Precise Repair of Orbital Maxillary Zygomatic Fractures

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  • JKJemshed Khan
    Jemshed Khan
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Abstract
Objective: To demonstrate the techniques, advantages, indications, and potential pitfalls of the transconjunctival approach with lateral canthotomy, sublabial approach, and coronal approach in the treatment of complex trimalar fracture with associated blow-out fractures. Design: All patients diagnosed as having complex trimalar fractures with or without blow-out treated by either of us over a 2-year period were included. Follow-up ranged from a minimum of 6 months to 2 years. Setting: All patients were treated from December 1989 to December 1991 at either Louisiana State University Medical Center, Shreveport, or University of Kansas Medical Center, Kansas City. Patients: Eighteen patients with complex trimalar fractures were included in this study. Eight patients had associated orbital blow-out fractures. Simple isolated arch fractures were excluded. Intervention: All subjects underwent a transconjunctival approach with lateral canthotomy. Seven subjects also had associated sublabial flaps. Five patients required hemicoronal or coronal approaches. Results: There were seven minor complications. Ninety-three percent (14/15 [three didn't respond to the survey]) of patients surveyed were either very satisfied or satisfied with their functional and cosmetic results. Conclusion: The management of complex trimalar fracture with blow-outs is greatly facilitated by the rational application of the described techniques. (Arch Otolaryngol Head Neck Surg. 1994;120:613-619)

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