Transconjunctival incision for total maxillectomy—an alternative for subciliary incision

Goyal, Amit; Tyagi, Isha; Jain, Shilpa; Syal, Rajan; Singh, Alok Pratap; Kapila, Rajeev Kumar

doi:10.1016/j.bjoms.2010.07.002

Cited by 14 publications

(8 citation statements)

References 12 publications

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“…Subciliary as well as transconjunctival approaches have their own advantages and disadvantages with each approach having proponents who vouch for them [11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Comparison of ‘sutureless’ Transconjunctival and Subciliary Approach for Treatment of Infraorbital Rim Fractures: a Clinical Study

Vaibhav

Keerthi

Nanjappa

et al. 2015

J. Maxillofac. Oral Surg.

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Purpose The aim of the study is to compare subciliary incision and 'sutureless' transconjunctival incision in the treatment of infraorbital rim fractures. Materials and method In this prospective study, 40 patients with fractures of the infraorbital rim were selected and divided into 2 groups using random sampling technique. Group A patients were treated using 'sutureless' transconjunctival technique and group B patients were treated using subciliary approach. The following parameters were compared a) time taken, intraoperative ease of access, exposure achieved; b) clinical outcome and postoperative complications; c) Aesthetic outcome at intervals of 15 days, 1 month and 3 months. Results Total time taken for completion of surgery was lesser in group A patients. The presence of subconjunctival ecchymosis (at 1 month interval) and neurological deficit was found to be statistically significant (P\0.05) in the 'subciliary' group of patients. The transconjunctival approach showed better esthetic results and fewer postoperative complications. Conclusion The subciliary approach gives good exposure of the infra-orbital rim and is better suited to reduce extensively displaced fractures of the infra-orbital rim. The transconjunctival approach is comparatively faster, gives better esthetic results and fewer post-operative complications but is technique sensitive and requires an additional lateral canthotomy in cases where more exposure is needed.

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“…Subciliary as well as transconjunctival approaches have their own advantages and disadvantages with each approach having proponents who vouch for them [11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Comparison of ‘sutureless’ Transconjunctival and Subciliary Approach for Treatment of Infraorbital Rim Fractures: a Clinical Study

Vaibhav

Keerthi

Nanjappa

et al. 2015

J. Maxillofac. Oral Surg.

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“…The cicatricial ectropion may be secondary to the frequent use of the Weber–Ferguson incision with subciliary extension for maxillary tumor extirpation 9 . Some authors favor use of the transconjunctival approach as an alternative to the subciliary incision in total maxillectomies 42 . Furthermore, the irradiation of the orbital–facial region is likely to be associated with tissue retraction, muscle atrophy, and skin dystrophy, favoring the occurrence of ectropion.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction techniques of the orbit after Brown class III maxillectomy: A systematic review

et al. 2023

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This systematic review aimed to evaluate the surgical techniques used for orbital floor reconstruction after Brown class III maxillectomy for cancer. Three databases were searched from January 1990 to January 2022. Of the 614 studies identified, 20 were retained after eligibility assessment. The surgical techniques were classified into four groups: free bone flaps (A), alloplastic implants (B), bone grafts (C), and soft-tissue reconstructions (D). Ectropion and diplopia concerned 42.6% and 6.6% of the patients, respectively. Soft tissue reconstruction was more likely to cause ectropion (17/27), followed by the reconstruction techniques of group B (34/79), group C (26/70), and group A (1/7). Postoperative enophthalmos was identified in 18 patients (9.6%), mostly in group D (5/35), followed by groups B (8/68), A (3/33), and C (2/52). Free bone flaps and alloplastic implants represent good reconstructive options in terms of postoperative ocular parameters.

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“…Over subsequent decades, numerous reports in the literature have described this incision in the treatment of intraorbital tumors, orbital malformations, and orbital fractures. Via the lower eyelid, this approach provides the soft tissue access necessary for a maxillectomy (6). Several studies have compared complications between subciliary incisions in the eyelid and the transconjunctival approach and found a significantly higher rate of eyelid-related complications with transcutaneous incisions.…”

Section: Discussionmentioning

confidence: 99%

The Transconjunctival Transorbital Approach: A Keyhole Approach to the Midline Anterior Skull Base

et al. 2013

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OBJECTIVE To report an initial experience with a medial transorbital approach to the midline skull base performed via a transconjunctival incision. METHODS The authors retrospectively reviewed their clinical experience with this approach in the management of benign cranial base pathology. Preoperative imaging, intraoperative records, hospitalization charts, and postoperative records were reviewed for relevant data. RESULTS During the period 2009–2011, six patients underwent a transconjunctival craniotomy performed by a neurosurgeon and otolaryngologist–head and neck surgeon working together. The indications for surgery were esthesioneuroblastoma in one patient, juvenile angiofibroma in one patient, Paget disease in one patient, and recalcitrant cerebrospinal fluid leaks in three patients. Three patients had prior cranial base surgery (either open craniotomy or an endonasal approach) done at another institution. The mean length of stay was 3.8 days; mean follow-up was 6 months. Surgery was considered successful in all cases (negative margins or no leak recurrence); diplopia was noted in one patient postoperatively. CONCLUSIONS The transconjunctival medial orbital craniectomy provides a minimally invasive keyhole approach to lesions located anteriorly along the anterior cranial fossa that are in the midline with lateral extension over the orbital roof. Based on our initial experience with this technique, the working space afforded limits complex surgical dissection; this approach is primarily well suited for less extensive pathology.

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Transconjunctival incision for total maxillectomy—an alternative for subciliary incision

Cited by 14 publications

References 12 publications

Comparison of ‘sutureless’ Transconjunctival and Subciliary Approach for Treatment of Infraorbital Rim Fractures: a Clinical Study

Comparison of ‘sutureless’ Transconjunctival and Subciliary Approach for Treatment of Infraorbital Rim Fractures: a Clinical Study

Reconstruction techniques of the orbit after Brown class III maxillectomy: A systematic review

The Transconjunctival Transorbital Approach: A Keyhole Approach to the Midline Anterior Skull Base

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