COMPARATIVE STUDY BETWEEN SUBCILIARY APPROACH VERSUS COMBINED TRANSCONJUNCTIVAL WITH LATERAL PARACANTHAL APPROACH FOR MANAGEMENT OF ZYGOMATICO-MAXILLARY COMPLEX FRACTUREWITH SYSTEMATIC REVIEW

Background: Zygomatic fractures represent one of the most common conditions encountered today in our modern mechanized life which produces multiple injuries that involve the maxillofacial region, in the form of blowout variety or as a part of more complex zygomatic fractures. These patients usually look for treatment for cosmetic reasons. Aim of the work: This study aimed to compare surgical and esthetic outcomes and complication of transconjunctival versus subciliary approach in treatment of Zygomatico-Maxillary Complex fracture. Patients and Methods: The study was conducted on twenty adult patients suffering traumatic injuries in the maxillofacial region indicated for surgical repair .The included patients were randomly divided into two equal groups (10 patients in each group). Group 1 subciliary approach was performed to expose, reduce and reconstruct the orbital floor and walls with titanium mesh and plates. While in group II transconjunctival approach with lateral canthotomy was performed to expose, reduce and reconstruct the orbital floor and walls with titanium mesh and plates. Results: the subciliary approach is associated with a high rate of complications. The study therefore advocates the use of a transconjunctival incision for orbital fractures. When combined with a lateral paracanthal incision. this incision provides wide exposure of the infraorbital rim and orbital floor with a significantly lower complication rate and higher esthetic outcome.