TY - JOUR
T1 - Subciliary vs. transconjunctival approach for the management of orbital floor and periorbital fractures
T2 - A systematic review and meta-analysis
AU - Al-Moraissi, Essam Ahmed
AU - Thaller, Seth R.
AU - Ellis, Edward
PY - 2017/10
Y1 - 2017/10
N2 - Purpose This study compared complications between subciliary and transconjunctival approaches to the infraorbital rim/orbital floor, using systematic review and meta-analysis. Materials and Methods A systematic review with meta-analysis was conducted according to PRISMA guidelines. An electronic search in PubMed, Embase, and Cochrane Library was performed. Randomized controlled and controlled (retrospective or prospective) clinical studies, with the aim of comparing subciliary to transconjunctival approaches in the management of infraorbital rim/orbital floor fractures, were included. Outcome variables were lower lid malposition including ectropion, entropion, scleral shows, canthal malpositions, and others complications. An odds ratio (OR) of outcome variables, using a Mantel–Haenszel (M−H) test with 95% confidence intervals (95% CIs), was calculated using Comprehensive Meta-analysis Software. A descriptive analysis of postoperative complications was also presented. Results The subciliary approach had a significantly higher incidence of ectropion and scleral show when compared with the subconjunctival approach (p < 0.001). The subconjunctival approach had a significantly higher incidence of entropion than the subciliary approach (p < 0.001). Conclusions Both the subciliary and the transconjunctival approaches are associated with specific complications. Overall, the transconjunctival approach shows the lowest incidence of complications.
AB - Purpose This study compared complications between subciliary and transconjunctival approaches to the infraorbital rim/orbital floor, using systematic review and meta-analysis. Materials and Methods A systematic review with meta-analysis was conducted according to PRISMA guidelines. An electronic search in PubMed, Embase, and Cochrane Library was performed. Randomized controlled and controlled (retrospective or prospective) clinical studies, with the aim of comparing subciliary to transconjunctival approaches in the management of infraorbital rim/orbital floor fractures, were included. Outcome variables were lower lid malposition including ectropion, entropion, scleral shows, canthal malpositions, and others complications. An odds ratio (OR) of outcome variables, using a Mantel–Haenszel (M−H) test with 95% confidence intervals (95% CIs), was calculated using Comprehensive Meta-analysis Software. A descriptive analysis of postoperative complications was also presented. Results The subciliary approach had a significantly higher incidence of ectropion and scleral show when compared with the subconjunctival approach (p < 0.001). The subconjunctival approach had a significantly higher incidence of entropion than the subciliary approach (p < 0.001). Conclusions Both the subciliary and the transconjunctival approaches are associated with specific complications. Overall, the transconjunctival approach shows the lowest incidence of complications.
KW - Orbital floor
KW - Periorbital fractures
KW - Subciliary approach
KW - Transconjunctival approach
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U2 - 10.1016/j.jcms.2017.07.004
DO - 10.1016/j.jcms.2017.07.004
M3 - Article
C2 - 28823598
AN - SCOPUS:85027563775
SN - 1010-5182
VL - 45
SP - 1647
EP - 1654
JO - Journal of Cranio-Maxillofacial Surgery
JF - Journal of Cranio-Maxillofacial Surgery
IS - 10
ER -