Application of endoscope in zygomatic fracture repair

The endoscope has been used to visualise the upper face and brow in aesthet ic facial surgery which is performed without a coronal incision. We applied these principles to repair zygomatic fractures with the aid of a 4 mm, 30 degree telescope inserted through a small temporal incision. Fracture sires at the zygomatic arch and the zygomaticofrontal suture were exposed and fi xed with miniplates under endoscopic control. This technique was used in 15 consecutive patients including 2 with isolate d zygomatic arch comminuted fractures and 13 having displaced zygomatic fra ctures with segmental, displaced zygomatic arch fractures. Nine patients we re men and six patients were women with a mean age of 35 years, Three patie nts had associated mandibular fractures. The periods of follow-up ranged from 3 to 22 months. Two patients developed transient frontal nerve palsy which recovered within 2 months. One patient had mild temporal hollowing on the side of the facial fracture. All patien ts achieved the adequate anatomic reduction and satisfactory malar symmetry . There has been no case of chewing problems, cheek numbness or progressive enophthalmos developing postoperatively. Application of the endoscope in zygomatic fracture repair minimises the sca lp scar, avoids forehead numbness, provides a comfortable postoperative rec overy and shortens hospital stay Careful preoperative evaluation and proper surgical technique are mandatory for achieving optimal results in selected patients. (C) 2000 Harcourt Publishers Ltd.