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June 1991

Recent Advances in the Management of Orbital Trauma: Reconstruction and Complications

Arch Otolaryngol Head Neck Surg. 1991;117(6):593. doi:10.1001/archotol.1991.01870180027006

In the previous issue of the Archives, current concepts regarding anatomic considerations and the evaluation process for orbital trauma were reviewed. In this issue, reconstruction and complications will be considered.

RECONSTRUCTION  When reconstruction has been determined necessary secondary to findings on physical examination and radiographic evaluation, various approaches must be considered. The approach to the orbital rim and floor may be via the rim, subciliary, or transconjunctival incisions.1 The former has the advantage of a direct approach to the rim and floor, but may lead to an unsightly facial scar. The subciliary incision has the advantage of being relatively well hidden and offers excellent exposure to the entire medial and lateral aspects of the inferior orbital rim and corresponding regions of the orbital floor. However, there is an increased risk of ectropion and "rounding" of the eye with this approach. Regardless, this is the most commonly utilized approach at