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经结膜切口:眼眶区域无痕手术的福音——病例系列

The Transconjunctival Incision: A Boon for Scarless Surgery of the Orbital Region-A Case Series.

作者信息

Punga Rohit, Rai Meha, Rawat Siddharth, Bhagat Nitin

机构信息

Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh India.

Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Manav Rachna International University of Research and Studies, Faridabad, Haryana India.

出版信息

J Maxillofac Oral Surg. 2025 Jun;24(3):646-652. doi: 10.1007/s12663-025-02448-w. Epub 2025 Feb 7.

Abstract

INTRODUCTION

Complications following surgery are common, particularly in procedures involving the orbit. Various surgical approaches such as subciliary, subtarsal, and infraorbital incisions often lead to scar formation, which is an inevitable outcome. In contrast, the transconjunctival incision, performed over the palpebral conjunctiva, avoids visible scarring and offers distinct advantages. This case series aims to present the outcomes of using the transconjunctival access in patients with orbital trauma, including infraorbital rim and floor fractures, revision surgery for residual post-traumatic orbital deformities, and ocular cleft revisions.

MATERIALS AND METHODS

This retrospective study included 15 patients who underwent surgical intervention via transconjunctival access. The patients presented with orbital trauma affecting the infraorbital rim and floor, post-traumatic deformities, and those requiring corrective surgery for Tessier 4 cleft. Surgical procedures were performed with careful attention to minimizing visible scarring and optimizing functional and aesthetic outcomes.

RESULTS

The transconjunctival approach was successfully used in all cases, with no visible external scars. All patients showed significant improvement in both functional and aesthetic outcomes. In cases of orbital trauma, the restoration of anatomical structure was achieved, while patients undergoing Tessier 4 cleft revision showed substantial correction of the deformity. Complications were minimal, with no major postoperative issues.

CONCLUSION

The transconjunctival surgical approach for orbital trauma, post-traumatic deformities, and Tessier 4 cleft revisions provides a highly effective, scar-free alternative to traditional incisions. This method not only enhances aesthetic outcomes but also ensures functional restoration, making it a viable option for managing complex orbital and facial injuries.

摘要

引言

手术后的并发症很常见,尤其是在涉及眼眶的手术中。各种手术入路,如睑缘下、睑板下和眶下切口,常常会导致瘢痕形成,这是不可避免的结果。相比之下,经结膜切口是在睑结膜上进行的,可避免可见瘢痕形成,并具有明显优势。本病例系列旨在介绍经结膜入路在眼眶外伤患者中的应用结果,包括眶下缘和眶底骨折、创伤后眼眶残留畸形的修复手术以及眼眶裂修复手术。

材料与方法

这项回顾性研究纳入了15例经结膜入路接受手术干预的患者。这些患者患有影响眶下缘和眶底的眼眶外伤、创伤后畸形,以及需要对Tessier 4裂进行矫正手术的患者。手术过程中仔细注意尽量减少可见瘢痕形成,并优化功能和美学效果。

结果

所有病例均成功采用经结膜入路,无可见外部瘢痕。所有患者在功能和美学效果方面均有显著改善。在眼眶外伤病例中,实现了解剖结构的恢复,而接受Tessier 4裂修复手术的患者畸形得到了显著矫正。并发症极少,术后无重大问题。

结论

经结膜手术入路用于眼眶外伤、创伤后畸形和Tessier 4裂修复,为传统切口提供了一种高效、无瘢痕的替代方法。这种方法不仅提高了美学效果,还确保了功能恢复,使其成为处理复杂眼眶和面部损伤的可行选择。

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本文引用的文献

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