A study on coronal incision for treating zygomatic complex fractures

Abstract

Objective To study the value of coronal incisions for treating zygomatic complex fractures and evaluate the advantages, indications and complications associated with it. Method In this prospective study, 12 patients were randomly selected regardless of age, sex requiring open reduction and internal fixation of communited zygomatic complex fractures with or without other associated fractures of the midface. Patients were all treated by coronal approach for open reduction and internal fixation of fracture of the zygomatic complex. Other local incisions were used if required. Results In all cases postoperative complications were relatively minor except in one case were the temporal branch of facial nerve weakness persisted at 3 months. Whereas 5 cases reported with slight weakness of the temporal branch of the facial nerve which resolved at the end of 3 months. The time taken for exposure of the fracture site via the coronal incision had a mean of 28.7 minutes. There were no cases of flap infection and just 1 case of stitch abscess reported. The same case later reported with a hypertrophic scar formation of greater than 0.5cm at 3months. In all other cases scar formation was negligible and well hidden within the hairline.There were no reported cases of paraesthesia at the operated site or hollowing of the temporal fossa. ConclusionThe coronal incision provides excellent access to the zygomatic arch and zygomatic complex, aiding in good anatomical reduction and also has the added advantage of the scar hidden in the hairline. It also has disadvantages like long operating time, risk of facial nerve injury, scarring in patients with male pattern baldness, paraesthesia of operated site etc. Therefore the incision should be judiciously used and not overused and indications strictly applied.

Does Training Background Influence Outcomes after Coronal Scalp Incision for Treating Craniomaxillofacial Injuries?: A German Pilot Study

“… N/A 5 (62.5) .1 (.3; .06 to .14) vs. g .048 (.2; .04 to .99) vs. h .06 (.24; .05 to 1.1) vs. i Shetty et al . [ 23 ] (2009, India) Staffs, [single-degree/BDS] OMFS 12 (3) 28.7 ± ? (25–40) N/A ?…”

Minimizing complications associated with coronal approach by application of various modifications in surgical technique for treating facial trauma: A prospective study

“…[15] and Adam et al . [16] who, had a male to female ratio of 4:1 and study conducted on coronal approach for zygomatic complex fracture by Shetty et al .,[17] who had a male to female ratio of 12:0. Road traffic accidents are the major cause of fractures of the upper and middle third facial region (100%).…”

“…Shetty et al . [17] reported no case of hematoma in his study of coronal approach for the treatment of the zygomatic complex fractures. Hodges and Altman[14] reported that the use of stabilize drains while closing coronal flap will minimize the complication of hematoma.…”

Raney Clip Free Coronal Scalp Flap: Case Series

“…This surgical approach has been used by neurosurgeons for over a century [1]. It was originally described in 1907 by Hartley and Kenyon for use in neurosurgical procedures and then adopted by Tessier in craniomaxillofacial surgery in 1970s [1][2][3]. A coronal flap is a versatile flap used by plastics surgery [4], neurosurgery [5] and oral and maxillofacial surgery [2].…”