Transconjuctival Incision with Lateral Paracanthal Extension for Corrective Osteotomy of Malunioned Zygoma.
10.7181/acfs.2016.17.3.119
- Author:
Jae Ho CHUNG
1
;
Hi Jin YOU
;
Na Hyun HWANG
;
Deok Woo KIM
;
Eul Sik YOON
Author Information
1. Department of Plastic and Reconstructive Surgery, Korea University Ansan Hospital, Ansan, Korea. deokwookim@gmail.com
- Publication Type:Original Article
- Keywords:
Conjunctiva;
Eyelids;
Osteotomy;
Zygomatic fracture
- MeSH:
Alopecia;
Cicatrix;
Conjunctiva;
Decompression;
Eyelids;
Follow-Up Studies;
Hematoma;
Humans;
Hypesthesia;
Maxilla;
Methods;
Orbit;
Osteotomy*;
Retrospective Studies;
Sutures;
Wounds and Injuries;
Zygoma*;
Zygomatic Fractures
- From:Archives of Craniofacial Surgery
2016;17(3):119-127
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Conventional correction of malunioned zygoma requires complete regional exposure through a bicoronal flap combined with a lower eyelid incision and an upper buccal sulcus incision. However, there are many potential complications following bicoronal incisions, such as infection, hematoma, alopecia, scarring and nerve injury. We have adopted a zygomaticofrontal suture osteotomy technique using transconjunctival incision with lateral paracanthal extension. We performed a retrospective review of clinical cases underwent correction of malunioned zygoma with the approach to evaluate outcomes following this method. METHODS: Between June 2009 and September 2015, corrective osteotomies were performed in 14 patients with malunioned zygoma by a single surgeon. All 14 patients received both upper gingivobuccal and transconjunctival incisions with lateral paracanthal extension. The mean interval from injury to operation was 16 months (range, 12 months to 4 years), and the mean follow-up was 1 year (range, 4 months to 3 years). RESULTS: Our surgical approach technique allowed excellent access to the infraorbital rim, orbital floor, zygomaticofrontal suture and anterior surface of the maxilla. Of the 14 patients, only 1 patient suffered a complication—oral wound dehiscence. Among the 6 patients who received infraorbital nerve decompression, numbness was gradually relieved in 4 patients. Two patients continued to experience persistent numbness. CONCLUSION: Transconjunctival incision with lateral paracanthal extension combined with upper gingivobuccal sulcus incision offers excellent exposure of the zygoma-orbit complex, and could be a valid alternative to the bicoronal approach for osteotomy of malunioned zygoma.
