Study Design: A descriptive-observational study of a series case report of patients diagnosed with orbito-zygomatic complex (OZMC) fracture with lateral wall involvement, was conducted. All patients were assessed in the Oral and Maxillofacial Surgery Service at Hospital El Carmen, Maipu, Santiago, Chile. Objective: The purpose of this study was to evaluate a single-institution experience with the transconjunctival approach to the orbit, utilizing a lateral skin extension as unique approach to access to fronto-zygomatic suture, infraorbital rim and/or orbital floor. Method: The authors identified 41 patients with OZMC fractures who underwent to surgical treatment over a 45 months period. Among this group, 21 patients needed fixation with osteosynthesis of the frontozygomatic suture, and 16 of whom were treated with the approach being studied. The authors assessed scleral exposure, eyelid position changes, ectropion, and entropion as outcome measures, and reported satisfactory outcomes at a minimum of 9 months follow-up. Conclusions: This study concludes that in our experience, the transconjunctival approach utilizing a lateral skin extension allows a direct, easy, and quick access to the entire infra orbital rim, orbital floor, fronto-zygomatic suture and lateral wall of the orbit, up to spheno-zygomatic suture, with low associated morbidity and complications.

The aim of this report is to provide a vision of the approaches used to resolve Nasal-Orbit-Ethmoidal (NOE) fractures, a purpose of two cases treated by two different types of approaches. The first case corresponds to a patient with a complex Nasal-Orbit-Ethmoidal fracture, treated by the use of pre-existing lacerations and with a transconjunctival approach with canthotomy and lateral extension, to access an orbital zygomatic fracture. The second case corresponds to a patient with Nasal-Orbit-Ethmoidal Fracture treated by the use of a conventional Coronal approach. Both cases were treated by the maxillofacial surgery team at Hospital El Carmen, Santiago Chile, and prior evaluation by Neurology, ophthalmology and anesthesiology was necessary due to the magnitude and extent of the trauma, ruling out neurological and ophthalmological compromise. Finally, it can be concluded from these cases that both, coronal approach and the use of prior lacerations are a viable alternative for access to the fractured area, obtaining good visibility, access and aesthetic results. We also conclude that fractures of the Nasal-Orbit-Ethmoidal complex are a great challenge for the maxillofacial surgeon due to its high morbidity, added to the aesthetic and psychological component associated with them and functional alterations. This is why the correct and timely management of these fractures is key to minimize complications and sequelae that they have