Endoscopic repair of a complex midfacial fracture

Inadequate treatment of complex midfacial fractures involving the orbit and zygomatic arch can result in important functional and aesthetic deformity. Accurate repair of fractures at the zygomatic arch and orbital floor has traditionally necessitated coronal scalp and lower eyelid incisions respectively. Complications such as facial nerve injury, alopecia, external scarring, ectropion, and eyelid edema have been associated with these traditionally open surgical techniques. We report an endoscopic-assisted technique of open reduction and rigid fixation of a complex midfacial fracture. The endoscopic-assisted technique facilitated the anatomic repair of associated zygomatic arch and orbital floor fractures. The technique minimized ocular globe manipulation and eliminated the need for coronal scalp and lower eyelid incisions.