Lee Su-Shin, Lin Sin-Daw, Chiu Yu-Te, Tsai Chih-Cheng, Lin Tsai-Ming, Chang Kao-Ping
Division of Plastic and Reconstructive Surgery, Department of Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Taiwan.
Ann Plast Surg. 2002 Nov;49(5):452-9. doi: 10.1097/00000637-200211000-00002.
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.
内镜技术已被用于处理粉碎性颧骨骨折。然而，报道的解剖平面靠近面神经额支，术后有时会出现额肌麻痹。1998年1月至2001年11月，42例患者在高雄医学大学附属医院和高雄市小港医院接受了内镜辅助颧骨修复术。通过颞深筋膜下方的解剖平面进入颧弓，将接骨板固定在颧弓上缘。该方法的优点是：1）一个颞部切口足以处理颧弓骨折；2）缩短了内镜技术的学习曲线；3）面神经额支损伤风险较小；4）保留了颧弓前下缘的骨膜。该深部方法是内镜辅助粉碎性颧骨骨折修复的一种安全替代方法。
