Temporal flap incision for the malunited zygomatic arch fractures

Abstract

The temporal flap incision from temporal to preauricular region was made in 7 patients with malunited zygomatic arch fractures.
This approach allows maximal exposure of the zygomatic arch. The osteotomy along the malunited fracture line, mobilization of the fractured bone, and reduction and stabilization of the segment into normal anatomic position could be accomplished without difficulties under direct vision. The skin incision produces a cosmetically acceptable scar. Damages to facial nerve branches and the parotid gland were not observed postoperatively. The temporal flap approach can be applied to the temporo-mandibular joint and to the retromaxillary space.
In one of the 7 cases in which the zygomatic arch fracture remained unstable even with direct osteosynthesis, a method of stabilization with a metal eye shield and with circumferential zygomatic wires was made. Satisfactory arch alignment was obtained without residual deformity.