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Deep dissection plane for endoscopic-assisted comminuted malar fracture repair
Su-Shin Lee1, Sin-Daw Lin, Yu-Te Chiu
1Division of Plastic and Reconstructive Surgery, Department of Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Taiwan.
Annals of Plastic Surgery
|November 20, 2002
Summary
A novel endoscopic approach for comminuted malar fractures uses a deep temporal fascia dissection plane. This method enhances safety by reducing facial nerve injury risk and offers surgical advantages for zygomatic bone repair.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- Endoscopic Surgery
Background:
- Endoscopic techniques are utilized for comminuted malar fractures.
- Traditional dissection planes risk injury to the frontal branch of the facial nerve, potentially causing frontal muscle paralysis.
Purpose of the Study:
- To evaluate a modified endoscopic-assisted zygomatic bone repair technique.
- To assess the safety and efficacy of a dissection plane beneath the deep temporal fascia.
Main Methods:
- 42 patients with comminuted malar fractures underwent endoscopic-assisted zygomatic bone repair.
- The zygomatic arch was accessed via a dissection plane deep to the temporal fascia.
- Plate fixation was performed on the superior border of the zygomatic arch.
Main Results:
- The deep dissection plane minimized risk to the frontal branch of the facial nerve.
- A single temporal incision was sufficient for zygomatic arch fracture management.
- Preservation of the periosteum at the anterior and inferior borders of the zygomatic arch was achieved.
- A shortened learning curve for the endoscopic technique was observed.
Conclusions:
- Endoscopic-assisted zygomatic bone repair using a deep temporal fascia dissection is a safe and effective alternative.
- This technique reduces the risk of facial nerve injury compared to traditional endoscopic methods.
- The approach facilitates efficient management of comminuted malar fractures.