ENDOSCOPIC APPLICATION IN AESTHETIC AND RECONSTRUCTIVE FACIAL BONE SURGERY

Twenty-three cases of endoscopically assisted facial bone surgery were performed over the past 3 years. Our series is consistent with 16 cas es of aesthetic contouring surgery and 12 treatments of facial bone fr acture, including three cases for recontouring of frontal bone, three cases for recontouring of zygoma, endoscopically assisted correction o f three zygomatic and blowout fractures, four cases for rhinoplasty an d septoplasty for deviated nose, and three cases for mandible contouri ng surgery. To accomplish this technique, a rigid 4-mm, 30-degree down -angled endoscope was used. The frontal bone or zygomatic arch was app roached endoscopically through two or three small incisions on the fro ntal or temporoparietal scalp. All endoscopic instruments were then ma nipulated through these incisions. The approach for endoscopically ass isted rhinoplasty is the same as with standard rhinoplasty procedures. The approach for zygoma complex and maxillary sinus needs an intraora l incision. Recontouring of zygoma, mandible, and nasal dorsum by an a ir-driven burr and rasp was performed with endoscopic visual assistanc e. A plate and screw fixation for zygomatic arch fracture requires an additional small skin incision over the plate for the trocar method. T he duration of follow-up ranged from 6 months to 30 months. The postop erative course was satisfactory with a few complications. The extra ti me needed for the endoscopic procedures was less than I hour. Endoscop ically assisted facial bone surgery can be performed with adequate vis ualization and direct manipulation of all facial bones. Complications usually associated with extensive incisions in the bicoronal approach may be avoided. Poor visualization in the conventional approach for op eration of orbit, nose, maxillae, and mandible may be avoided by use o f the endoscope. This technique may prove to be ideal for aesthetic su rgery for facial skeleton with smaller scar and less morbidity.