Management of Infraorbital Rim Fracture Through Intraoral Approach

Purpose: The aim of our study was to evaluate the feasibility of an intraoral approach in the management of infraorbital rim fracture.

Patients and methods: A total of 12 patients of which four were female and five were male with isolated unilateral zygomaticomaxillary complex (ZMC) fractures, essentially involving the infraorbital foramen (right or left), were included in this study. Indications for surgical intervention were cosmetic deformity, disturbance of vision, persistent paresthesia, or impaired mandibular movement. All the patients were subjected to thorough preoperative evaluation. A three-point fixation was performed in all the patients. Various parameters such as time required for exposure and the amount of accessibility were assessed intraoperatively, while the stability of the fixation and paresthesia pertaining to the distribution of the infraorbital nerve were assessed postoperatively.

Results: A total of 12 patients with a mean age of 35.75 ± 12.7 years were included in the study. The mean time recorded for exposure and fixation was 21.33 ± 2.8 min. The accessibility was rated as "excellent" in 92% (11 patients) of the operated cases and rated "satisfactory" in 8% (1 patient) of the operated cases. The fixation was found to be stable in 100% of the cases. By the end of 8 months, normal mechanoreceptor response was elicited in 42% (five patients) of the cases and normal nocireceptor response was elicited in 92% (11 patients) of the cases.

Conclusion: The intraoral approach for fixation of the infraorbital rim is versatile and can be mastered even by novice surgeons. The virtual lack of complications and short learning curve make this approach an invincible modus operandi in a surgeon's repertoire.