Faculty Collaboration Database

Transconjunctival versus subciliary approach for orbital fracture repair--an anthropometric evaluation of 221 cases. Clin Oral Investig 2013 Apr;17(3):933-42

Date

07/04/2012

Pubmed ID

22752335

DOI

10.1007/s00784-012-0776-3

Scopus ID

2-s2.0-84884211339 (requires institutional sign-in at Scopus site)   33 Citations

Abstract

OBJECTIVES: In the literature, there is an ongoing discussion about the influence of orbital fractures and the surgical approach on the rate of eyelid deformities of the lower eyelid.

MATERIALS AND METHODS: We present an evaluation of a series of 221 patients 9 months after zygomaticomaxillary complex fracture repair that underwent implant removal. Reference anthropometric data were measured on standardized pre- and postoperative photographs. Analysis included eye fissure width and height, lid sulcus and upper lid height, upper and lower iris coverage, position of cornea to palpebra inferior, canthal tilt, scleral show, ectropion, and entropion. Both operated and contralateral eyelids were evaluated as well as whether a transconjunctival or a subciliary approach was performed.

RESULTS: Time, surgery, and surgical approach presented significant effects on eye fissure index and lower iris coverage. Scleral show was significantly influenced by the surgical procedure itself as well as by the type of incision. The rate of ectropion increased significantly pre- to postoperative.

CONCLUSIONS: The subciliary approach included the highest risk of lower lid retraction. The low pre- to postoperative increase of scleral show and ectropion compared to recent studies gives us an idea about the influence of the underlying trauma on the rate of lower lid retraction. The standardized measurements described are accurately and objective to evaluate postoperative results.

CLINICAL RELEVANCE: The transconjunctival approach is preferable in orbital fracture repair.

Author List

Raschke GF, Rieger UM, Bader RD, Schaefer O, Guentsch A, Schultze-Mosgau S

Author

Arndt Geuntsch in the CTSI department at Medical College of Wisconsin - CTSI

MESH terms used to index this publication - Major topics in bold

Adult
Analysis of Variance
Bone Plates
Conjunctiva
Device Removal
Ectropion
Eye
Eyelids
Female
Humans
Male
Middle Aged
Ophthalmologic Surgical Procedures
Orbit
Orbital Fractures
Orbital Implants
Photography
Postoperative Complications
Statistics, Nonparametric
Young Adult