Preseptal transconjunctival vs. subciliary approach in treatment of infraorbital rim and floor fractures

BACKGROUND: Injuries in the orbital region have profound functional as well as aesthetic implications. Treatment of orbital fractures remains one of the most controversial issues in maxillofacial trauma with regard to the classification, diagnosis, surgical approach and treatment. PURPOSE: This study evaluated and compared the efficacy of two most commonly applied approaches the preseptal transconjunctival with lateral canthotomy and the subciliary approach for the treatment of infraorbital floor and rim fractures. PATIENTS AND METHODS: Twenty patients reported to G.D.C.R.I. Bangalore who suffered infraorbital floor and rim fractures, were randomly divided into two groups with 10 patients in each group. In one group, anatomic reduction and reconstruction was done with preseptal transconjunctival approach with lateral canthotomy and in the other group with subciliary approach. RESULTS: In transconjunctival group, transient entropion was significant (30%). In subciliary group, transient ectropion was significant (30%). CONCLUSION: In our study, preseptal transconjunctival approach with lateral canthotomy and subciliary skin-muscle flap approach for the open reduction and rigid fixation of infraorbital floor and rim fractures had showed less morbidity and lesser risk of complications and given satisfactory results.