Zygomatic fractures, Maxillofacial injuries, Facial nerve injuries, Fracture fixation, internal, Minimal surgical procedure, Surgery, RD1-811

Abstract Background Zygomatic complex fractures are prevalent among maxillofacial bone injuries due to the prominence of the zygomatic arch, which can significantly impact facial aesthetics and the ability to open the mouth. Although non-surgical interventions are available for mild cases, severe fractures necessitate surgical intervention. The surgical repair of zygomatic arch fractures poses a risk of injuring the temporal branch of the facial nerve (TBFN). This study aimed to develop a modern modification to reduce the probability of common complications. Method We conducted a retrospective study involving 163 patients at the Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, spanning from March 2021 to June 2024. Our study introduced a novel modification of the temporal hairline approach for the treatment of these fractures. Results Among the patients who underwent the modified approach (n = 38), there were no instances of TBFN injuries. In contrast, the traditional approach (n = 125) resulted in 17 cases of nerve-related complications. Conclusion Our findings indicate that the modified temporal hairline approach offers distinct advantages in minimizing the risk of TBFN injury with minimally noticeable scarring, while ensuring that the fracture is securely repaired. This provides a new safe surgical approach option for the osteosynthesis of zygomatic arch fractures.