Clinical Experience of Zygomatic Arch Fracture Reduction Using Surgical Navigation: A Single-Institution Case Series

Background and Objectives Zygomatic arch fractures are common facial injuries that may lead to facial asymmetry and functional impairment. Recently, minimally invasive techniques, such as the Gillies approach, have been widely adopted to treat the fractures. This study aimed to evaluate the clinical outcomes of applying an image-guided navigation system using the Gillies approach for the reduction of isolated zygomatic arch fractures.Subjects and Method A retrospective review was performed for 25 patients who underwent zygomatic arch fracture reduction using the Gillies approach assisted by an image-guided navigation system at a single tertiary center over the past 10 years. The precise positioning of the reduction instrument and the restored anatomical contour of the zygomatic arch were verified intraoperatively using the navigation system. Preoperative symptoms, including facial asymmetry and trismus, were recorded, and postoperative outcomes were assessed using 3D CT imaging at 3 months postoperatively.Results Most fractures occurred on the left side and were most frequently caused by slipdown injuries. All patients showed satisfactory cosmetic and functional outcomes. Trismus observed preoperatively in 13 patients was resolved in all cases. No postoperative complications, such as facial nerve palsy or infection were noted. Based on postoperative CT evaluation, reduction outcomes were classified as good in 16 cases and moderate in 9 cases.Conclusion The use of an intraoperative image-guided navigation system along with the Gillies approach enabled accurate and safe reduction of zygomatic arch fractures. The navigation system allowed real-time confirmation of instrument positioning and anatomical contour restoration, potentially improving surgical precision and outcomes.