title: Transconjunctival approach vs subciliary skin-muscle flap approach for orbital fracture repair.
abstract: OBJECTIVE
  To compare the transcutaneous and transconjunctival approaches for repair of orbital rim and floor fractures.
  
  
  METHODS
  We conducted a retrospective study of the occurrence of eyelid retraction following the repair of 63 orbital fracture, 27 with the subciliary skin-muscle flap approach and 36 with the transconjunctival preseptal approach.
  
  
  METHODS
  Academic tertiary referral medical center.
  
  
  METHODS
  Fifty-nine patients underwent 63 orbital explorations.
  
  
  METHODS
  Of the 27 transcutaneous explorations, 24 were done early within the first 2 weeks of injury and three were performed for correction of late posttraumatic enophthalmos. Of the 36 transconjunctival explorations, 25 were done early and 11 were performed for correction of late posttraumatic enophthalmos.
  
  
  METHODS
  Clinically noted complications.
  
  
  RESULTS
  We found a 12% rate of transient ectropion and a 28% rate of permanent scleral show with the subciliary skin-muscle flap approach compared with no transient ectropion and a 3% rate of permanent scleral show with the transconjunctival approach.
  
  
  CONCLUSIONS
  We believe that the transconjunctival approach provides excellent exposure with less risk of postoperative eyelid retraction and ectropion.
authors.affiliation: Department of Otohinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Tex.
authors.forename: W D
authors.initials: WD
authors.lastname: Appling
authors.forename: J R
authors.initials: JR
authors.lastname: Patrinely
authors.forename: T A
authors.initials: TA
authors.lastname: Salzer
mesh_terms: D000273:Adipose Tissue / Q000033:anatomy & histology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D002648:Child; D003228:Conjunctiva / Q000033:anatomy & histology / Q000601:surgery; D062109:Dermatologic Surgical Procedures; D004210:Dissection; D004483:Ectropion / Q000209:etiology; D015841:Enophthalmos / Q000601:surgery; D005141:Eyelid Diseases / Q000209:etiology; D005143:Eyelids / Q000033:anatomy & histology / Q000601:surgery; D005152:Facial Muscles / Q000033:anatomy & histology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009917:Orbital Fractures / Q000601:surgery*; D010521:Periosteum / Q000601:surgery; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000009:adverse effects / Q000379:methods*; D013536:Suture Techniques; D013710:Tendons / Q000033:anatomy & histology / Q000601:surgery