Comparison of Subsiliary, Subtarsal and Transconjunctival Approaches for Management of Zygomaticoorbital Fractures in Isfahan,2015

Background and objective: This study compare access of the surgeon and bleeding during surgery, ectropion and scar following the surgery in subciliary, subtarsal and transconjunctival incisions for treatment of the zygomaticoorbital region. Method of evaluation: This study was Analytic descriptive cross-sectional and conducted in Isfahan, 2015. 51 patients with unilateral zygomaticoorbital trauma were included in this study in three groups. Access during surgery was evaluated by the surgeon. Intraoperative bleeding was evaluated by counting the number of gauzes used during the incision and also observation of the amount of blood in the suction container after performing incisions which was emptied before the procedure. Patients visited in 2 and 4 weeks follow up. After 2 weeks ectropion and after 4 weeks scars were evaluated. The scars evaluated by visual analogue score(VAS). Finding: Intraoperative bleeding was not significantly different among the three groups. Similarly no significant difference was observed among the groups in access during surgery . In two-week follow-up it was revealed that ectropion was present only in 3 patients of the subciliary group. None of the patients of the subtarsal and transconjunctival group had post-operative ectropion. The difference in presence of ectropion between subciliary group and the other two groups was statistically significant .The VAS was 0 for pationts at first and None of the transconjunctival group had scar So the VAS score of scar for both surgeon and patient was 0 in this group. This shows a difference between transconjunctival group and other two groups in VAS score of scar by both surgeon and patient .However, mean VAS score of scar by surgeon or patient did not have any significant difference between subciliary and subtarsal groups. 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.

کلیدواژه ها:

Subciliary ، subtarsal ، transconjunctival ، zygomaticoorbital fracture