Approach of the Zygoma Complex Fractures Through the Zig-zag Coronal Incision.

Yoon, Eul Sik; Koo, Sang Hwan; Park, Seung Ha; Ahn, Duck Sun

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1999;26(1):68-73.
Published online January 1, 1999.

Approach of the Zygoma Complex Fractures Through the Zig-zag Coronal Incision.

Eul Sik Yoon, Sang Hwan Koo, Seung Ha Park, Duck Sun Ahn

Department of Plastic and Reconstructive Surgery, College of Medicine, Korea University, Seoul, Korea.

Abstract

The ideal surgical approach to treat craniomaxillofacial fractures should provide maximum exposure of the fractured segments, ensure less potential for injury to facial structures, and allow for good cosmetic results. The most frequently used approach is the coronal incision. However, the coronal approach poses some disadvantages. The most common complication is widening of the scar at the head. The inevitable scar, whether narrow or wide, produce a natural separation of the hair. Also, hairline recession may expose the scar above the level of the ear and preauricular sensory deficits and motor deficits involving the frontal branch of the facial nerve have been reported. In order to avoid above problems, we have used zig-zag coronal incision with a postauricular extension from September, 1996 to May, 1998 in 35 cases with diagnosis varying from zygoma complex fracture to extensive facial fracture. Clinical follow-up ranged from 2 to 22 months. In our series of 35 patients, one patient had hematoma, one patient transient weakness of the frontalis muscle and one patient had sensory deficit. We found that this approach maintains the advantages of lowering the pivot point but also lessens the disadvantages of an anterior incision and unlike the straight-line coronal incision, this incision line is immediately much less visible.

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