Modified Gillies approach for zygomatic arch fracture reduction in the setting of bicoronal exposure

The Journal of Craniofacial Surgery
Edward SwansonChad R Gordon

Abstract

Zygomatic arch fractures are common injuries, occurring in isolation in 5% of all patients with facial fractures and in 10% of patients with any fracture to the zygomaticomaxillary complex. Isolated noncomminuted depressed zygomatic arch fractures are easily treated with the minimally invasive Gillies approach, which most often provides long-term stability. However, zygomatic arch fractures often occur in conjunction with zygomaticomaxillary complex, Le Fort, calvarial, and naso-orbitoethmoid fractures. In situations requiring a bicoronal incision to address concomitant injuries, zygomatic arch fractures are frequently treated with wide dissection and rigid fixation. Using principles obtained from isolated arch fractures, we present for the first time to our knowledge the use of a modified Gillies approach to noncomminuted zygomatic arch fractures in a case requiring a bicoronal incision. With the deep temporal fascia exposed from the reflected bicoronal flap, a 1-cm horizontal incision is made within the deep temporal fascia allowing a Gillies elevator to easily reduce the arch fracture in a plane between the deep layer of the deep temporal fascia and the temporalis muscle. This technique exploits the advantages of the traditi...Continue Reading

References

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Citations

Nov 8, 2015·Oral and Maxillofacial Surgery·Christian PedemonteHernán Pérez
Aug 6, 2013·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Xiang-Zhen LiuXin Liao
May 24, 2016·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Sae Bin LeeHyun Jin Min
May 10, 2018·The Journal of Craniofacial Surgery·Jinwoo Kim, Woosuk Hwang
Apr 28, 2016·Plastic and Reconstructive Surgery·Ziv M Peled
Nov 14, 2013·The Journal of Craniofacial Surgery·Furkan CertelAyhan Numanoğlu
May 21, 2019·Plastic Surgery·Hakan CinalOnder Tan
Nov 14, 2013·The Journal of Craniofacial Surgery·Ozgur PilanciSamet Vasfi Kuvat
Jul 10, 2020·Craniomaxillofacial Trauma & Reconstruction·Jason E CohnSeth Zwillenberg
Jan 27, 2021·BMJ Case Reports·Santhosh RaoSruthi Rao

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