J Korean Cleft Palate-Craniofac Assoc.  2006 Apr;7(1):35-39.

Short Scar Incision Using Modified Z-Incision For Restoration of Medial Orbital Blow-Out Fracture

• Kim KH
• Choi HJ
• Kim MS
• Kim YB

Abstract

Blow-out fracture is frequently encountered in facial bone trauma. And the frequency of medial orbital wall fracture in Asia is high. Various approaches have been reported for medial orbital wall fractures. The field of medial orbital surgery is difficult due to lack of visualization of fracture site, blind dissection of orbital wall, susceptibility of injury of orbital structures. Recently, endoscopic reduction of orbital wall was provided good fuctional and cosmetic results. In order to address this shortcoming we have explored the use of endoscopic external short scar approach in medial orbital wall dissection to allow direct visualization of orbital content and nearly whole fracture components. In this study a direct local approach through a 2cm, modified Z-shaped incision on superior medial orbital area was used as a consistent method to reconstruct medial blow-out fractures. The incision line consist 3 limbs. The angle of the limbs is to 110 degrees. First, 1cm sized line exsists frontonasal line. Second, 5mm sized 2 limbs of the incision line were placed parallel or oblique to the relaxed skin tension line. During the follow-up period of 6 to 12 months, excellent functional and cosmetic results were observed with an inconspicuous scar. Therefore, a direct external short scar incision approach with endoscope on the superior medial orbit may be a consistent method to gain the surgical goal in treatment of blow-out fractures of the medial orbital wall.

Keyword

Blow-out fracture; External approach; Endoscopic approach

MeSH Terms

Asia
Cicatrix*
Endoscopes
Extremities
Facial Bones
Follow-Up Studies
Orbit*
Orbital Fractures*
Skin