Orbital Reconstruction via Extended Transconjuctival and Transpalpebral Approach

ABSTRACT

In case of blow-out fracture involving floor or inferomedial wall, the fracture site can be accessed by methods such as subcilliary incision, mid-lower eyelid incision, infra-orbital incision and transconjunctival incision. Meanwhile, in case of orbital fracture involving supero-medial wall or roof, above-mentioned methods have the limitation of fracture site exposure, and bicoronal incision is required to overcome the difficult approach. The authors exposed fracture site widely and executed accurate reduction through extended transconjunctival approach and transpalpebral approach, instead of the approach by bicoronal incision. We executed 118 cases of orbital reconstruction by above method among 96 patients who consulted doctors to reconstruct blow-out fracture and enophthalmos from September 1997 to May 2001. Among the 118 cases were 50 cases of orbital floor fracture, 4 cases of orbital roof fracture, 48 cases of orbital medial wall fracture, 13 cases of complex type and 3 cases of enophthalmos. The authors made wide dissection of antero-superial medial wall of orbit and roof fracture of orbit enabled by above methods, which allowed enough exposure and approach to orbital fracture site and prevented side effects such as post operative lower eyelid scar or ectropion and scleral show.