Transconjunctival approach in orbital traumatology: a review of 56 cases.
OBJECTIVE
The aim of this study is to analyze the transconjunctival approach in the treatment of orbital fractures and to evaluate the indications, the advantages of the surgical approach, and the occurrence of possible complications.


METHODS
From 2005 to September 2009 we used a transconjunctival approach on 53 patients for a total of 56 cases of orbital fractures (three cases with bilateral floor fractures), 54 cases of acute trauma, and two outcomes of previous fractures. We evaluated the incidence of intra or postoperative complications and in the postoperative follow-up we investigated the presence of: entropion, ectropion, scleral show, trichiasis, conjunctival granuloma, mobilization or exposure of orbital reconstruction material.


RESULTS
In 56 cases we had four temporary postoperative complications and no long-term complications; two cases of trichiasis and two cases of partial entropion were treated only with medical therapy. All complications, as described in the literature, were transitory and did not require corrective surgery.


CONCLUSIONS
The transconjunctival approach is the most effective surgical access, not only to the medial orbital wall, but also to the orbital floor, as it does not interfere with the lachrymal drainage system and gives as wide a visualization of the orbital floor as does the palpebral approach. This surgical approach is simple to perform and gives good functional and aesthetic results.
Novelli
Giorgio
G
Department of Maxillofacial Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy. g.novelli@hsgerardo.org
Ferrari
Luca
L
Sozzi
Davide
D
Mazzoleni
Fabio
F
Bozzetti
Alberto
A
D003228:Conjunctiva / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D009915:Orbit / Q000601:surgery*; D009917:Orbital Fractures / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies