A comparison of conjunctival and subciliary incisions for orbital fractures

Wray, R. Christie; Holtmann, Barbel; Ribaudo, J. M.; Keiter, John E.; Weeks, Paul M.

doi:10.1016/0007-1226(77)90009-1

Cited by 123 publications

(52 citation statements)

References 4 publications

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“…The cheek-skin component would mean that the infraorbital incision is more likely to form conspicuous scar (Bahr et al [13]). These findings are however, in contrast to those of Wray et al [12] in 1977. Their grades were 1.8 for infraorbital, 1.7 for subciliary, 1.9 for transconjunctival with lateral canthotomy and 1.6 for subciliary.…”

Section: Anatomical Considerationcontrasting

confidence: 90%

“…Wray et al [12] reported one case of transient ectropion, 2 scar hypertrophies after subciliary incision in their series of 62 patients. No complications were reported following the use of transconjunctival, infraorbital and subtarsal incisions.…”

Section: Anatomical Considerationmentioning

confidence: 99%

“…Infraorbital, subtarsal, single eye lid incision, provided more rapid access to infraorbital rim (8, 10, 14 minutes) than did trans-conjunctival incision (22 minutes). Wray et al [12] reported the time as 5 minutes for infraorbital, 8 minutes for subciliary and subtarsal and 20 minutes for trans-conjunctival. They however did not state if a lateral canthotomy was included or not.…”

Section: Anatomical Considerationmentioning

confidence: 99%

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Comparison of various approaches for exposure of infraorbital rim fractures of zygoma

Subramanian

Krishnamurthy

Kumar

et al. 2009

J. Maxillofac. Oral Surg.

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Objective The aim of this study was to randomly compare four incisionssubciliary, subtarsal, infraorbital and transconjunctival with lateral canthotomy for treatment of orbital rim or floor fractures. Methods 40 patients with zygomatic complex fractures either isolated or in association with pan facial fractures, were selected for the study. They were divided into four groups of 10 patients each, Group I-Transconjunctival with lateral canthotomy, Group II-Subciliary [single eyelid incision], Group IIISubtarsal incision, and Group IV-Infraorbital incision. The following parameters were compared a) The average time from incision to fracture exposure b) The amount of exposure of the site provided c) The aesthetic appearance of the 'scar' d) Complications e) Factor of 'time' -its effect on scar and complications. Results The study revealed that all four incisions provided adequate exposure of fracture site and transconjunctival (22 minutes) required the maximum time for exposure. The complications included ectropion in group I and prolonged edema in group IV. Group II and III patients had relatively lesser number of complications. Group IV patients had visible scar as compared to no scar in group I patients. Conclusion We conclude by saying that transconjunctival approach provides an excellent aesthetic result when done meticulously. However the subciliary and the subtarsal incisions provide a more rapid, direct approach to the orbital floor and infraorbital rim with minimal morbidity and an aesthetically acceptable scar. The infraorbital incision is the least acceptable aesthetically.

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Section: Anatomical Considerationcontrasting

confidence: 90%

Section: Anatomical Considerationmentioning

confidence: 99%

Section: Anatomical Considerationmentioning

confidence: 99%

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Comparison of various approaches for exposure of infraorbital rim fractures of zygoma

Subramanian

Krishnamurthy

Kumar

et al. 2009

J. Maxillofac. Oral Surg.

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“…Several authors have proposed that the transconjunctival approach decreases the risk of postoperative eyelid retraction, which varies from scleral show to persistent ectropion. These studies have shown a lower incidence of ectropion using a transconjunctival compared with a subciliary approach for the treatment of orbital trauma [4,5].…”

Section: Introductionmentioning

confidence: 99%

Transconjunctival Preseptal Approach for Orbital Floor and Infraorbital Rim Fracture

Santosh¹,

Giraddi

2011

J. Maxillofac. Oral Surg.

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The transconjunctival preseptal approach is most effective surgical access to infraorbital rim and orbital floor and even to medial orbital wall. This approach is surgically similar in providing exposure and access, but aesthetically superior to other approaches and has minimal complications. There are no disadvantages to transconjunctival preseptal approach, if performed meticulously with sound knowledge of anatomy of periorbital tissues.

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“…The zygomatic bone projects outward to provide the prominence of the malar region in the aesthetically pleasing face and is susceptible to Approaches to the lower orbit include the following: (1) the subciliary skin incision with a subtarsal orbicularis muscle flap, (2) skin-only flap, (3) skin-muscle flap, (4) midtarsal or orbital rim incision, and (5) transconjunctival approach. Converse was an advocate of the subciliary approach because of the preservation of the pretarsal orbicularis and superior appearance of the scar.1 The skin-only flap was popularized in the late 1960s but was soon abandoned due to the high complication rate.…”

mentioning

confidence: 99%