Evaluating Vertical Versus Horizontal Vestibular Incision in Treating Zygomaticomaxillary Fractures

The zygomatic buttress is the functionally and structurally important vertical buttress. The strength and support of the midface are mainly by the buttresses. A study was done to evaluate and compare vertical with horizontal vestibular incision to reduce and plate fractures involving zygomatic buttress. Intraoperative evaluation and comparison of exposure time and time taken for surgery, herniation of the buccal fat pad and exposure of the fracture site were performed, followed by postoperative evaluation and comparison of pain, wound, sialocele formation and infection done on 7th, 14th and 21st days. Horizontal incision gives limited accessibility and visualization, with buccal fat interference and difficulty in suturing the distal part of the incision. It also, in some instances, caused injury to Stenson’s duct. An obliquely placed vertical incision eliminates the need to reflect all muscle attachments and provides a good amount of soft tissue for closure. Vertical incision shows no instances of injury to the duct of the parotid gland.