A Clinical and Anatomical Study on the Localization of the Temporal Branch of the Facial Nerve Crossing the Zygomatic Arch / Estudio Clínico y Anatómico sobre la Localización del Ramo Temporal del Nervio Facial que Cruza el Arco Cigomático

SUMMARY: To clarify the path of the temporal branch of facial nerve (TB) crossing the zygomatic arch (ZA). Eighteen fresh adult heads specimens were carefully dissected in the zygomatic region, with the location of TB as well as its number documented. The hierarchical relationship between the temporal branch and the soft tissue in this region was observed on 64 P45 plastinated slices. 1. TB crosses the ZA as type I (21.8 %), type II (50.0 %,), and type III (28.1 %) twigs. 2. At the level of the superior edge of the ZA, the average distance between the anterior trunk of TB and the anterior part of the auricle is 36.36±6.56 mm, for the posterior trunk is 25.59±5.29 mm. At the level of the inferior edge of the ZA, the average distance between the anterior trunk of TB and the anterior part of the auricle is 25.77±6.19 mm, for the posterior trunk is 19.16±4.71 mm. 3. The average length of ZA is 62.06±5.36 mm. TB crosses the inferior edge of the ZA at an average of 14.67±6.45 mm. TB crosses the superior edge of the ZA at an average of 9.08±4.54 mm. 4. At the level of the ZA, TB passes on the surface of the pericranium while below the SMAS. The TB obliquely crosses the middle 1/3 part of the superior margin of the ZA and the junction of the middle 1/3 part and the posterior 1/3 part of the inferior margin of the ZA below the SMAS while beyond the periosteum. It is suggested that this area should be avoided in clinical operation to avoid the injury of TB.

El objetivo de estudio fue esclarecer el trayecto del ramo temporal del nervio facial (RT) que cruza el arco cigomático (AC). Se disecaron la región cigomática de 18 especímenes de cabezas sin fijar de individuos adultas y se documentó la ubicación del RT y su número de ramos. La relación jerárquica entre el ramo temporal y el tejido blando en esta región se observó en 64 cortes plastinados o P45. 1º El RT cruza el AC como tipo I (21,8 %), tipo II (50,0 %) y tipo III (28,1 %). 2º A nivel del margen superior del AC, la distancia promedio entre el tronco anterior de RT y la parte anterior de la aurícula fue de 36,36±6,56 mm, para el tronco posterior fue de 25,59±5,29 mm. A nivel del margen inferior del AC, la distancia promedio entre el tronco anterior del RT y la parte anterior de la aurícula era de 25,77±6,19 mm, para el tronco posterior era de 19,16±4,71 mm. 3º La longitud media de RT fue de 62,06±5,36 mm. EL RT cruzaba el margen inferior del AC a una distancia media de 14,67±6,45 mm. El RT cruzaba el margen superior del AC a una distancia media de 9,08±4,54 mm. 4º Anivel del AC, el RT pasaba por la superficie del pericráneo mientras se encuentra por debajo del SMAS. El RT cruza oblicuamente el tercio medio del margen superior del AC y la unión del tercio medio y el tercio posterior del margen inferior del AC por debajo del SMAS, más allá del periostio. Se sugiere que esta área debe evitarse en la operación clínica para evitar la lesión de la RT.

Facial shaping filled with autologous high density fat in zygomatic arch area / 中华医学美学美容杂志

Objective:To explore a simple and effective method to improve the facial shape coordination for patients.Methods:From May 2015 to May 2020, 36 female patients (aged 24-32 years, mean 26.8 years) who were required to change face shape were enrolled in Zhengzhou Mylike Medical Cosmetology Hospital to improve face shape by adjusting frontaI arch width combined with autologous high-density fat transplantation.Results:Thirty-three patients (91.7%) were satisfied (31 satisfied, 2 basically satisfied). Three patients were not satisfied with the filling effect, and two of them were satisfied after the second filling (3 months after operation). 35 of the 36 patients were satisfied, accounting for 97.2%, only 1 case was dissatisfied. No other compIications such as fat liquefaction were observed. The mean morphological surface index of patients was 90.2 before operation and 88.1 after operation, showing significant improvement.Conclusions:Autologous high density fat transplantation is a good method to adjust the coordination of the frontal arch.

Digital measurement of anatomical morphology of a zygomatic arch / 中华医学美学美容杂志

Objective:To analyze the anatomical morphology of the zygomatic arch for reduction malarplasty.Methods:Computed tomography (CT) data were obtained from the electronic records of 45 patients in the Tianjin Stomatological Hospital from January 2018 to February 2020. Among them, there were 30 patients with normal protrusion of zygoma (group A) and 15 patients with prominent protrusion of zygoma (group B). The data were imported into modeling and analysis software (Mimics). Left and right three-dimensional (3D) zygoma models were created through standard procedures. In the 3D models, a vertical cut of the zygomatic arch was done, and anatomical morphological characteristics of the zygomatic arch were obtained through bone data measurement and morphological observation. Mean values with 95% confidence intervals ( CI) were calculated for the positional data. Independent sample T-test was conducted on the positional data and anatomical morphology data of the zygomatic arch in the two groups. P< 0.05 was considered as statistically significant. Results:In group B, the anterior edge of the stabilization area was located in front of the articular tubercle point (15.12 mm, 17.16 mm). The posterior edge of the stabilization area was located in front of the articular tubercle point (7.11 mm, 8.24 mm). The posterior edge of the enlarged area was located in front of the articular tubercle point (3.17 mm, 3.94 mm). There were significant differences between group A and group B in the posterior edge of the stabilization area ( t= 2.41, P= 0.018), the posterior edge of the enlarged area ( t=2.58, P= 0.012), and the width of the unilateral face ( P<0.01). Conclusions:There exists a stabilization area of bone morphology and enlargement area in zygomatic arch. The anatomical morphology of the zygomatic arch is different in width of the unilateral face and location of the enlarged area between populations with normal protrusion and prominent protrusion of the zygoma.

Tratamento de fratura isolada do arco zigomático - relato de caso / Treatment of isolated fracture of the zygomatic arch - case report

Devido ao comprometimento estético funcional, as fraturas do arco zigomático (AZ) devem ser abordadas, o mais breve possível, com o objetivo de minimizar as sequelas. Há várias formas de tratamento descritas na literatura. O objetivo deste trabalho é relatar um caso clínico de fratura isolada do AZ tratada pela técnica de Keen sob anestesia local.

Due to functional aesthetic impairment, fractures of the zygomatic arch (ZA) should be addressed, as soon as possible, in order to minimize the sequelae. There are several forms of treatment described in the literature. The objective of this work is to report a clinical case of isolated ZA fracture treated by Keen's technique under local anesthesia.

Morphometric and Topographic Assessment of Foramen Ovale in Skulls of Jharkhand Population

Foramen ovale, situated in the greater wing of sphenoid, posterolateral to the foramen rotundum, transmits the sensory and motor root of mandibular nerve, accessory meningeal artery, emissary vein and lesser petrosal nerve to the infratemporal fossa. The normal shape of the foramen is oval, but its shape and size is quite variable. It plays an important role in the diagnostic and surgical procedures related to the middle cranial fossa. So, knowledge of the variations, dimensions and the topographic location is of importance to the neurosurgeons while dealing with surgeries in this region. Our study aims at finding the morphological variations in shape, dimensions of foramen ovale and its location in relation to the zygomatic arch.METHODSA cross-sectional observational study was carried out over a period of one year from 1/6/2018 to 31/5/2019, on 46 adult human skulls, taken from the department of Anatomy, RIMS, Ranchi. Fully dried, intact, adult human skulls were included in the study. Foramen ovale was observed for variation in shape, size and location. The presence of any accessory bony structure like bony plate, spine or septa was looked for and prevalence noted. The maximum antero-posterior length and width of foramen ovale and its distance from articular tubercle and the anterior root of zygomatic arch were measured using Vernier callipers. Pathologically malformed and damaged skulls were excluded from the study.RESULTSFour types of shapes were observed – oval (76.08%) , almond (5.43%) , semilunar (8.69%) and triangular (9.78%). The mean anteroposterior dimension of foramen ovale was 6.96 ± 1.17 mm (6.89 ± 1.28 mm on the right side & 7.02 ± 1.05 mm on the left side) and the mean transverse dimension was 3.35 ± 0.66 mm (3.25 ± 0.57 mm on the right side, 3.45 ± 0.73 mm on the left side) . The mean distance of foramen ovale from articular tubercle on zygomatic arch was 32.58 ± 1.29 mm (32.41 ± 1.10 mm on the right side, 32.74 ± 1.45 mm on the left side) and from anterior root of zygomatic arch was 24.75 ± 1.70 (23.91 ± 0.85 mm on the right side, 25.59 ± 1.92 mm on the left side).CONCLUSIONSThere is no significant average difference between FO_AP_RT – FO_AP_LT. There is no significant average difference between FO Width_RT - FO_Width_LT. There is a significant average difference between FO to Art. Tubercle Right - FO to Art Tubercle left. There is a significant average difference FO to ant. root Right - FO to ant. root left.

Morphometric Analysis Of Pterion In Adult Human Dry Skull Of Gujarat Region

Background: Pterion is an area present on anterior part of floor of temporal fossa, formed by four bones frontal,parietal, squamous temporal and greater wing of sphenoid joined each other and form ‘H’ shaped suture. Thereare important neurovascular structure lies beneath the pterion. It is weakest area of skull, as the bones here arevery thin so it is more prone to fracture by traumatic blow over it or by indirect blow from top or back of head.Pterion is an important extracranial landmark for lateral or pterional approaches in various neurosurgicalprocedures.Objectives: The aim of this study was to observe various types of pterion and to determine exact location ofpterion from various bony landmarks like Frontozygomatic suture and zygomatic arch.Materials and methods: The present study was carried out on 326 adult human dry skulls collected from variousmedical colleges of Gujarat. The lateral side of skull was visually assessed for the various types of pterion as perMurphy’s classification. The measurements were carried out from center of pterion to superior edges of midpointzygomatic arch (PMPZ) and from center of pterion to posterolateral aspect of frontozygomatic suture (PFZS).Measurements were taken using a digital vernier caliper.Results: We found all four types of pterion in our study. The most common type of pterion is Sphenoparietal 523(80.21%), followed by Epipteric 71 (10.89%), Frontotemporal 34 (5.22%) and Stellate 24 (3.68%). The meandistance of PMPZ was 36.85 ± 3.61 mm and PFZS was 29.69 ± 3.91. The Mean & SD of PMPZ & PFZS on right sidewas little more as compared to left side.Conclusion: The knowledge of various types of the pterion and exact location of center of pterion from variousbony landmarks are important not only to anatomist but also important for neurosurgeon for pterional approachesin various neurovascular surgery, for radiologist to accurate interpretation of radiograph, CT & MRI of skull andfor anthropologist to racial comparison.

Reduction of Isolated Zygomatic Arch Fractures with Gillies Approach / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The incidence of facial bone fracture is increasing. The zygomatic bone, due to its anatomical prominence, is the second most common site of all facial bone fractures. In this study, we present the clinical experiences of zygomatic arch fracture in a tertiary hospital and introduce the Gillies approach for reduction and its outcome results. SUBJECTS AND METHOD: We collected data from retrospective chart reviews of patients who underwent surgeries from 2010 to 2017 for zygomatic arch fractures at Chungbuk National University Hospital. Data were analyzed according to age, gender, cause of trauma, location of trauma, and clinical symptoms including trismus. All surgery was performed under general anesthesia and via the use of Gillies approach. The result of surgery was evaluated by postoperative facial computed tomography. RESULTS: Sixteen patients underwent surgery for zygomatic arch fracture. The patients had the average age of 41.3 years, a male predominance of 15:1 and physical assault as the most common cause of trauma. The time lag between injury and surgical reduction was 5.5 days. The surgical outcomes were assessed “good” in 14 cases and “moderate” in one case. Patients who had trismus preoperatively were resolved of it in all cases after operation. Postoperative complications were absent. CONCLUSION: The Gillies approach proved to be a relatively easy, safe, and reliable method, and its surgical outcomes was satisfactory in our experiences.

Reduction anaplasty of zygomatic arch through a minor pre-auricular incision / 中华医学美学美容杂志

Objective To explore the clinical application of reduction anaplasty trough a minor pre-auricular incision.Methods A retrospective analysis of 89 patients with wide zygomatic arch treated with reduction anaplasty through pre-auricular incision from 2012 to 2016 in our hospital had been studied.Through a short incision in front of ear,zygomatic arch at the most narrow part,located about 5 cm in front of temporomandibular joint,was completely transected,whereas the junction of malar and zygomatic bone was drilled to make a greenstick fracture.No dissection of zygomatic ligament was perforemed.The dissected zygomatic arch was then pressed down and adjusted into a appropriate position.In the case of the protrusion of zygomatic body,the protrusion part could be reducted using grinding ablation.Results All the patients were followed up for 3 months to 5 years.The results were satisfactory,no serious complications were found,and the facial tissue did not show obvious ptosis.Postoperative numbness occurred on the left side in one patient and recovered spontaneously after two months.Conclusions Reduction anaplasty trough a minor pre-auricular incision is a simple,safe and effective approach for wide zygomatic arch,which could avoid facial tissue ptosis.

Analysis of the curative effect of extensive pterional approach combined with cutting of the zygomatic arch for the resection of large sphenoid ridge meningioma / 中国肿瘤临床

Objective: To explore the application of extensive pterional approach combined with cutting of the zygomatic arch for the resection of large sphenoid ridge meningioma. Methods: Thirty-three patients with large sphenoid ridge meningioma underwent operation using the extensive pterional approach combined with cutting of the zygomatic arch. Twenty patients with large sphenoid ridge meningioma received operation with the traditional pterional approach as the control. The resection rate, operative time, intraoperative blood loss, and postoperative complications were compared between the groups. Results: Two groups of patients underwent craniotomy under microscope. The Simpon grade I resection and grade Ⅱ resection rate was 93.9％ in the cutting of the zygomatic arch approach group and 60.0％ in the control group (P<0.01). The operative time was (325.2±121.3) min in the cutting of the zygomatic arch approach group, which was significantly shorter than that in the control group with (406.4±182.9) min (P<0.05). The intraoperative blood loss was (502.5±101.8) mL and (697.7±115.4) mL in the two groups (P<0.05). In addition, postoperative complication rate was 15.2％ and 45.0％ in the cutting the zygomatic arch approach group and the control group, respectively (P<0.05). No death was reported in both groups. Conclusion: Extensive pterional approach combined with cutting of the zygomatic arch can fully expose the anatomical structures of the skull base and the sellar region to eliminate the influence of temporal muscle in the exposure of the surgical area. The operative field is exposed to reduce the stretch injury to only the frontotemporal brain tissue, which might be helpful for the complete resection of large sphenoid ridge meningioma, and is more conducive to neurovascular anatomy and relevant functional protection.

Clinical research on the simulation accuracy of zygomatic reduction using an L-shaped osteotomy by Proplan CMF software / 中华整形外科杂志

Objective@#To evaluate the surgical prediction accuracy of Proplan CMF software for zygomatic reduction surgery using L-shaped osteotomy.@*Methods@#Pre-and-postoperative 1-year CBCT data of 26 patients with zygomatic arch hypertrophy were imported in Proplan CMF software during 2014 Jan. to 2016 Jun., the 3D models were reconstructed for simulation of L-shaped osteotomy, characteristic landmarks were selected and 3D point measurement system was established. The measurement result were analyzed by one-way ANOVA. Meanwhile, the overlap color grading charts of preoperative and simulated images were also observed.@*Results@#The facial width, bilateral zygomatic process angle and facial width index were [(128.56±2.72) mm, (106.87±2.53)°, (108.56±3.02)°and 1.41±0.03] in postoperative result, [(129.49±2.26) mm, (108.68±2.40)°, (108.85±3.02)°and 1.42±0.03]in simulated result and [(135.45±2.45) mm, (102.50±2.60)°, (103.41±2.56)°and 1.48±0.05] in preoperative result, with significant difference between preoperative and postoperative result, or between preoperative and simulated result (P<0.05), while no significance between postoperative and simulated result (P>0.05). The soft tissue zygomatic process distance was(153.25±2.58) mm in preoperative result, (150.23±2.76)mm in postoperative result , (149.36±3.27)mm in simulated result, with no significance between any of two groups result (P>0.05). The zygomatic process distance and bilateral zygomatic process tragal distance were (126.35±2.56) mm, (68.75±2.15) mm and(68.86±3.21) mm in postoperative result, showing significant differences compared with preoperative result [(120.16±3.18) mm, (74.58±3.19) mm and(76.14±3.15) mm] and simulated result [(118.86±3.45) mm, (73.85±3.57) mm and(76.87±2.58) mm] respectively(P<0.05), while zygomatic arch distance was not statistically different among the three groups(P>0.05). It indicated that predictive accuracy of facial width, facial width index, zygomatic process angle, soft tissue zygomatic arch distance was high but the soft tissue zygomatic process distance and zygomatic process tragal distance was relatively low. Meanwhile, the color overlay image showed that predictive accuracy was not good in the zygomatic region while the zygomatic arch area was high.@*Conclusions@#The predictive accuracy of Proplan CMF software for zygomatic arch hypertrophy is relatively high except for the zygomatic region. Further improvement of the CMF software is needed.

Comparison of Bispectral Index Scores Between the Standard Frontal Sensor Position and an Alternative Zygomatic Position Under General Anesthesia by Propofol Combined with Remifentanil / 医药导报

Objective To compare the bispectral index score ( BIS) correlationbetween standard frontal sensor position and an alternative zygomatic position under general anesthesia with propofol combined with remifentanil during neurosurgery. Methods Twenty patients undergoing neurosurgery were enrolled. Everyone received total intravenous anesthesia by target-controlled infusion of propofol and remifentanil. Two BISTM Quatro sensors mounted on the frontal and zygomatic regions were connected to BIS VistaTM monitors on each patient during general anesthesia.Data from each position were collected and analyzed at the time of awakening ( t1 ) , intubation ( t2 ) , incision ( t3 ) , the end of surgery ( t4 ) , and extubation ( t5 ) . Results At t1 , zygomatic BIS(88.95±6.42) was significantly lower than frontal BIS (84.85±9.64,P0.05). Scatter plot analysis revealed a significant correlation between BIS of frontal positionand that of zygomatic position( R2=0.892,P=0.000) . Conclusion During the anesthesia maintenance period,the zygomatic position can be availably used as an alternative position for monitoring if the operative field renders the standard frontal position unavailable.

Solitary Intraosseous Myofibroma of the Zygomatic Bone: A Case Report.

Myofibroblasts have been implicated in most fibro-contractive diseases and even in developing and specialized normal body tissues. Myofibroma denotes benign neoplasms composed of contractile myoid cells arranged around thin-walled blood vessels affecting the soft tissue, bone, or internal organs at all ages with the intraosseous variant being an uncommon entity. Histologically, these tumors are characterized by being circumscribed masses of spindle cells, which may lead to confusion in diagnosis with more aggressive soft tissue spindle cell tumors. A case is reported of a 7-year-old female patient who presented with a solitary intraosseous myofibroma in the inferolateral aspect of the left orbit. This article describes the clinical, radiographic, histopathologic, and immunohistochemical features of an intraosseous myofibroma in a female child.

An innovated surgical strategy of coronoid process fracture combined with ipsilateral zygomatic arch fracture / 重庆医学

Objective To explore an effective and safe therapeutic strategy in the treatment of coronoid process fracture com‐bined with ipsilateral zygomatic arch fracture .Methods Through the semi coronoid scalp incision ,`an open reduction and internal fixation of zygomatic arch fracture was done .The operation was modified that the area of zygomatic arch fracture was exposed ade‐quately ,and then the fracture fragments of zygomatic arch were turned up .The coronoid process fracture pieces were isolated and removed along with the direction of muscle fibers in the temporalis muscle .Results All Cases of the surgical incisions were healed by primary intention .After 3 - 24 months following up ,the function of mouth opening and closing ,and the other movements of mandible became normal .Conclusion Through the semi coronoid scalp incision ,zygomatic arch fracture reduction and internal fixa‐tion and the coronoid process fracture pieces removing can be done simultaneously .In this way ,an effective and safe therapeutic strategy for treating coronoid process fracture combined with ipsilateral zygomatic arch fracture .

Clinical application of modified preauricular and temporal approach for open reduction and fixation in zygomatic bone and arch fracture / 中华医学美学美容杂志

Objective To explore a new approach that is better than coronal scalp incision and facial percutaneous small incision in surgical treatment of zygomatic bone and zygomatic arch fracture.Methods The modified auriculotemporal incision was applied in 43 patients with zygomatic bone and zygomatic arch fracture that needed open reposition,and the exposure degree,bleeding,postoperative elasticity and texture of skin,facial nerve function and satisfactory degree were evaluated after operation.Results In present study,the upper part of zygomatic arch and lateral orbital margin could be greatly explored for operation of zygomatic bone and zygomatic arch fracture in all 43 patients by application of this approach.Less bleeding was observed during operation.All patients had primary healing and none of them presented with temporal numbness and facial palsy.After 6 months follow-up,41 cases (95.3％) and 43 cases (100％) showed fine elasticity of operative skin and satisfactory degree,respectively.Conclusions The modified auriculotemporal incision is better than conventional approach in surgical treatment of zygomatic bone and zygomaticarch fracture.

Zygomatic Arch Fracture Reduction via Gillie's (Temporal) Approach—Report of 3 Cases

In mid-face, the zygomatic bone and arch represents the bridge between the maxilla, orbital cavity and temporal bone anterosuperior and posterior, respectively. Zygomatic arch plays a potential relation with the maxilla, petrous part of temporal bone, orbits and the multitude of structures contained within and posterior to it make the temporomandibular joint functionally. Fracture of the zygomatic arch of the bone is potentially disturb the function of the mandibular jaw while opening and closing as well as disfigure by forming depression on face even in case of undisplaced. In time and reduction of arch fracture provides the best chance to avoid facial deformity, jaw dysfunction and prevents unfavorable sequelae. We conclude that, Gillies approach for undisplaced arch fracture reduction will be considerable due to simple and effective method and cosmetically more acceptable.

The Avalibility of C-Arm in Reduction of Zygomatic Arch Fracture Intraoperatively: Case Report

Closed Reduction of Zygomatic Arch Fracture with Intraoperative Mobile Computed Tomography Scan

PURPOSE: The purpose of this study is to describe the usefulness of intraoperative mobile CT scans in the reduction of zygomatic arch fracture. Method: Two patients with zygomatic arch fractures were selected who were indications of closed reduction by Gilles' approach. After the reduction was done in the operating room with zygomatic arch elevator, intraoperative CT scan was done to check the extent of reduction. Additional reduction was performed according to the obtained images from the intraoperative mobile CT scan. Examination of the preoperative CT, intraoperative CT after the reduction, and postoperative plain X-ray films were done for documentation and analysis. RESULTS: Reduction was carried out successfully to the patients without any complications. Both patients were satisfied with the postoperative cosmetic and functional outcome. Revisional surgery was not necessary during the 6 months follow up. CONCLUSION: The advantage of this method is that it is easier to obtain three dimensional relationships of the fracture site. Furthermore, the operator is less exposed to radiation hazards compared to other methods that obtain intraoperative images such as the C-arm. In conclusion, intraoperative mobile CT scan can be a useful surgical aid in the reduction of zygomatic arch fractures.

Topographic Relationship between the Zygomatic Arch and Coronoid Process of the Mandible / 체질인류학회지

Illustrations in almost all textbooks and atlases of anatomy normally show that the zygomatic arch (ZA) and coronoid process (CP) of the mandible overlap vertically. Their topographic relationship is important for plastic surgeons in various situations, such as restorations of ZA fractures. The present study investigated the topographic relationship between the ZA and CP of the mandible in three-dimensional models of Korean human cadavers. The topographic relationship was classified into three types: overlapped, tangential, and separate. The overlapped type was the most common, but the three types showed similar incidences in three-dimensional models. There were no lateral or sex differences according to the three types. The incidence of both sides showing the same type was 70.1%. In conclusion, the predominance of illustrations in almost all textbooks and atlases showing the overlapped type is misleading, since the other two types - where the CP of the mandible does not overlap the ZA - are almost as common.

Intraoral Reduction Malarplasty with Simultaneous Zygomatic Soft Tissue Lifting: Prevention of the Mid-Face Sag

No abstract available.

The Effective Reduction Method of Unstable Zygomatic Arch Fracture with Thermo-Splint

PURPOSE: The objective of this study is to propose an effective management of unstable zygomatic arch fracture. The reduction methods of arch fracture were relatively simple but the maintenance of reduction state is very troublesome. On this, authors introduce an effective management method of unstable zygomatic arch fracture. METHODS: Authors experienced 23 cases of unstable segmental zygomatic arch fractures and used Thermo- splint in all cases. All the arch fractures were reduced through Gillies' approach under the general anesthesia. After the reduction, the most effective suspension points were marked on the covering skin of the fractured arch. A needle of heavy nonabsorbable suture material was inserted toward the marking site under the reduced zygomatic arch. And then Therm-splint was dipped in the hot water, and we got the splint pattern of patient face. Reshaped Thermo-splint was trimmed and fixated with previous suspension suture materials. More additive suspension was done if necessary. The splint was applied for in two to three weeks postoperatively. RESULTS: In all the cases, good cosmetic and functional results were observed without severe complications. There were 4 cases of incomplete reductions but they also had no specific problems. There were no facial nerve symptom and scar(stitch mark). Postoperative slight tenderness and trismus were completely subsided after removal of the splint. CONCLUSION: The Thermo-splint safely protect and maintain the postoperative reduction state. The application, maintenance and removal were easy and simple. It could be reformed to any contour of face and had enough rigidity for supporting. Above all these things, effective prevention of displacement and easy manipulation were significant merit. Authors experienced good results with Thermo-splint, and would introduce it for another method of management of zygomatic arch fracture.