IADR Abstract Archives

Living FRISBEE: Transconjunctival versus Subcilliary approach for orbitary fractures

Objectives:

To identify and analyze all published systematic reviews (SR) on the effectiveness and safety of the pre-septal transconjunctival approach (TCA) compared to the subcilliary approach (ACS) for orbital floor fractures and infraorbital rim.
Methods:

We performed a systematic search in Epistemonikos, the largest database of SR in health, which is maintained by searching multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We ordered the body of evidence using the evidence matrix tool using Epistemonikos and extracted the data from the SRs that compared both techniques. We re-analyzed the data and performed a meta-analysis using a random-effects model. Finally we prepared a summary of findings table using the GRADE framework. All processes were performed in duplicate and reviewed by a methodological and clinical team.
Results:

We identified six systematic reviews that presented 21 PS, four randomized clinical trials (RCTs), and 17 observational studies. RCTs included 120 patients with 120 orbital fractures without age restriction. The use of pre-septal TCA compared to the SCA may reduce the risk of ectropion (low certainty of the evidence), RR 0.41 [95% CI 0.11 to 1.56]. The use of pre-septal TCA compared to the SCA probably reduces the risk of other complications (moderate certainty of the evidence), such as diplopia, transient paraesthesia, ecchymosis, scleral show, tarsal plate laceration, and lower eyelid laceration, RR 0.30 [95% CI 0.09-0.94]. On the other hand, TCA’s use probably increases the risk of entropion (moderate certainty of the evidence), 5.97 [95% CI 1.10-32.60].
Conclusions:

Both approaches are associated with specific complications. Overall, TCA’s use showed the lowest incidence of complications. New RCTs comparing both techniques are required for other outcomes of clinical relevance, effectiveness, safety, and patient preferences.

2020 Chilean Division Meeting (Virtual)

2020

Oral & Maxillofacial Surgery Research
  • Vargas, Juan Pablo  ( Pontificia Universidad Catolica de Chile , Santiago , Chile )
  • Uribe Monasterio, Macarena  ( Pontificia Universidad Catolica de Chile , Santiago , Chile )
  • Pinedo Henríquez, Francisco Javier  ( Pontificia Universidad Catolica de Chile , Santiago , Chile ;  Hospital Santiago Oriente, Dr. Luis Tisné Brousse , Santiago , Chile )
  • Ortuño, Duniel  ( Pontificia Universidad Catolica de Chile , Santiago , Chile )
  • Verdugo Paiva, Francisca  ( Centro Evidencia UC, Pontificia Universidad Católica de Chile , Santiago , Chile ;  Epistemonikos Foundation , Santiago , Chile )
  • NONE
    Poster Session
    Poster Session B