The “Double-channel, Tunnel-like” Approach for Managing Zygomatic Arch Fractures

We propose a minimally invasive surgical approach for open reduction and internal fixation (ORIF) of zygomatic arch fractures. The incision is made within the preauricular hairline. A "double-channel tunnel-like" approach achieves complete exposure of the zygomatic arch without requiring any special instruments or auxiliary incisions. This enables precise reduction and robust fixation of zygomatic arch fractures under full direct visualization. A patient presenting with a left zygomatic arch fracture following a fall underwent closed reduction via Keen technique, which proved unsuccessful. Subsequently, zygomatic arch fracture reduction and fixation were achieved via a preauricular incision. Postoperative computed tomography revealed that the fracture had been satisfactorily reduced and fixed. The postoperative scar was inconspicuous, and no injury to the frontal branch of the facial nerve was observed. This technique significantly streamlines the surgical procedure for zygomatic arch fractures.