Management of ZMO Fracture Using Transcutaneous Approaches Versus ‎Retroseptal Transconjunctival Approach

Document Type : Original articles

Authors

1 Ain Shams Surgery Department

2 Oral and Maxillofacial Surgery, Ain Shams University, Cairo, Egypt.‎

3 Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Ain-Shams University

4 Head of Maxillofacial department of Maadi Military Hospital

Abstract

Objective: ZMO fracture indicated for ORIF can be accessed using many approaches, ‎comparison and evaluation of methods was mandatory to reveal the most convenient approach ‎with special attention to surgical scar appearance and patient’s esthetics.‎
Design: Prospective study of the ZMO trauma patients.‎
Participants: Twenty-one patients were operated. Distributed in three groups seven ‎patients in each. Groups represented the three approaches, transconjunctival, subtarsal and ‎subciliary. Additional healthy un-operated patients were examined as control.‎
Methods: Patients suffering from ZMO fracture were randomly distributed and ‎operated using the three mentioned approaches. Patients were evaluated post operatively ‎regarding to esthetic outcome, patient satisfaction, pain, incidence of poor wound healing and ‎the quality of fixation.‎
Results: Modified Vancouver Scar Scale (MVSS) results showed lower values for ‎Transconjunctival approach (‎4 ±1.225) followed by Subtarsal approach (‎6 ±2.83) and highest ‎value for Subciliary approach (‎7.2 ±1.095). With statistically significant difference between ‎Subciliary and Transconjunctival but there is no statistically significant difference between ‎Subtarsal and the other two groups. ‎
Conclusions: The transconjunctival approach was associated with lower rates of ‎complications, patient complaints and pain.‎

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