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Precaruncular Approach for the Reconstruction of Medial Orbital Wall Fractures

You, Hi-Jin MD*; Kim, Deok-Woo MD, PhD; Dhong, Eun-Sang MD, PhD; Yoon, Eul-Sik MD, PhD*

doi: 10.1097/SAP.0b013e31826a1a75
Head and Neck Surgery

To reconstruct medial orbital wall fractures with a clear, least dissection, an alternative method, precaruncular approach, has been performed. We reviewed 36 patients with medial blowout fractures treated with this technique. The incision was made between the caruncle and medial canthal skin at the mucocutaneous junction, and was continued along the conjunctival fornix superiorly and inferiorly. An extended conjunctival incision was carried for additional access to the orbit floor. The dissection continued medially and proceeded along the preseptal plane. The clinical results were assessed by postoperative computed tomographic scan and by reviewing postoperative complications. Postoperatively, computed tomographic scans demonstrated adequate reduction of soft tissues and correct positioning of the inserted implant without surgical complications. In most cases, the edema resolved within 24 to 48 hours after surgery. The precaruncular approach is a good option in reconstructing medial orbital wall fractures because it provides satisfactory exposure with superior cosmetic result.

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From the *Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul; and †Department of Plastic and Reconstructive Surgery, Korea University Ansan Hospital, Danwon-Gu, Ansan-Si, Gyeonggi-Do, Korea.

Received November 18, 2011, and accepted for publication, after revision, July 16, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Eul-Sik Yoon, MD, PhD, Department of Plastic and Reconstructive Surgery, Korea University Anam Hosptial, Anam-Dong 5-Ga, Seongbuk-gu, Seoul, 136-705, Korea. E-mail:

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