Evaluation of the lateral orbital approach in management of zygomatic bone fractures

Abstract

Zygomatic maxillary fractures, also known as tripod fractures, are usually the result of a direct blow to the body of the zygoma. Tripod fracture consists of (a) zygomatic arch fracture, (b) fracture of the lateral orbital wall, and (c) fracture of the inferior orbital floor. The purpose of this study is to evaluate the functional and esthetic outcome following this lateral orbital approach in the management of zygoma fracture. This study was carried out in VMS Dental College, Salem, and in a private hospital. This study was based on the experience gained from a retrospective study of the 30 lateral orbital approaches that were used in 30 patients with fractures of the zygomatic complex, which were conducted for a period of 8 years between January 2003 and January 2011. In the retrospective study, all the 30 patients were able to open the mouth completely; eyeball movements were normal; esthetically, all patients appeared normal. There were no sinusitis or visual problems in any of the studied patients. We conclude that the lateral orbital approach is an ideal option in reduction and treatment of zygomatic bone and arch fractures.

Zygomaticomaxillary buttress and its dilemma

“…They also include the maxillary vestibular approach, the temporal approach, and the supraorbital approach. Du Verney et al have described closed reduction techniques that take advantage of the mechanical forces of the masseter and temporalis muscles on the zygoma 23 . Another closed reduction technique is Lothrop's transantral approach through the maxillary sinus, below the inferior turbinate.…”

“…Dingman and Natvig concluded that most displaced zygomatic fractures should be treated by open reduction and direct wire fixation. 23 These authors preferred the suprafrontal approach. Although various methods are available to treat a fractured zygoma, the most common techniques in use are Gillies temporal approach and the intraoral approach.…”

“…And, the treatment can be done under local anesthesia. The supraorbital approach can be used to reduce all types of zygoma and arch fractures 23 . The chosen incision technique depends entirely on the clinical situation of the patient and the surgeon's preference and expertise, although the most popular incision techniques for such fractures are the lateral eyebrow, the buccal sulcus, and the infraorbital incision techniques.…”

“…The lateral eyebrow approach is the most commonly used technique to elevate the fracture segment through an eyebrow incision 17 . In a study on 30 patients, Thangavelu et al 23 observed that this approach is not advisable for treating an isolated arch fracture. It also leaves a visible scar in the lateral orbital region.…”

Comparative Study of Osseous Alignment in Isolated Tripod Zygomatic Bone Fracture Osteosynthesis At Frontozygomatic Suture Versus Zygomaticomaxillary Suture

“…Although there are several approaches are in uses to decrease the fractured zygoma. 4 To overcome these short comings open reduction method was stated to have a better assess and appropriate anatomical bony alignment. Moreover, these reduced fractures also needed to have some fixation to avoid the functional and post-operative cosmetic deformities.…”