Lower eyelid complications associated with transconjunctival versus subciliary approaches to orbital floor fractures.
OBJECTIVE
The aim of this study was to compare the frequencies of lower eyelid complications after subciliary versus transconjunctival approaches to orbital floor fractures.


METHODS
The investigators implemented a retrospective cohort study and enrolled a sample composed of subjects who had orbital floor repair. The predictor variable was surgical approach, classified as subciliary or transconjunctival. The primary outcome variable was postoperative lower eyelid complications (ectropion, entropion, and eyelid retraction). Other variables were demographic, anatomic, or time to surgery. Descriptive and bivariate statistics were computed. Statistical significance was set at P ≤ 0.05.


RESULTS
The study samples were composed of 346 patients (98 [28.3%] females; 225 [65%] underwent a subciliary approach) with a mean age of 42.7 ± 21.1 years. The subciliary approach was significantly linked to the higher rates of ectropion and the lower rates of entropion at 7 days and 6 months postoperatively. There was no statistically significant difference in the frequency of eyelid retraction between both groups.


CONCLUSIONS
In the setting of orbital floor fractures, these results suggest that the use of the subciliary approach increases the frequency of ectropion, while the transconjunctival approach increases the frequency of entropion. The authors decline to comment on what the better surgical approach to the orbital floor fractures is. The selection should be based on an individual patient basis and surgeon's preference.
Research Group for Clinical and Psychosocial Research, Evidence-Based Surgery and Ethics in Oral and Maxillofacial Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany. niels.pausch@medizin.uni-leipzig.de.|Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany. niels.pausch@medizin.uni-leipzig.de.
Niels Christian
NC
Pausch
Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany.
Nattapong
N
Sirintawat
Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany.
Rouven
R
Wagner
Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany.
Dirk
D
Halama
Research Group for Clinical and Psychosocial Research, Evidence-Based Surgery and Ethics in Oral and Maxillofacial Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany.|Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University Bangkok, Bangkok, Thailand.
Kittipong
K
Dhanuthai
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003228:Conjunctiva / Q000601:surgery*; D004483:Ectropion / Q000209:etiology; D004774:Entropion / Q000209:etiology; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009917:Orbital Fractures / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D055815:Young Adult
Eyelid complications; Orbital fracture; Subciliary approach; Transconjunctival approach