Gruss J S, Van Wyck L, Phillips J H, Antonyshyn O
Division of Plastic Surgery, Sunnybrook Medical Centre, Toronto, Ontario, Canada.
Plast Reconstr Surg. 1990 Jun;85(6):878-90. doi: 10.1097/00006534-199006000-00008.
Collapse of the zygomatic arch following trauma results in inadequate anteroposterior projection of the zygomatic body and an increase in facial width. Accurate assessment of the position of the zygomatic arch in relation to the cranial base posteriorly and the midface anteriorly is the key to the acute repair of complex midfacial fractures and the secondary reconstruction of posttraumatic deformities of the orbitozygomaticomaxillary complex. Loss of projection of the zygomatic arch may occur with injuries confined to the orbitozygomaticomaxillary region or in association with complex midfacial fractures. A safe anatomic approach to the zygomatic arch allows exact anatomic restoration of the zygomatic arch using miniplates and screws and results in the reconstruction of an outer facial frame with a correct anteroposterior projection and facial width. The zygomatic arch injury is diagnosed using axial CT scanning. Three-hundred and seventeen arches have been exposed through a coronal incision following acute trauma and 47 arches have been exposed in patients requiring late correction of a posttraumatic orbitozygomaticomaxillary deformity. Permanent palsy to the frontal branch of the facial nerve has occurred in one patient following the exact definition of the anatomy of this region.
创伤后颧弓塌陷会导致颧体前后投影不足，面部宽度增加。准确评估颧弓相对于后方颅底和前方中面部的位置，是复杂中面部骨折急性修复以及眶颧上颌复合体创伤后畸形二期重建的关键。颧弓投影丧失可能发生于局限于眶颧上颌区域的损伤，或与复杂中面部骨折相关。一种安全的颧弓解剖入路可使用微型钢板和螺钉实现颧弓的精确解剖复位，并重建具有正确前后投影和面部宽度的面部外框架。颧弓损伤通过轴向CT扫描进行诊断。急性创伤后有317例通过冠状切口暴露了颧弓，47例在需要晚期矫正创伤后眶颧上颌畸形的患者中暴露了颧弓。1例患者在精确界定该区域解剖结构后出现了面神经额支永久性麻痹。
