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  • Transposition of Zygomatic Arc in Replacement of Orbital Wall Defects

    Final Number:

    Abdulkerim Gokoglu MD(1); Ayhan Comert(2); Turker Kilic MD(3)

    Study Design:
    Laboratory Investigation

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting - Late Breaking Science

    Introduction: Reconstruction of orbital wall defects perturb surgeons not only for cosmetic problems but also for facing the risqs of clinically significant functional ophthalmic disturbances as enophthalmos or dystopia. Traumas,infections,tumoral invasions and/or iatrogenic extensive bone resections are known main causes of orbital wall defects

    Methods: 2 fixed head cadavers on four sides were used in order to define incision technique, the anatomy of zygomatic arc(ZA) and neigbourhood in BAU, Rhoton's Anatomy Lab,Istanbul.Mayfield head-holders were used for positioning.Titanium miniplate and mini screws systems utilized for attachement of ZA autogrefts in replacement orbital wall defects in unison.

    Results: Optimal positioning principles for best exposure of anatomical landmarks has been defined.The modification of Al-Mefty’s cranioorbitozygomatic approach incision with Gillie’s was performed in order to dissect zygomatic arc(ZA)(Figure-1). The anatomy of ZA is defined with measures(Figure-2, Figure-3). Successful well-matched replacement of ZA autogreft attached with mini-plate/screw sytems has shown as lateral and/or superior orbital walls in Figure-3.

    Conclusions: Modifications of different incison techniques may result better exposure. Detailed anatomical definitions of selected anatomical regions and neighbourhood is essential in order to avoid complications. Zygomatic arc transposition may be a feasible, economical technique with other known advantages of autogrefts, and also very handy in emergency cases.

    Patient Care: Known advantages of autogenous grefts are expected to have better results in orbital reconstruction.

    Learning Objectives: To obtain a cosmetic and estehetic results after surgery of orbital pathologies. Safe, economic and less risqué material as an autogreft and other known advantages of autogreft


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