Advantages of intraoral and transconjunctival approaches for posterior displacement of a fractured zygomaticomaxillary complex

Abstract

BackgroundFracture of the zygomaticomaxillary complex (ZMC) is one of the most common facial injuries. A previous study has performed 3D analyses of the parallel and rotational displacements that occur in a fractured ZMC. However, few studies have investigated adequate fixation methods according to these displacements. Here, we assessed whether specific approaches and fixation methods for displacement of ZMC fractures produce esthetic results.MethodsHospital records and pre- and post-surgical computed tomographic scans of patients treated for ZMC fractures at the Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang University, between January 2010 and December 2015, were selected. Data were analyzed according to the direction of displacement and post-reduction prognosis using a 3D software.ResultsWith ZMC fractures, displacement in the posterior direction occurred most frequently, while displacement in the superior-inferior direction was rare. A reduction using a transconjunctival approach and an intraoral approach was statistically better than that using an intraoral approach, Gillies approach, and lateral canthotomy approach for a posterior displacement (P < 0.05).ConclusionsWhen posterior displacement of a fractured ZMC occurs, use of an intraoral approach and transconjunctival approach simultaneously is recommended for reducing and fixing the displaced fragment accurately.

Comparison of the Efficacy of Transconjunctival Incision with Lateral Canthotomy and Intraoral Vestibular Incision for Management of Infra-orbital Rim Fracture

“…The transconjunctival incision is made for orbital floor and infraorbital rim exposure [6]. Lateral canthotomy is done along with transconjunctival incision for more exposure [6].…”

“…The transconjunctival incision is made for orbital floor and infraorbital rim exposure [6]. Lateral canthotomy is done along with transconjunctival incision for more exposure [6]. Using this approach would hide the scar and if used along with lateral canthotomy, the scar remains in a skin crease and goes unnoticed [6].…”

“…Lateral canthotomy is done along with transconjunctival incision for more exposure [6]. Using this approach would hide the scar and if used along with lateral canthotomy, the scar remains in a skin crease and goes unnoticed [6]. However, entropion can be seen in some cases which is seen as a disadvantage.…”