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New Aspects

Markus Zingg, MD, DMD; Khalid Chowdhury, MD, FRCSC; Kurt Lädrach, MD, DMD; Thierry Vuillemin, MD, DMD; Franz Sutter, DMD; Joram Raveh, MD, DMD

Arch Otolaryngol Head Neck Surg. 1991;117(6):611-620.

Abstract
• A 10-year experience with surgical treatment of 813 zygomalateral orbital complex fractures is reviewed. Regardless of the type or severity of the fracture pattern, concomitant fractures of the orbital floor and rim were approached exclusively through the transconjunctival approach without a lateral canthotomy. The advantages of this approach compared with the subciliary access are the avoidance of a visible scar and markedly reduced incidence of postoperative lower eyelid complications such as ectropion and edema. Implants of lyophilized dura or cartilage and autogenous bone were used to reconstruct orbital floor defects. Malar asymmetry is a frequent complication of zygoma fractures resulting from inadequate three-dimensional reduction. Methods for accurate reduction and stabilization, indications for closed and open reduction, and management of the fractured infraorbital rim are emphasized. The indications for miniplates vs wire ligatures for the infraorbital rim are discussed. Long-term follow up and evaluation of the results with regard to the fracture pattern, complications, maxillary sinus dysfunction, and facial and orbital symmetry are presented.

(Arch Otolaryngol Head Neck Surg. 1991;117:611-622

Author Affiliations
From the Division of Craniomaxillofacial Surgery, Department of Otolaryngology, University Hospital, Bern, Switzerland (Drs Zingg, Chowdhury, Vuillemin, Lädrach, and Raveh), and the Research Center, Institute Straumann AG, Waldenburg, Switzerland (Dr Sutter).

Footnotes
Accepted for publication July 31, 1990.

Reprint requests to Division of Craniomaxillofacial Surgery, Department of Otolaryngology, Inselspital, Bern, Switzerland CH-3010 (Dr Raveh).

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