Endoscopic application in treatment of fracture of the zygomatic arch

ABSTRACT

Although the zygomatic arch can be employed as a key landmark to the accurate alignment of a displaced zygoma fracture, it has been traditionally avoided because of the need for a bicoronal incision. Exposure of the zygomatic arch by means of the conventional bicoronal incision has several possible disadvantages, including an increased risk of blood loss, alopecia, loss of sensation posterior to the incision, and traction palsy of the facial nerve. Endoscopic-assisted exposure of a zygomatic arch can largely obviate the disadvantages of a bicoronal incision and yield this site accessible to reduction and internal fixation in the routine treatment of displaced zygoma fractures. 9 cases of endoscope-assisted open reduction of zygomatic arch fracture and 3 cases of internal fixation of a moderately displaced zygoma fracture are presented. To accomplish this technique, a rigid 4 mm, 30 degree down-angled endoscope, trocar and cannula, endoscopic forehead lift instrument were used. The postoperative courses were satisfactory with few complications. The use of endoscope in the treatment of zygoma reduction provided an expanded field of vision, direct manipulation of lesions, minimal postoperative scar. In particular, exposure and fixation of the zygomatic arch were performed without the need for a bicoronal incision.