Case presentation
A 23 year old male patient reported to the department of oral and
maxillofacial surgery with a chief complaint of swelling and pain in
left side of face. The patient gave a history of fall from height
causing trauma to face 8 days back at the time of presentation. On
examination, a depression was found on the left pre-auricular region
(Fig:1,2).
Palpation over the same area revealed step deformity and tenderness.
Patient had restricted mouth opening, however the occlusion was
satisfactory. The patient was subjected to routine investigations and
radiographs like submentovertex view and CT scan. Both the
submentovertex (Fig:3)and CT scan (Fig:4,5) reveals left side zygomatic
fracture with depressed arch. A diagnosis of left sided isolated
zygomatic arch fracture was made based on the clinical examination and
radiographs.
The case was posted for surgery under general anaesthesia. Pre
operatively USG was used to identify the zygomatic arch fracture.
Marking was done (Fig:6). Pre op USG shows discontinuation of left side
of zygomatic arch due to fracture (Fig:7). Reduction of the zygomatic
arch fracture was done by Gille’s temporal approach using Rowe’s
zygomatic elevator. Post reduction USG was done to evaluate the fracture
site which shows the reduced arch (Fig:8). Post-operative recovery was
uneventful with good mouth opening and with no cosmetic deficit.