Incidence Comparison of Common Complications, Including Ectropion and Entropion, in Transconjunctival and Subciliary Approaches for the Treatment of ZMC Fractures

Statement of the Problem: 

Treating zygomaticomaxillary complex fractures (ZMC Fx) can result in postoperative complications that should be minimized by choosing the best surgical approach.

This study compared incidence rates of some common postoperative complications with emphasis on ectropion (an outward curling of the lower eyelid) and entropion (an inward curling of the lower eyelid) occurring with transconjunctival or subciliary approaches for the treatment of ZMC fractures.

This prospective study enrolled 80 patients with ZMC Fx who had been surgically treated. Patients were visited within one month and five months postoperatively by the same surgeon, and an information checklist was completed for each patient to clinically assess postoperative complications.

There was no significant difference between the two groups in the type of trauma (simple or comminuted) (p = 0.1) or the frequency of ectropion and entropion one month and five months postoperatively, respectively (p > 0.05). The same results were observed for history of massage under the eye or around the field of surgery (p = 0.151), scleral show (p = 0.414), history of post-surgical epiphora (overflow of tears and accumulation of tear) (p = 0.059), duration of the use of suspension/frost sutures (used to prevent eyelid distortion secondary to wound injury applied at the skin inferior to the incision to help elevate the lid) (p = 0.057), and the use of porex (an alloplastic material over the defect in the orbital floor) (p = 0.91).

There is no significant difference between the transconjunctival approach and the subciliary approach in terms of common postoperative complications such as ectropion and entropion.