Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
BMC Oral Health
Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Canthotomy | Research

Zygomaticomaxillary complex fractures: finding the least complicated surgical approach (A Randomized Clinical Trial)

Authors: Lydia N. Melek, Marwa G. Noureldin

Published in: BMC Oral Health | Issue 1/2023

Login to get access

Abstract

Background

Many approaches have been suggested for management of zygomaticomaxillary fractures. Each approach has its own advantages and limitations.

Aim of this study

The study is intended to compare between the subtarsal approach, conventional transconjuctival approach and the Y- modification of the transconjuctival approach in the management of zygomatico-maxillay complex fractures.

Materials and methods

Twenty-four patients with age range of 20–50 years requiring open reduction and fixation of a fractured zygomatic complex were randomly divided into three equal groups. Group A: subtarsal approach group, group B: a conventional transconjunctival approach group and group C: Y- modification of the transconjunctival approach group. Intraoperative and postoperative parameters were evaluated.

Results

As for the exposure time, group C had the longest duration. Easy access to the site of fracture was reached in all groups with no statistically significant difference. During the first 24 h, the pain was only statistically significant between groups A and B with higher pain level in group A. After the first week, pain was significantly higher in groups A and C, with respect to group B. The least edema was observed in group B after 24 h, one week and four weeks postoperatively. Regarding ocular complications, wound healing and sensory nerve function, there was no statistically significant difference between the groups. Scarring was only noticeable in group A patients.

Conclusion

The transconjunctival approach provides adequate exposure with excellent esthetics and minor complications. The Y-modification also delivers an esthetic access with inconspicuous scar to the frontozygomatic region.

Trial registration

The trial has been registered on clinicaltrials.gov (ID: NCT05695872).
Literature
1.
Sharara AA. Transconjunctival versus subtarsal approach in open reduction of zygomaticomaxillary fractures [Master]. Alexandria Univeristy Faculty of Dentistry; 2019.
2.
Kurita M, Okazaki M, Ozaki M, Tanaka Y, Tsuji N, Takushima A, et al. Patient satisfaction after open reduction and internal fixation of zygomatic bone fractures. J Craniofac Surg. 2010;21(1):45–9.CrossRefPubMed
3.
Melek LN, Sharara AA. Retrospective study of maxillofacial trauma in Alexandria University: Analysis of 177 cases. Tanta Dental J. 2016;13(1):28–33.CrossRef
4.
5.
Subramanian B, Krishnamurthy S, Suresh Kumar P, Saravanan B, Padhmanabhan M. Comparison of various approaches for exposure of infraorbital rim fractures of zygoma. J Maxillofac Oral Surg. 2009;8(2):99–102.CrossRefPubMedPubMedCentral
6.
Waheed El-Anwar M, Elsheikh E, Sweed AH, Ezzeldin NJO, Surgery M. Electromyography assessment in zygomaticomaxillary complex fractures. Oral Maxillofac Surg. 2015;19(4):375–9.CrossRefPubMed
7.
Kumar R, Ali R, Zaidi SAA, Maheshwari B, Ahmed K. Subciliary and Subtarsal incision in management of zygomatico-orbital fracture, a study on scar assessment. Pak J Med Health Sci. 2022;16(05):624.
8.
Novelli G, Ferrari L, Sozzi D, Mazzoleni F, Bozzetti A. Transconjunctival approach in orbital traumatology: a review of 56 cases. J Craniomaxillofac Surg. 2011;39(4):266–70.CrossRefPubMed
9.
El-Anwar MW, Elsheikh E, Hussein AM, Tantawy AA, Abdelbaki YM. Transconjunctival versus subciliary approach to the infraorbital margin for open reduction of zygomaticomaxillary complex fractures: a randomized feasibility study. Oral Maxillofac Surg. 2017;21(2):187–92.CrossRefPubMed
10.
Martinez AY, Bradrick JP. Y modification of the transconjunctival approach for management of zygomaticomaxillary complex fractures: a technical note. J Oral Maxillofac Surg. 2012;70(1):97–101.CrossRefPubMed
11.
Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ (Clinical research ed). 2010;340c332:698–702.
12.
Yassin AM, Shaaban AM, Noureldin MG. Evaluation of the Y-shaped modification of the transconjuctival approach in open reduction of zygomatic maxillary complex fracture (clinical trial). Alex Dent J. 2022;47(1):9–15.
13.
Petrie A, Sabin C. Medical Statistics at a Glance. 3rd ed. Oxford: Blackwell; 2009.
14.
Suresh K. An overview of randomization techniques: An unbiased assessment of outcome in clinical research. J Human Reprodu Sci. 2011;4(1):8–11.
15.
16.
Shoukath S, Taylor GI, Mendelson BC, Corlett RJ, Shayan R, Tourani SS, et al. The lymphatic anatomy of the lower eyelid and conjunctiva and correlation with postoperative chemosis and edema. Plast Reconstr Surg. 2017;139(3):628e-e637.CrossRefPubMed
17.
18.
19.
Sanhoury MI, El Touny KA, Loutfi MA, Sobhy MA, Zaki MA. Comparison between percutaneous coronary intervention and medical treatment in the management of Egyptian patients with chronic coronary syndrome: a randomized controlled trial. Egypt J Crit Care Med. 2022;9(3):62–9.
20.
Kar IB, Mahavoi BR. Retrospective analysis of 503 maxillo-facial trauma cases in odisha during the period of dec’04-nov’09. J Maxillofac Oral Surg. 2012;11(2):177–81.
21.
Santosh BS, Giraddi G. Transconjunctival preseptal approach for orbital floor and infraorbital rim fracture. J Maxillofac Oral Surg. 2011;10(4):301–5.CrossRefPubMedPubMedCentral
22.
Holtmann B, Wray RC, Little AG. A randomized comparison of four incisions for orbital fractures. Plast Reconstr Surg. 1981;67:731–7.CrossRefPubMed
23.
Rajkumar K, Mukhopadhyay P, Sinha R, Bandyopadhyay TK. “Y” Modification of the transconjunctival approach for management of zygomatic complex fractures: a prospective analysis. J Maxillofac Oral Surg. 2016;15(1):45–51.
24.
Ilankovan V, Hadley D, Moos K, el Attar A. A comparison of imaging techniques with surgical experience in orbital injuries. A prospective study. J Craniomaxillofac Surg. 1991;19:348–52.CrossRefPubMed
25.
26.
Oztel M, Goh R, Hsu E. Subtarsal versus transconjunctival approach: a long-term follow-up of esthetic outcomes and complications. J Oral Maxillofac Surg. 2021;79(6):1327.e1-1327.e6.CrossRefPubMed
27.
Ridgway EB, Chen C, Lee BT. Acquired entropion associated with the transconjunctival incision for facial fracture management. J Craniofac Surg. 2009;20(5):1412–5.CrossRefPubMed
28.
Wray RC Jr, Holtmann B, Ribaudo JM, Keiter J, Weeks PM. A comparison of conjunctival and subciliary incisions for orbital fractures. Br J Plast Surg. 1977;30(2):142–5.CrossRefPubMed
29.
Devi RS. Comparison of y- modification of transconjunctival approach versus subtarsal – lateral eyebrow approach for zygomaticomaxillary complex fractures: A Prospective study. M.Sc. Thesis. Oral and Maxillofacial Surgery department, Tamilnadu Government Dental College and Hospital, Chennai. 2015.
Metadata
Title
Zygomaticomaxillary complex fractures: finding the least complicated surgical approach (A Randomized Clinical Trial)
Authors
Lydia N. Melek
Marwa G. Noureldin
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-03249-8

Other articles of this Issue 1/2023

BMC Oral Health 1/2023 Go to the issue

Research

Oral microbiome contributes to the failure of orthodontic temporary anchorage devices (TADs)

Research

Evaluation of the masking ability, marginal adaptation, and fracture resistance of screw-retained lithium disilicate implant-supported crowns cemented to titanium bases versus preparable abutments

Research

Effect of bleaching treatments on the adhesion of orthodontic brackets: a systematic review

Research

Comparison of topical purslane & topical 0.1% triamcinolone acetonide in the management of oral lichen planus - a double blinded clinical trial

Research

COVID-19 infection rates and mitigation strategies in orthodontic practices

Research

Investigating oral health among US adults with sleep disorder: a cross-sectional study