A 35-year-old man was punched on the right side of the face. He has a palpable depression over the right zygomatic arch, limitation of mandibular opening due to impingement of the coronoid process, but normal vision, normal occlusion and no malar flattening. The best approach for elevation of this fracture is:
- A Intraoral gingivobuccal (Keen) approach
- B Subciliary lower eyelid approach
- C Gillies temporal approach ✓
- D Coronal approach
Correct answer: C. Gillies temporal approach
Explanation
An isolated depressed zygomatic arch fracture without ocular or occlusal disturbance is classically reduced by the closed Gillies temporal approach: an incision in the temple hairline, dissecting deep to the temporalis fascia onto the underlying temporalis muscle, and elevating the arch with an instrument passed beneath it. The Keen intraoral approach is used for ZMC reduction, the subciliary approach for the orbital floor, and the coronal approach for extensive panfacial or frontal bone injuries.
Reference: Peterson's Principles of Oral and Maxillofacial Surgery, 3rd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.