TRANSCONJUTIVAL ACCESS WITH SIDE CANTOTOMY TO APPROACH THE ORBITO-ZYGOMATIC-MAXILLARY COMPLEX
CASE REPORT
DOI:
https://doi.org/10.5335/rfo.v27i1.14755Keywords:
Orbital Fractures; Cicatrix; Conjunctiva.Abstract
Objective: to report a clinical case, basing the aspects related to the transconjunctival surgical technique with lateral canthotomy as a treatment for COZM fracture. Case report: Patient, male gender, attended the Oral and Maxillofacial Surgery and Traumatology Service of the General Hospital of the State (HGE), victim of a motorcycle accident, presenting ocular dystopia, bone step in the right infraorbital ridge, loss of right malar projection, mouth opening limited with ipsilateral deviation and occlusal dystopia with signs suggestive of a fracture of the right orbito-zygomatico-maxillary complex along with a complex fracture of the mandible. The surgical approach to access the contoured COZM with the transconjunctival incision technique with lateral canthotomy for better visualization of the fractured bone stumps. Final considerations: the choice for this type of access resulted in a successful behavioral approach, providing security in the experience of the respiratory field for subsequent rehabilitation of the patient, establishing a devolutionary and functional aesthetics, imperceptible healing and, consequently, a better prognosis for the patient.
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References
1. Mayrink G, Avila NGA, Belonia JB. Epidemiological survey of face trauma in a public hospital in vitória/ES (Brazil). J Braz Coll Oral Maxillofac Surg. Sept-Dec 2018; 4(3): 42-7. DOI: 10.14436/2358-2782.4.3.042-047, oar.
2. Silva e Farias IP, Saboia RSC, Antunes AA, Soriano EP, Laureano Filho JR, Porto GG. Use of Helmet and alcoohol between motorcyclists with facial trauma in Agreste and Sertão of the state of Pernambuco Brazil. J Braz Coll Oral Maxillofac Surg 2018; 4(3): 28-36. DOI: 10.14436/2358.4.3.028-036, oar.
3. Wahdini SI, Dachlan I, Seswandhana R, Hutagalung MR, Putri IL & Afandy, D. Neglected orbito zygomaticomaxillary fractures with complications: A case report. International journal of surgery case reports 2019; 62: 35-39. DOI: 10.1016/j.ijscr.2019.07.055, oar.
4. Mendonça JCG, Gaetti-Jardim EC, dos Santos MA, Ximenes WLA, dos Santos CM, de Quadros DC & Macena JA. Tratamento cirúrgico de fratura do complexo zigomático orbital: relato de caso. Archives Of Health Investigation 2016; 5 (5): 251-55. DOI: 10.21270/ archi. v5i5.1695, oar.
5. Nguyen DC, Shahzad F, Snyder-Warwick A, Patel KB, Woo AS. Transcaruncular Approach for treatment of medial wall and large orbital blowout fractures. Craniomaxillofac Trauma Reconstr 2016; 9(1): 46-54. DOI: 10.1055/s-0035-1563390, oar.
6. Starch-Jensen T, Linnebjerg LB, Jensen JD. Treatment of Zygomatic Complex Fractures with Surgical Nonsurgical Intervention: A Retrospective Study. Open Dent J 2018; (21) 12: 377-87. DOI: 10.2174/1874210601812010377. eCollection 2018, oar.
7. Almeida ARB, Martins AO, Cavasini AN, Patrocínio JA, Naves MM, Patrocínio LG. Avaliação do acesso transconjuntival com cantotomia lateral no tratamento cirúrgico das fraturas zigomático-orbitárias. Rev Bras Cir Craniomaxilofac 2011; 14(2): 75-9, oar.
8. Lock JZ, Hegde R, Young S, Lim TC, Amrith S, Sundar G. A study of sports-related orbital fractures in Singapore 2017; 36 (5): 301-6. DOI: 10.1080/01676830.2017.1337167, oar.
9. Chou C, Kuo YR, Chen CC, Lai CS, Lin SD, Huang SH, et al. Medial orbital wall reconstruction with porous polyethylene by using a transconjunctival approach with a caruncular extension. Ann Plast Sur 2017; 78 (3 Suppl 2): 89-94. DOI: 10.1097/ SAP.0000000000001012, oar.
10. Converse JM, Smith B, Wood-Smith D. Reconstrutive Plastic Surgery. 2.ed. Philadelphia: Saunders, 1977. 2007; 246 (1): 159, oar.
11. Yang S, Cho JY, Shim WC, Kim S. Estudo retrospectivo sobre a estabilidade pós-operatória da fratura do complexo zigomático-maxilar. Maxillofac Plast Reconstr Surg . 2021; 43 (1): 36. DOI: 10.1186 / s40902-021-00311-9, oar.
12. Davies BW, Hink EM, Durairaj VD. Orbitotomia inferior transconjuntival: indicações, técnica cirúrgica e complicações. Craniomaxillofac Trauma Reconstr. 2014; 7 (3): 169-174. DOI: 10.1055 / s-0034-1374063, oar.
13. Wolkow N, Freitag SK. Abordagens transconjuntivais e transcarunculares da órbita. J Neurol Surg B da base do crânio. 2020; 81 (4): 422-434. DOI: 10.1055 / s-0040-1713849, oar.
14. Scolari N; Heitz C. Protocolo de tratamento em fraturas orbitárias. Revista da Faculdade de Odontologia-UPF, v. 17, n. 3, p. 365-69, set/dez. 2012, oar.
15. De Morais HHA, Grempell RG, Barbalho JC, De Sousa TG. Fratura Blow Out tratada com acesso transconjuntival e cantotomia lateral: relato de caso. Revista de Cirurgia e Traumatologia Buco-maxilo-facial, v. 14, n. 1, p. 39-42, jan./mar. 2014, oar.
16. El-Anwar MW, Elsheik E, Hussein AM, Tantawy AA, Abdelbaki YM. Transconjuctival versus subciliary approach to the infraorbital margin for open reduction of zygomaticmaxillary complex fractures: a randomized feasibility study. Oral Maxillofac Surg 2017; 21(2): 187-192. DOI: 10.1007/s10006-017-0617-2, oar.
17. Nunery WR. Lateral canthal approach to repair of trimalarfractures of the zygoma. Ophthal Plast Reconstr Surg 1985; 1(3): 175-83. DOI: 10.1097/00002341-198501030-00004, oar.
18. Zamboni RA, Wagner JCB, Volkweis MR, Gerhardt EL; Buchmann EM, Bavaresco CS. Epidemiological study of facial fractures at the Oral and Maxillofacial Surgery Service, Santa Casa de Misericordia Hospital Complex, Porto Alegre - RS - Brazil. Rev Col Bras Cir 2017; 44(5): 491-97. DOI: 10.1590/0100-69912017005011, oar.
19. Graf .R.; Auerswald .A.; Bernardes .A.; Damasio .R.C.; Araujo, .G.C.M. Blefaroplasia Inferior Transconjuntival. Rev Soc Bras CirPlást 2001; 16 (2): 59-74, oar.
20. Oliva MA. Acesso subciliar para fraturas do complexozigomático-orbitári. Rev Bras Cir Cabeça Pescoço. 2013; 42(2): 106-8, oar.
21. Antonyshyn O, Gruss JS, Galbraith DJ, Hurwitz JJ. Complexorbital fractures: a critical analysis of immediate bone graftreconstruction. Ann Plast Surg. 1989; 22(3): 220-33. DOI: 10.1097/00000637-198903000-00009, oar.
22. Hwang K, & Kim DH. (2011). Analysis of zygomatic fractures. Journal of Craniofacial Surgery, 22(4), 1416-21. DOI: 10.1097/SCS.0b013e31821cc28d, oar.
23. Lu W, Zhou H, Xiao C, Shen Q, Lin M & Fan X. (2012). Late correction of orbital-zygomatic-maxillary fractures combined with orbital wall fractures. Journal of Craniofacial Surgery, 23(6), 1672-76. DOI: 10.1097/SCS.0b013e318266f963, oar.
24. Angelim DD, Silva LF, Gondim RF, Bezerra GLJ, Mello MJR, Carvalho ACGS. Acesso transconjuntival no tratamento de fraturas do osso zigomático – relato de caso. Rev. Odontologia (ATO). 2015; 15(8): 445-455, oar.
25. Peretti N, & MacLeod S (2017). Zygomaticomaxillary complex fractures: diagnosis and treatment. Current opinion in otolaryngology & head and neck surgery 2017; 25(4), 314-19. DOI: 10.1097/MOO.0000000000000372, oar.
26. El-Anwar MW, Elsheikh E, Hussein AM, Tantawy AA, & Abdelbaki YM (2017). Transconjunctival versus subciliary approach to the infraorbital margin for open reduction of zygomaticomaxillary complex fractures: a randomized feasibility study. Oral and maxillofacial surgery 2017; 21(2), 187-192. DOI: 10.1007/s10006-017-0617-2, oar.
27. Jardim ECG, Lima HC, Pereira TTM, Masocatto DC, Oliveira MM & de Mendonça JCG. Tratamento de fratura complexa de terço médio de face associada a ferimento extenso. Archives Of Health Investigation 2014; 3(3), oar.
2. Silva e Farias IP, Saboia RSC, Antunes AA, Soriano EP, Laureano Filho JR, Porto GG. Use of Helmet and alcoohol between motorcyclists with facial trauma in Agreste and Sertão of the state of Pernambuco Brazil. J Braz Coll Oral Maxillofac Surg 2018; 4(3): 28-36. DOI: 10.14436/2358.4.3.028-036, oar.
3. Wahdini SI, Dachlan I, Seswandhana R, Hutagalung MR, Putri IL & Afandy, D. Neglected orbito zygomaticomaxillary fractures with complications: A case report. International journal of surgery case reports 2019; 62: 35-39. DOI: 10.1016/j.ijscr.2019.07.055, oar.
4. Mendonça JCG, Gaetti-Jardim EC, dos Santos MA, Ximenes WLA, dos Santos CM, de Quadros DC & Macena JA. Tratamento cirúrgico de fratura do complexo zigomático orbital: relato de caso. Archives Of Health Investigation 2016; 5 (5): 251-55. DOI: 10.21270/ archi. v5i5.1695, oar.
5. Nguyen DC, Shahzad F, Snyder-Warwick A, Patel KB, Woo AS. Transcaruncular Approach for treatment of medial wall and large orbital blowout fractures. Craniomaxillofac Trauma Reconstr 2016; 9(1): 46-54. DOI: 10.1055/s-0035-1563390, oar.
6. Starch-Jensen T, Linnebjerg LB, Jensen JD. Treatment of Zygomatic Complex Fractures with Surgical Nonsurgical Intervention: A Retrospective Study. Open Dent J 2018; (21) 12: 377-87. DOI: 10.2174/1874210601812010377. eCollection 2018, oar.
7. Almeida ARB, Martins AO, Cavasini AN, Patrocínio JA, Naves MM, Patrocínio LG. Avaliação do acesso transconjuntival com cantotomia lateral no tratamento cirúrgico das fraturas zigomático-orbitárias. Rev Bras Cir Craniomaxilofac 2011; 14(2): 75-9, oar.
8. Lock JZ, Hegde R, Young S, Lim TC, Amrith S, Sundar G. A study of sports-related orbital fractures in Singapore 2017; 36 (5): 301-6. DOI: 10.1080/01676830.2017.1337167, oar.
9. Chou C, Kuo YR, Chen CC, Lai CS, Lin SD, Huang SH, et al. Medial orbital wall reconstruction with porous polyethylene by using a transconjunctival approach with a caruncular extension. Ann Plast Sur 2017; 78 (3 Suppl 2): 89-94. DOI: 10.1097/ SAP.0000000000001012, oar.
10. Converse JM, Smith B, Wood-Smith D. Reconstrutive Plastic Surgery. 2.ed. Philadelphia: Saunders, 1977. 2007; 246 (1): 159, oar.
11. Yang S, Cho JY, Shim WC, Kim S. Estudo retrospectivo sobre a estabilidade pós-operatória da fratura do complexo zigomático-maxilar. Maxillofac Plast Reconstr Surg . 2021; 43 (1): 36. DOI: 10.1186 / s40902-021-00311-9, oar.
12. Davies BW, Hink EM, Durairaj VD. Orbitotomia inferior transconjuntival: indicações, técnica cirúrgica e complicações. Craniomaxillofac Trauma Reconstr. 2014; 7 (3): 169-174. DOI: 10.1055 / s-0034-1374063, oar.
13. Wolkow N, Freitag SK. Abordagens transconjuntivais e transcarunculares da órbita. J Neurol Surg B da base do crânio. 2020; 81 (4): 422-434. DOI: 10.1055 / s-0040-1713849, oar.
14. Scolari N; Heitz C. Protocolo de tratamento em fraturas orbitárias. Revista da Faculdade de Odontologia-UPF, v. 17, n. 3, p. 365-69, set/dez. 2012, oar.
15. De Morais HHA, Grempell RG, Barbalho JC, De Sousa TG. Fratura Blow Out tratada com acesso transconjuntival e cantotomia lateral: relato de caso. Revista de Cirurgia e Traumatologia Buco-maxilo-facial, v. 14, n. 1, p. 39-42, jan./mar. 2014, oar.
16. El-Anwar MW, Elsheik E, Hussein AM, Tantawy AA, Abdelbaki YM. Transconjuctival versus subciliary approach to the infraorbital margin for open reduction of zygomaticmaxillary complex fractures: a randomized feasibility study. Oral Maxillofac Surg 2017; 21(2): 187-192. DOI: 10.1007/s10006-017-0617-2, oar.
17. Nunery WR. Lateral canthal approach to repair of trimalarfractures of the zygoma. Ophthal Plast Reconstr Surg 1985; 1(3): 175-83. DOI: 10.1097/00002341-198501030-00004, oar.
18. Zamboni RA, Wagner JCB, Volkweis MR, Gerhardt EL; Buchmann EM, Bavaresco CS. Epidemiological study of facial fractures at the Oral and Maxillofacial Surgery Service, Santa Casa de Misericordia Hospital Complex, Porto Alegre - RS - Brazil. Rev Col Bras Cir 2017; 44(5): 491-97. DOI: 10.1590/0100-69912017005011, oar.
19. Graf .R.; Auerswald .A.; Bernardes .A.; Damasio .R.C.; Araujo, .G.C.M. Blefaroplasia Inferior Transconjuntival. Rev Soc Bras CirPlást 2001; 16 (2): 59-74, oar.
20. Oliva MA. Acesso subciliar para fraturas do complexozigomático-orbitári. Rev Bras Cir Cabeça Pescoço. 2013; 42(2): 106-8, oar.
21. Antonyshyn O, Gruss JS, Galbraith DJ, Hurwitz JJ. Complexorbital fractures: a critical analysis of immediate bone graftreconstruction. Ann Plast Surg. 1989; 22(3): 220-33. DOI: 10.1097/00000637-198903000-00009, oar.
22. Hwang K, & Kim DH. (2011). Analysis of zygomatic fractures. Journal of Craniofacial Surgery, 22(4), 1416-21. DOI: 10.1097/SCS.0b013e31821cc28d, oar.
23. Lu W, Zhou H, Xiao C, Shen Q, Lin M & Fan X. (2012). Late correction of orbital-zygomatic-maxillary fractures combined with orbital wall fractures. Journal of Craniofacial Surgery, 23(6), 1672-76. DOI: 10.1097/SCS.0b013e318266f963, oar.
24. Angelim DD, Silva LF, Gondim RF, Bezerra GLJ, Mello MJR, Carvalho ACGS. Acesso transconjuntival no tratamento de fraturas do osso zigomático – relato de caso. Rev. Odontologia (ATO). 2015; 15(8): 445-455, oar.
25. Peretti N, & MacLeod S (2017). Zygomaticomaxillary complex fractures: diagnosis and treatment. Current opinion in otolaryngology & head and neck surgery 2017; 25(4), 314-19. DOI: 10.1097/MOO.0000000000000372, oar.
26. El-Anwar MW, Elsheikh E, Hussein AM, Tantawy AA, & Abdelbaki YM (2017). Transconjunctival versus subciliary approach to the infraorbital margin for open reduction of zygomaticomaxillary complex fractures: a randomized feasibility study. Oral and maxillofacial surgery 2017; 21(2), 187-192. DOI: 10.1007/s10006-017-0617-2, oar.
27. Jardim ECG, Lima HC, Pereira TTM, Masocatto DC, Oliveira MM & de Mendonça JCG. Tratamento de fratura complexa de terço médio de face associada a ferimento extenso. Archives Of Health Investigation 2014; 3(3), oar.
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2023-11-06
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TRANSCONJUTIVAL ACCESS WITH SIDE CANTOTOMY TO APPROACH THE ORBITO-ZYGOMATIC-MAXILLARY COMPLEX: CASE REPORT. (2023). Revista Da Faculdade De Odontologia - UPF, 27(1). https://doi.org/10.5335/rfo.v27i1.14755
