A comparative study of different approaches in the treatment of orbital trauma: an experience based on 274 cases.
OBJECTIVE
The aim of the study was to compare the aesthetic results, complications and surgical indications in patients treated for orbital trauma by one of three different approaches: subciliary, transconjunctival or transconjunctival with lateral canthotomy.


METHODS
In this retrospective study, 274 patients (169 men and 105 women aged 16-78 years) who had been treated for orbital trauma without soft tissue lacerations of orbital region and then returned for long-term follow-up (6-48 months) between 2000 and 2007 were evaluated in terms of aesthetics and function for the presence of a visible scar and lower-eyelid malposition (scleral show or ectropion).


RESULTS
Of the 274 patients, 50 (18.2%) experienced complications. In the group of 219 patients treated with the subciliary approach, 41 experienced complications, whereas amongst the 32 patients treated with the transconjunctival approach, there was one complication (0.3%) and amongst the 23 patients treated with the transconjunctival approach and canthotomy, there were eight complications (34.8%).


CONCLUSIONS
Patients treated for orbital trauma with the transconjunctival approach with canthotomy had a higher rate of lower eyelid malposition. Transconjunctival incision without canthotomy was the most successful surgical approach for the treatment of isolated fracture of the orbital floor; however, when major surgical exposure is necessary, subciliary incision is recommended.
Salgarelli
Attilio Carlo
AC
Unit of Maxillofacial Surgery, Department of Head and Neck, Modena and Reggio Emilia University, Via del Pozzo 71, 41100, Modena, Italy. attiliocarlo.salgarelli@unimore.it
Bellini
Pierantonio
P
Landini
Barbara
B
Multinu
Alessandra
A
Consolo
Ugo
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000517:prevention & control*; D003228:Conjunctiva / Q000601:surgery; D004954:Esthetics; D005143:Eyelids / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009917:Orbital Fractures / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult