Zygomatic Reduction using Infracture Technique through Intraoral and Short Preauricular Incision

Yang, Doo Byung

Abstract

Nowadays infracture technique for the zygomatic body and arch reduction has been popularized in North East Asians. Previously, we could obtain sufficient operative field to handle the zygoma through the intraoral and temporopreauricular incision, and control the amount of shaving and infracturing of zygomatic prominence. To reduce the length of the large temporopreauricular incision, we developed a technique using short 22 mm preauricular incision. We performed malar reduction with the technique in 91 cases from September, 2000 to June, 2001 using infracture technique through short 22 mm preauricular and intraoral incision. We performed posterior bony cutting on the zygomatic arch through the preauricular incision and anterior bony greenstick cutting through the intraoral incision. Then, lateral bulging of zygomatic arch was reduced with infrature and the posterior fractured ends were fixed with a microplate and 3 screws. Advantages of the technique are operative time saving, improved external scar and reduction of postoperative edema around the operative site. However, due to decreased operative field through small preauricular incision, shaving of the lateral portion of zygomatic body is limited and postoperative complications may occur such as asymmetry, undercorrection, overcorrection and incorrect contour lines. To overcome these, the correct understanding of the anatomy and much experience of operator are imperative. With this combined approach, we can sufficiently expose the zygomatic arch and body and change the lateral convex arch to a concave one. We can effectively perform the infracture technique through much smaller preauricular incision without resulting in a large and conspicuous external scar.