The
endoscope has been used to visualise the upper face and brow in aesthetic facial surgery which is performed without a coronal incision. We applied these principles to repair
zygomatic fractures with the aid of a 4 mm, 30 degree
telescope inserted through a small temporal incision. Fracture sites at the zygomatic arch and the zygomaticofrontal
suture were exposed and fixed with miniplates under endoscopic control. This technique was used in 15 consecutive patients including 2 with isolated zygomatic arch
comminuted fractures and 13 having displaced
zygomatic fractures with segmental, displaced zygomatic arch fractures. Nine patients were men and six patients were women with a mean age of 35 years. Three patients had associated
mandibular fractures. The periods of follow-up ranged from 3 to 22 months. Two patients developed transient frontal nerve
palsy which recovered within 2 months. One patient had mild temporal hollowing on the side of the facial fracture. All patients achieved the adequate anatomic reduction and satisfactory malar symmetry. There has been no case of chewing problems, cheek
numbness or progressive
enophthalmos developing postoperatively. Application of the
endoscope in
zygomatic fracture repair minimises the scalp
scar, avoids forehead
numbness, provides a comfortable postoperative recovery and shortens
hospital stay. Careful preoperative evaluation and proper surgical technique are mandatory for achieving optimal results in selected patients.