infraorbital rim and zygomatic complex fractures. With good exposure and nonvisible scar, transconjunctival approach is superior to other techniques. The numerous advantages of this approach nullify the longer time taken for the procedure.

Keywords

• lateral canthotomy
• retroseptal
• transconjunctival approach
• zygomatic complex fractures