Comparison of Subciliary, Subtarsal and Transconjunctival Approaches for Management of Zygomaticoorbital Fractures

Aims: To compare access of the surgeon and bleeding during surgery, and ectropion and scar following the surgery in subciliary, subtarsal, and transconjunctival incisions for treatment of the zygomaticoorbital region.

Study Design: Descriptive cross-sectional

Place and Duration of the Study: This study was conducted in maxillofacial surgery ward in Alzahra and Kashani hospitals in Isfahan, Iran between March to December 2015.

Patients and Methods: 51 patients with unilateral zygomaticoorbital trauma were included in this study in three groups (17 in each). Subciliary, subtarsal, and transconjunctival incisions were performed and intraoperative access and bleeding, presence of ectropion in two-week follow-up, and visual analogue scale (VAS) score for scar by surgeon and patient in four-week follow-up were recorded. Data was statistically analyzed.

Results: The study sample consisted of 7 (13.71%) females and 44 (86.29%) males aging from 17 to 44 years (mean±SD=26.70±6.52). Although intraoperative bleeding and access during surgery were not significantly different between subciliary, subtarsal, and transconjunctival groups, ectropion was more common in subciliary group and VAS score for scar was higher in subciliary and subtarsal group for both surgeon and patient.

Conclusion: Transconjunctival incision without visible scar and ectropion and with intraoperative access and bleeding comparable to subciliary and subtarsal incisions seems to be an appropriate choice in most cases of zygomaticoorbital fractures.