Advantages of the upper eyelid approach with lateral canthotomy in the resolution of complex fronto-orbito-zygomatic fractures - bibliographic review of conventional approaches and a case report

Sep 29, 2026

Uploaded by James

A modified upper eyelid approach that incorporates lateral canthotomy is developed to enhance surgical access for complex fronto-orbital fractures. A 69-year-old male with a left fronto-orbital-zygomatic fracture underwent general anesthesia surgery using an upper eyelid incision plus lateral canthotomy. Reduction and osteosynthesis of the lateral orbital wall and part of the frontal bone were achieved without complications. The approach provided wide, direct exposure, expanded the operative field for comminuted fractures requiring multiple fixation elements, and produced an excellent aesthetic outcome with a nearly imperceptible scar, supporting its usefulness in extended injuries where visualization is critical.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

I. Introduction

Background and clinical rationale

Key concepts and technique overview

Upper eyelid approach and aesthetic considerations

Role of lateral canthotomy in surgical exposure

Case and outcomes

CASE REPORT [https://doi.org/10.5125/jkaoms.2025.51.6.404](https://doi.org/10.5125/jkaoms.2025.51.6.404)[ ](https://doi.org/10.5125/jkaoms.2025.51.6.404)pISSN 2234-7550 · eISSN 2234-5930 Advantages of the upper eyelid approach with lateral canthotomy in the resolution of complex fronto-orbito-zygomatic fractures: bibliographic review of conventional approaches and a case report Pedro Tapia1,2,3 , Fernanda Díaz4 , Jessica Zeballos1 , Sofía Díaz5 , Florencia Jollán5 , Benjamín Ossandón-Zúñiga6 1Department of Oral and Maxillofacial Surgery, Regional Hospital Dr. Franco Ravera Zunino, Rancagua, 2Department of Oral and Maxillofacial Surgery, Clínica RedSalud Vitacura, 3Department of Oral and Maxillofacial Surgery, Universidad del Desarrollo, 4Oral and Maxillofacial Surgery and Traumatology Specialty Program, Universidad del Desarrollo, 5Faculty of Dentistry, Universidad del Desarrollo, 6Faculty of Dentistry, Universidad de Chile, Santiago, Chile Abstract (J Korean Assoc Oral Maxillofac Surg 2025;51:404-409) This study presents a modified upper eyelid approach incorporating a lateral canthotomy to improve surgical access in complex fronto-orbital fractures. A 69-year-old male patient with no comorbidities was admitted to the regional hospital of Rancagua with a left fronto-orbital-zygomatic fracture. Surgery was performed under general anesthesia using an upper eyelid incision combined with a lateral canthotomy to enhance exposure of the fracture site. Reduction and osteosynthesis of the lateral orbital wall and part of the frontal bone were successfully achieved without complications. The modified approach provided wide and direct access to the affected areas, particularly beneficial in cases with comminuted fractures requiring the placement of multiple osteosynthesis elements. The lateral canthotomy significantly expanded the surgical field, facilitating accurate reconstruction. Additionally, the eyelid incision, placed along the natural palpebral crease, offered excellent aesthetic results with a nearly imperceptible scar. This technique proves to be a valuable option for the management of complex fronto-orbital injuries, combining effective exposure with favorable cosmetic outcomes. It is especially useful in extended fractures where optimal visualization is critical for successful repair. The upper eyelid approach with lateral canthotomy thus stands out as a reliable and aesthetically conscious alternative for orbital fracture surgery. Key words: Orbital fractures, Canthotomy, Facial bones, Eyelids [paper submitted 2025. 4. 25 / revised 2025. 8. 11 / accepted 2025. 8. 23] I. Introduction The zygomatic bone forms the lateral portion of the midface and upper third of the face. It articulates with several bones of the craniofacial skeleton and constitutes a significant part of both the inferior and lateral orbital walls1,2 . Zygomatic bone fractures account for approximately 23% to 43% of all facial fractures1, whereas frontal bone fractures represent 5% to 15% of traumatic facial injuries. Both types of fractures can result in significant aesthetic and functional morbidity, Benjamín Ossandón-Zúñiga Faculty of Dentistry, Universidad de Chile, Olivos 943, Independencia, Santiago 8380544, Chile TEL: +56-964806411 [E-mail: benjamin.ossandon@ug.uchile.cl](E-mail: benjamin.ossandon@ug.uchile.cl) ORCID: [https://orcid.org/0000-0001-5039-9337](https://orcid.org/0000-0001-5039-9337) CC This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([http://creativecommons.org/](http://creativecommons.org/)[ ](http://creativecommons.org/)[licenses/by-nc/4.0/](licenses/by-nc/4.0/)), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2025 The Korean Association of Oral and Maxillofacial Surgeons. and their management must be tailored to the individual patient1. Mu

FAQs

What surgical modification does the study propose for complex fronto-orbital fractures?

It proposes a modified upper eyelid approach that includes lateral canthotomy to improve access and exposure of the fracture site.

What was reported about outcomes in the presented case?

Reduction and osteosynthesis of the lateral orbital wall and part of the frontal bone were successfully achieved without complications, with a nearly imperceptible scar.

Why is lateral canthotomy considered beneficial in this technique?

The study states that lateral canthotomy significantly expands the surgical field, facilitating accurate reconstruction, especially in comminuted fractures requiring multiple fixation elements.

Sep 29, 2026

Uploaded by James