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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Rivista Italiana di Chirurgia Maxillo-Facciale 2002 April;13(1):15-9
Retrocaruncular incision for access to the medial wall of the orbit
Raffaini M., Ghilardi R., Spinelli G., Giannini D.
Department of Maxillo-Facial Surgery, CTO Careggi, University of the Study, Florence
Background. There are many limits and complications, chiefly of an aesthetic nature, of the surgical access techniques traditionally used to reach the medial wall of the orbit. This report describes the retro-caruncular conjunctival surgical access technique to explore and reduce fractures of the medial orbital wall.
Methods. We applied this surgical technique to five cases of fracture of the medial wall, reconstructed with bone graft from the iliac crest in two cases, with septal cartilage in two cases, and with alloplastic material in the fifth case (Medpor).
Results. In all five cases treated, access was found to be quick and relatively easy, and to provide adequate exposure of the fracture and sufficient freedom of surgical movement. All patients, at one year follow-up, presented stability of the reconstructed wall without enophtalmos or diplopia; clinical ocular complications, in particular to the lacrimal structures and conjunctival tissues, were not present in any of the cases.
Conclusions. We may conclude that this access route is efficacious to explore and reduce fractures of the medial wall of the orbit.