title: Single buccal sulcus approach with fluoroscan assistance for the management of simple zygomatic fractures.
abstract: BACKGROUND
  Zygomatic fractures are associated with functional and aesthetic problems. The purpose of this study was to evaluate the adequacy of management and the surgical satisfaction of patients with simple zygomatic fractures treated through a single buccal sulcus approach and fluoroscan assistance.
  
  
  METHODS
  Between 2008 and 2012, 42 patients with simple zygomatic fractures were included in the study. The surgical procedure was performed through a single buccal sulcus incision. The fracture sites were aligned under direct vision and fluoroscan assistance and stabilized with rigid internal fixation. The adequacy of reduction was evaluated based on postoperative plain radiographic films and computed tomographic scans using mirror image analyses. The satisfaction of functional and aesthetic results was also evaluated subjectively using a visual analog scale during follow-up.
  
  
  RESULTS
  Twenty-nine male and thirteen female patients with a mean age of 33.2 years were evaluated. Motorcycle crashes (78.6%) were the most common mechanism of trauma. Based on follow-up imaging studies, 2 patients had inadequate reduction of zygomatic body, and there was a slight depression of the zygomatic arch in one patient. Ninety-three percent (39/42) of patients had satisfactory results, although one patient complained of malar asymmetry and another felt a depression in the arch area. Two patients complained of persistent hypesthesia during follow-up at 6 months.
  
  
  CONCLUSIONS
  Our results suggest that a single buccal sulcus approach without lower eyelid or lateral eyebrow incision in the repair of simple fractures of the zygoma can be achieved with high patient satisfaction if the reduction and fixation are adequate and stable.
authors.affiliation: From the *Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC; and †Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Keelung, Chang Gung University College of Medicine, Keelung, Taiwan, ROC.
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Chen
authors.forename: Shih-Hsuan
authors.initials: SH
authors.lastname: Mao
authors.forename: Victor Bong-Hang
authors.initials: VB
authors.lastname: Shyu
authors.forename: Chien-Tzung
authors.initials: CT
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000601:surgery; D019637:Orthopedic Procedures / Q000379:methods; D017060:Patient Satisfaction; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D055815:Young Adult; D015051:Zygomatic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*