Endoscopic Reconstruction of Zygomatic Bone Fracture without Periorbital Incision

ABSTRACT

Endoscopic techniques have revolutionized current surgical techniques and have now been introduced to plastic surgery including zygomatic fracture repair. The main advantages of endoscopic zygomatic fracture repair are the minimization of scars, avoidance of undesirable risks and sequelae of the traditional open method. In previous endoscopic techniques for repair of zygomatic fracture, some used various additional percutaneous incisions besides temporal scalp and intraoral incisions for approach of the infraorbital rim and the zygomaticofrontal region, and others who did not use those additional incisions skipped the infraorbital rim fixation. The authors performed 16 cases of the reconstructions of the zygomatic bone fractures with endoscopic approach between September 1999 and April 2002, and all the fracture sites showing fracture displacement were approached using temporal and intraoral incisions only. The fracture sites over the zygomaticofrontal area and arch were stabilized with plates and screws through temporal scalp incisions under endoscopic control. Also the fracture of the zygomaticomaxillary buttress and the infraorbital rim were restored through upper buccal sulcus incision. All the patients showed rapid recovery without visible scar, and obtained acceptable zygoma symmetry, which was confirmed on the postoperative CT scans. With the use of the endoscope, we could minimize morbidity, and obtained favorable functional and aesthetic results.