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'Sutureless' transconjunctival approach for infraorbital rim fractures.

Nagaraj V, Ghosh A, Nanjappa M, Ramesh K - Contemp Clin Dent (2015)

Bottom Line: After reduction and fixation, the conjunctiva was just re-approximated and re-draped into position.Healing was satisfactory in all patients.The sutureless technique appears to be a time saving and technically simpler viable alternative to multilayered suturing in orbital trauma with minimal post-operative complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, V. S. Dental College and Hospital, Bengaluru, Karnataka, India.

ABSTRACT

Aim: To analyze the ease and surgical outcome of using sutureless transconjunctival approach for repair of infra-orbital fractures.

Design: Prospective clinical case series.

Materials and methods: Totally 5 patients with infra-orbital rim or orbital floor fractures were selected and the fractures were accessed through a pre-septal transconjunctival incision. After reduction and fixation, the conjunctiva was just re-approximated and re-draped into position. Incidence of post-operative complications such as diplopia, lid retraction, eyelid dystopia, foreign body granuloma and poor conjunctival healing was assessed at intervals of 1 week, 15 days and a month post-operatively.

Results: No complications were observed in any of the 5 patients. Healing was satisfactory in all patients.

Conclusion: The sutureless technique appears to be a time saving and technically simpler viable alternative to multilayered suturing in orbital trauma with minimal post-operative complications.

No MeSH data available.


Related in: MedlinePlus

Preseptal transconjunctival incision placement
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Figure 1: Preseptal transconjunctival incision placement

Mentions: After obtaining institutional review board approval, five patients with displacement (more than 5 mm) were chosen [Table 1]. The orbital fractures were accessed using a standard preseptal transconjunctival approach. The decision on the requirement of an additional lateral canthotomy was taken peri-operatively. Tarsorrhaphy was performed on the lower lid, the globe was protected by a corneal shield and the eye was lubricated at regular intervals using carboxymethyl cellulose eye gel. Care was taken to identify the periosteal plane and to ensure “crisp” periosteal incision and careful mimimal reflection [Figure 1]. The fracture fragments were reduced and forced duction test was performed to check for motility. Stabilization and fixation of the fracture were done using 1.5 mm titanium orbital plates.


'Sutureless' transconjunctival approach for infraorbital rim fractures.

Nagaraj V, Ghosh A, Nanjappa M, Ramesh K - Contemp Clin Dent (2015)

Preseptal transconjunctival incision placement
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374321&req=5

Figure 1: Preseptal transconjunctival incision placement
Mentions: After obtaining institutional review board approval, five patients with displacement (more than 5 mm) were chosen [Table 1]. The orbital fractures were accessed using a standard preseptal transconjunctival approach. The decision on the requirement of an additional lateral canthotomy was taken peri-operatively. Tarsorrhaphy was performed on the lower lid, the globe was protected by a corneal shield and the eye was lubricated at regular intervals using carboxymethyl cellulose eye gel. Care was taken to identify the periosteal plane and to ensure “crisp” periosteal incision and careful mimimal reflection [Figure 1]. The fracture fragments were reduced and forced duction test was performed to check for motility. Stabilization and fixation of the fracture were done using 1.5 mm titanium orbital plates.

Bottom Line: After reduction and fixation, the conjunctiva was just re-approximated and re-draped into position.Healing was satisfactory in all patients.The sutureless technique appears to be a time saving and technically simpler viable alternative to multilayered suturing in orbital trauma with minimal post-operative complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, V. S. Dental College and Hospital, Bengaluru, Karnataka, India.

ABSTRACT

Aim: To analyze the ease and surgical outcome of using sutureless transconjunctival approach for repair of infra-orbital fractures.

Design: Prospective clinical case series.

Materials and methods: Totally 5 patients with infra-orbital rim or orbital floor fractures were selected and the fractures were accessed through a pre-septal transconjunctival incision. After reduction and fixation, the conjunctiva was just re-approximated and re-draped into position. Incidence of post-operative complications such as diplopia, lid retraction, eyelid dystopia, foreign body granuloma and poor conjunctival healing was assessed at intervals of 1 week, 15 days and a month post-operatively.

Results: No complications were observed in any of the 5 patients. Healing was satisfactory in all patients.

Conclusion: The sutureless technique appears to be a time saving and technically simpler viable alternative to multilayered suturing in orbital trauma with minimal post-operative complications.

No MeSH data available.


Related in: MedlinePlus