Affiliation:
1. Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
2. Face Plastic Surgery Clinic, Daejeon 35230, Republic of Korea
Abstract
Subciliary incision is a common approach for facial fracture surgery; however, it has a higher incidence of lower lid ectropion, which can be particularly challenging for beginning surgeons to manage. This study reports the usage of lateral tarsoplasty combined with a full-thickness skin graft (FTSG) to correct severe ectropion following the subciliary approach for infra-orbital rim fractures. We retrospectively reviewed all facial fracture cases involving infra-orbital rim fractures through a subciliary approach treated in our department between March 2021 and May 2023. Electronic medical records and clinical digital photographs of patients who met the inclusion criteria were reviewed. After reviewing 196 cases that used the subciliary approach, we found 6 patients (3.06%; 4 males and 2 females; mean age, 68.5 ± 4.89 years) with postoperative severe ectropion managed using lateral tarsoplasty and FTSG. The mean ectropion development and correction times after facial fracture surgery were 0.78 ± 0.24 and 0.91 ± 0.37 months, respectively. At the 12-month follow-up, all patients showed favorable outcomes, and the position of their lower eyelids was well maintained without ectropion recurrence. Based on these successful outcomes, lateral tarsoplasty combined with FTSG is proposed to be an effective and straightforward method for managing lower eyelid ectropion caused by facial fracture surgery.
Reference33 articles.
1. Use of Triamcinolone Acetonide to Treat Lower Eyelid Malposition after the Subciliary Approach;Park;Arch. Craniofacial Surg.,2016
2. Comparison of transcutaneous Incisions Used for Exposure of the Infraorbital Rim and Orbital Floor: A Retrospective Study;Bahr;Plast. Reconstr. Surg.,1992
3. The Incidence of Lower Eyelid Malposition After Facial Fracture Repair: A Retrospective Study and Meta-Analysis Comparing Subtarsal, Subciliary, and Transconjunctival Incisions;Ridgway;Plast. Reconstr. Surg.,2009
4. The Incidence of Common Complications, Including Ectropion and Entropion, in Transconjunctival and Subciliary Approaches for Treatment of ZMC Fractures;Mehrnoush;J. Dent.,2021
5. Trevisiol, L., D’Agostino, A., Gasparini, S., Bettini, P., Bersani, M., Nocini, R., and Favero, V. (2021). Transconjunctival and Subciliary Approach in the Treatment of Orbital Fractures: A Study on Oculoplastic Complication. J. Clin. Med., 10.