Subciliary vs. transconjunctival approach for the management of orbital floor and periorbital fractures: A systematic review and meta-analysis

Essam Ahmed Al-Moraissi, Seth Thaller, Edward Ellis

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalJournal of Cranio-Maxillofacial Surgery
DOIs
StateAccepted/In press - 2017

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Entropion
Ectropion
Meta-Analysis
Incidence
Orbital Fractures
PubMed
Libraries
Software
Odds Ratio
Prospective Studies
Guidelines
Confidence Intervals

Keywords

  • Orbital floor
  • Periorbital fractures
  • Subciliary approach
  • Transconjunctival approach

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

Cite this

@article{40c2c680e80e4dd6a9aa9e508938e202,
title = "Subciliary vs. transconjunctival approach for the management of orbital floor and periorbital fractures: A systematic review and meta-analysis",
abstract = "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.",
keywords = "Orbital floor, Periorbital fractures, Subciliary approach, Transconjunctival approach",
author = "Al-Moraissi, {Essam Ahmed} and Seth Thaller and Edward Ellis",
year = "2017",
doi = "10.1016/j.jcms.2017.07.004",
language = "English (US)",
journal = "Journal of Cranio-Maxillo-Facial Surgery",
issn = "1010-5182",
publisher = "Churchill Livingstone",

}

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

AU - Ellis, Edward

PY - 2017

Y1 - 2017

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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