title: Deep dissection plane for endoscopic-assisted comminuted malar fracture repair.
abstract: Endoscopic technique has been used in the management of comminuted malar fractures. However, the reported dissection plane is close to the frontal branch of the facial nerve, and paralysis of the frontal muscle is sometimes noted postoperatively. From January 1998 to November 2001, 42 patients underwent endoscopic-assisted zygomatic bone repair at Kaohsiung Medical University Hospital and Kaohsiung Municipal Hsiao Kang Hospital. The zygomatic arch was approached via a dissection plane beneath the deep temporal fascia, and the plate was fixed on the upper border of the arch. The advantages of this method are 1) one temporal incision is sufficient for dealing with the zygomatic arch fracture; 2) the learning curve for endoscopic technique is shortened; 3) there is less risk of injury to the frontal branch of the facial nerve; and 4) the periosteum at the anterior and inferior border of the zygomatic arch is preserved. The deep method is a safe alternative for endoscopic-assisted comminuted malar fracture repair.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Taiwan.
authors.forename: Su-Shin
authors.initials: SS
authors.lastname: Lee
authors.forename: Sin-Daw
authors.initials: SD
authors.lastname: Lin
authors.forename: Yu-Te
authors.initials: YT
authors.lastname: Chiu
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Tsai
authors.forename: Tsai-Ming
authors.initials: TM
authors.lastname: Lin
authors.forename: Kao-Ping
authors.initials: KP
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004210:Dissection; D004724:Endoscopy; D005260:Female; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D015050:Zygoma / Q000293:injuries*