A Modified Pre-auricular Approach in the Treatment of Orbital Zygomatic Maxillary Complex Fractures

Objective: This study aimed to evaluate the safety of a modified pre-aricular approach in the treatment of orbital zygomatic maxillary complex fractures. Methods: This was a retrospective study of clinical data from 108 adults who were diagnosed with orbital zygomatic maxillary complex fractures and undergo open reduction and internal fixation through a modified pre-auricular approach. Exophthalmometry and limitation of extraocular muscle movement were determined using a Hertel exophthalmometer or synoptophore examination respectively. Primary complications were recorded, and postoperative facial nerve injury was tested by electrophysiologic analysis. Results: All patients received satisfied functional and cosmetic results at least 6 moths postoperatively. There were 2 cases (1.85%) involving complete or incomplete facial nerve injury confirmed by electrophysiologic analysis. The incidence of other postoperative complications including a hematoma rate of 1.85% patients and permanent hypesthesia or paresthesia in 2.78% of patients, and no cases of clinically significant temporal hollowing, alopecia, infection, or unacceptable scars encountered during a mean follow-up period of 2 years. Conclusion: A modified pre-auricular approach with dissection deep to the temporalis fascia offers a safe and reliable surgical technique for accessing the malar arch in orbital zygomatic maxillary complex fractures. Address correspondence and reprint requests to Zhengkang Li, MD and Yuan Deng, PhD, MD, Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China; E-mails: lizhengkang58@hotmail.com, ophden@163.com Received 15 May, 2018 Accepted 16 June, 2018 This work was supported by the National Natural Science Foundation of China (81501605), the Chenguang Plan of the Shanghai Education Development Foundation (16CG16) and the Science and Technology Commission of Shanghai (17DZ2260100). The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

https://ift.tt/2P8m5ex