Approaching the zygoma with an endoscope.

A hemicoronal or coronal incision is required in combination with a buccal incision to expose the zygoma, including zygomatic process of the temporal bone, and lateral orbital rim under direct visualization. An endoscope was used to expose zygoma in selected cases to reduce the length of the incision. The zygomatic bone and arch were exposed and corrected using an endoscope in eight cases of zygomatic fracture and one case of zygomatic reduction through a small incision just behind the temporal hairline together with a buccal incision. The results obtained were satisfactory with no complications. Clear, magnified endoscopic visualization made it possible to correct some deformities located in this area without using a coronal incision. Endoscopic procedures result not only in dramatically less postoperative scarring because of the small access incisions, but they also cause less damage to vascular and lymphatic circulation and, therefore, are associated with less postoperative edema. However, the fixation of the zygomatic arch using the percutaneous method with an endoscope is a complicated procedure that requires more time than conventional procedures.