title: Comparison of various approaches for exposure of infraorbital rim fractures of zygoma.
abstract: OBJECTIVE
  The aim of this study was to randomly compare four incisionssubciliary, subtarsal, infraorbital and transconjunctival with lateral canthotomy for treatment of orbital rim or floor fractures.
  
  
  METHODS
  40 patients with zygomatic complex fractures either isolated or in association with pan facial fractures, were selected for the study. They were divided into four groups of 10 patients each, Group I-Transconjunctival with lateral canthotomy, Group II-Subciliary [single eyelid incision], Group III-Subtarsal incision, and Group IV-Infraorbital incision. The following parameters were compared a) The average time from incision to fracture exposure b) The amount of exposure of the site provided c) The aesthetic appearance of the 'scar' d) Complications e) Factor of 'time' - its effect on scar and complications.
  
  
  RESULTS
  The study revealed that all four incisions provided adequate exposure of fracture site and transconjunctival (22 minutes) required the maximum time for exposure. The complications included ectropion in group I and prolonged edema in group IV. Group II and III patients had relatively lesser number of complications. Group IV patients had visible scar as compared to no scar in group I patients.
  
  
  CONCLUSIONS
  We conclude by saying that transconjunctival approach provides an excellent aesthetic result when done meticulously. However the subciliary and the subtarsal incisions provide a more rapid, direct approach to the orbital floor and infraorbital rim with minimal morbidity and an aesthetically acceptable scar. The infraorbital incision is the least acceptable aesthetically.
authors.affiliation: Dept. of Oral and Maxillofacial Surgery, Tamilnadu Government Dental College and Hospital, Chennai, India  ; 10/279, Raman Street, Sokkanathanpet, Pondicherry, 605009 India.
authors.forename: Balanand
authors.initials: B
authors.lastname: Subramanian
authors.forename: Srimathy
authors.initials: S
authors.lastname: Krishnamurthy
authors.forename: P
authors.initials: P
authors.lastname: Suresh Kumar
authors.forename: B
authors.initials: B
authors.lastname: Saravanan
authors.forename: M
authors.initials: M
authors.lastname: Padhmanabhan
keywords: Infraorbital; Subtarsal approach; Superciliary; Transconjunctival