Coronal incision for treating zygomatic complex fractures

Objectives: To study the value of coronal incisions for treating zygomatic complex fractures. Patients and methods: A retrospective study was conducted on 69 out of 83 patients regarding the indications and complications of scalp incisions for treating zygomatic complex fractures (the other 14 patients were treated by local incisions and approaches). Results: In the early postoperative period, 5 patients suffered from haemorrhage, 2 had infections, 24 patients reported immediate postoperative anaesthesia and paraesthesia affecting the supraorbital region. Six had symptoms and signs of facial nerve injury: difficulty with wrinkling the forehead or to closing the eyes. After a follow-up of 3-5 years, 6 cases suffered from a scar wider than 0.5 cm, paraesthesia in 2 cases (parietal region and temporal region), depression of the temporal fossa in 2 and 1 patient had (persistent) palsy of the temporal branch of the facial nerve. Conclusion: On one hand, coronal incisions offer advantages such as: extensive exposure to ensure exact anatomical reduction. On the other hand, this incision has disadvantages such as obvious scars, long operating time, infections, haemorrhage, paraesthesia in the operative region, palsy of the facial nerve and depression of the temporal fossa. Therefore, the indications for coronal incisions should be strictly applied, and this incision should not be overused. (C) 2006 European Association for Cranio-Maxillofacial Surgery.