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Rotational Mapping-Designed Approach for Minimally Invasive Fixation of Zygomaticomaxillary Fractures: A
Si Wu1, Zixing Wang, Chi Zhang
1From Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Objective:
This study aimed to evaluate the early clinical efficacy of a standardized incision approach based on the rotational mapping method. The approach was applied in significantly displaced Zingg Type B and mildly comminuted Zingg Type C zygomaticomaxillary complex (ZMC) fractures requiring direct exposure of the zygomatic arch.
Methods:
A total of 43 patients with selected Zingg Type B/C ZMC fractures requiring open reduction of the zygomatic arch were retrospectively assessed. The "rotational mapping method" was used intraoperatively to plan a preauricular incision for direct zygomatic arch exposure and fixation, combined with other standard incisions for ZMC reduction. Surgical parameters, postoperative complications, and facial symmetry restoration were evaluated using three-dimensional digital analysis of the mean absolute differences (MAD).
Results:
At 3 months postoperatively, maximum interincisal opening improved to 3.51±0.44 cm. Only 1 patient (2.3%) developed transient postoperative facial nerve dysfunction, which resolved completely within 3 months. The MAD between the bilateral zygomaticomaxillary complexes decreased from 1.18±0.11 mm preoperatively to 0.59±0.47 mm postoperatively. The mean incision length was 2.12±0.42 cm, and Vancouver Scar Scale scores improved during follow-up.
Conclusion:
The "rotational mapping method" provides a structured quantitative framework for designing preauricular incisions. The Rotational Mapping-Designed (RMD) approach serves as an effective adjunctive option for selected Zingg Type B/C ZMC fractures requiring direct visualization of the zygomatic arch, with favorable early safety and clinical outcomes.
