Upper Blepharoplasty and Lateral Brow Approaches for Zygomaticomaxillary Complex Fractures

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Otolaryngology

Background:

• Zygomaticomaxillary complex (ZMC) fractures require precise reduction for optimal outcomes.
• Adequate assessment of fracture reduction involves evaluating at least three of the four main articulation points: zygomaticomaxillary, zygomaticotemporal, zygomaticofrontal (ZF), and zygomaticosphenoid (ZS) sutures.

Purpose of the Study:

• To evaluate the effectiveness of different surgical approaches for assessing ZMC fracture reduction.
• To determine the optimal surgical approach for accessing critical ZF and ZS suture lines.

Main Methods:

• Review of surgical approaches for ZMC fracture management.
• Comparison of upper blepharoplasty and lateral brow approaches for accessing ZF and ZS sutures.
• Analysis of the extent of exposure and visualization provided by each approach.

Main Results:

• The upper blepharoplasty approach provides access to both the zygomaticofrontal (ZF) and zygomaticosphenoid (ZS) sutures.
• This approach offers wider exposure of the ZF/lateral orbital rim compared to the lateral brow approach.
• Assessment at the ZF and ZS sutures yields crucial anterior-posterior and rotational data for 3D zygoma positioning.

Conclusions:

• The upper blepharoplasty approach is advantageous for comprehensive ZMC fracture reduction assessment.
• This approach facilitates a more thorough evaluation of the zygoma's 3-dimensional position, particularly concerning rotation and anterior-posterior displacement.