Transconjunctival approach vs subciliary skin-muscle flap approach for orbital fracture repair
W. D. Appling, J. R. Patrinely and T. A. Salzer
Department of Otohinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Tex.
OBJECTIVE: To compare the transcutaneous and transconjunctival approaches
for repair of orbital rim and floor fractures. DESIGN: We conducted a
retrospective study of the occurrence of eyelid retraction following the
repair of 63 orbital fracture, 27 with the subciliary skin-muscle flap
approach and 36 with the transconjunctival preseptal approach. SETTING:
Academic tertiary referral medical center. PARTICIPANTS: Fifty-nine
patients underwent 63 orbital explorations. INTERVENTIONS: Of the 27
transcutaneous explorations, 24 were done early within the first 2 weeks of
injury and three were performed for correction of late posttraumatic
enophthalmos. Of the 36 transconjunctival explorations, 25 were done early
and 11 were performed for correction of late posttraumatic enophthalmos.
OUTCOME MEASURE: Clinically noted complications. RESULTS: We found a 12%
rate of transient ectropion and a 28% rate of permanent scleral show with
the subciliary skin-muscle flap approach compared with no transient
ectropion and a 3% rate of permanent scleral show with the
transconjunctival approach. CONCLUSIONS: We believe that the
transconjunctival approach provides excellent exposure with less risk of
postoperative eyelid retraction and ectropion.
