Arch Craniofac Surg.  2016 Sep;17(3):119-127. 10.7181/acfs.2016.17.3.119.

Transconjuctival Incision with Lateral Paracanthal Extension for Corrective Osteotomy of Malunioned Zygoma

• Chung JH
• You HJ
• Hwang NH
• Kim DW
• Yoon ES

• KMID: 2353510
• DOI: http://doi.org/10.7181/acfs.2016.17.3.119

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.

Keyword

Conjunctiva; Eyelids; Osteotomy; Zygomatic fracture

MeSH Terms

Alopecia
Cicatrix
Conjunctiva
Decompression
Eyelids
Follow-Up Studies
Hematoma
Humans
Hypesthesia
Maxilla
Methods
Orbit
Osteotomy*
Retrospective Studies
Sutures
Wounds and Injuries
Zygoma*
Zygomatic Fractures