Use of the preseptal transconjunctival approach in orbit reconstruction surgery.
OBJECTIVE
This report evaluated the advantages of the preseptal transconjunctival approach in reconstruction of the orbit.


METHODS
Ninety-nine preseptal incisions were used in 80 patients for different indications (blowout fracture, complex zygoma fracture, enophthalmos correction, midface hypoplasia, secondary incision). All operative procedures were performed without an additional lateral canthotomy. The infraorbital rim was stabilized with miniplates or microplates.


RESULTS
There was no ectropion or entropion in any patients. Complications included 1 laceration of the tarsal plate and 1 temporary entropion after a primary subciliary incision. The overall complication rate was 2%.


CONCLUSIONS
The preseptal transconjunctival incision without lateral canthotomy provides good exposure of the orbital floor and the caudal parts of the lateral and medial wall. This approach is preferable to a retroseptal approach in reconstructive orbital surgery because of minimal disturbance of the intraorbital connective tissue framework. The anatomic optimal dissection line also results in a lower complication rate.
Clinic of Oral and Maxillofacial Surgery, Medical School, University of Vienna, Austria. Arnulf.Baumann@akh-wien.ac.at
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Baumann
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Ewers
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D002648:Child; D003228:Conjunctiva / Q000293:injuries / Q000601:surgery*; D015841:Enophthalmos / Q000601:surgery; D004774:Entropion / Q000209:etiology; D005143:Eyelids / Q000293:injuries; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008866:Microsurgery / Q000295:instrumentation; D008875:Middle Aged; D009915:Orbit / Q000002:abnormalities / Q000601:surgery*; D009917:Orbital Fractures / Q000601:surgery; D010027:Osteotomy / Q000295:instrumentation; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D015051:Zygomatic Fractures / Q000601:surgery