Transconjunctival Approach to the Zygomatico-Frontal Limb of Orbitozygomatic Complex Fractures

ABSTRACT

Fractures of the orbitozygomatic complex represent one of the most common injuries of the facial skeleton. Repair of the fractures often requires multiple surgical access points and the necessity for skin incisions. As surgeons attuned to aesthetics, we strive to minimize the signs of injury and treatment. We propose an approach designed to treat orbitozygomatic fractures without the use of skin incisions. The objective of this article is to outline the surgical technique designed by the senior author (PRL) to address the zygomatico-frontal fracture component of orbitozygomatic complex fractures through an upper lid lateral transconjunctival approach. Relevant anatomy and technique is described. The combination of previously described lower lid transconjunctival and gingivobuccal sulcus incisions with this new upper lid lateral transconjunctival approach provides adequate access for rigid fixation of all major components of orbitozygomatic fractures without skin incisions.

KEYWORDS

Orbitozygomatic - transconjunctiva - tripod fracture - zygoma - trauma

REFERENCES

• 1 Nahum A M. The biomechanics of maxillofacial trauma.  Clin Plast Surg. 1975;  2 59-64
• 2 Stanley R B. The zygomatic arch: a guide to reconstruction of comminuted malar fractures.  Arch Otolaryngol Head Neck Surg. 1989;  115 1459
• 3 Manolidis S, Weeks B H, Kirby M et al.. Classification and surgical management of orbital fractures: experience with 111 orbital reconstructions.  J Craniofac Surg. 2002;  13 726-737
• 4 Stanley R B. Treatment of orbitozygomatic fractures. In: Papel ID Facial Plastic and Reconstructive Surgery. New York; Thieme 2002: 738-746
• 5 Guerra A B, Metzinger S E, Black III E B. Transconjunctival upper blepharoplasty: a safe and effective addition to facial rejuvenation techniques.  Ann Plast Surg. 2002;  48 528-533