Clinical Application of Middle Temporal Vein in Scalp Coronal Incision

doi:10.13701/j.cnki.kqyxyj.2023.05.006

Abstract

Abstract: Objective: To investigate the application value of middle temporal vein in coronal incision flap surgery for zygomatic complex fractures. Methods: Patients with zygomatic complex fractures who were hospitalized in Department of Oral Surgery, Changsha Central Hospital from January 2016 to March 2022 and required open reduction and internal fixation with coronal incision were selected. The flap was opened with the middle temporal vein as a marker for fracture reduction, and the postoperative follow-up was more than 6 months. Postoperative wound infection, postoperative hematoma, mouth opening, facial nerve injury, temporal depression, local alopecia, fracture, and healing satisfaction of patients were collected, analyzed, and compared with the patients with zygomatic complex fracture who underwent no such modified operation in our department. Results: A total of 47 patients underwent temporal flap with coronary incision guided by the middle temporal vein for internal fixation of zygomatic complex fracture. All patients underwent primary postoperative wound healing with good fracture healing and no postoperative hematoma or facial nerve injury. There was slight temporal fossa depression in 1 case, local alopecia in 2 cases, and slight restriction of mouth opening in 3 cases. The postoperative satisfaction rate was 97.87% (46 patients). There were 31 cases in the non-middle temporal vein flap group, and postoperative fracture healing was good, but there was postoperative wound infection in 1 case, postoperative hematoma in 4 cases, mild restriction of mouth opening in 3 cases, facial nerve injury in 3 cases, including 2 cases of frontal striae disappearance and 1 case of frontal striae disappearance combined with inability to close eyes, 1 case of temporal depression, 3 cases of local alopecia, and the postoperative satisfaction was 83.87% (26 cases). The incidence of postoperative hematoma and facial nerve injury in the non-middle temporal vein group was significantly higher than that in the middle temporal vein group (P<0.05). Postoperative satisfaction of middle temporal vein group was significantly higher than that of non-middle temporal vein group (P<0.05). There was no statistical difference between temporal depression, mouth opening, and local alopecia. Conclusion: When facing zygomatic complex fracture which needs flap surgery, using temporal vein in the temporal region combined with temporal vein across zygomatic screw as the operation sign will protect the facial nerve and ensures the venous return of temporal fat layer at the same time, reduce the incidence of facial nerve injury and postoperative hematoma, and simplify the flap surgery.

Key words: middle temporal vein, coronary incision, sentinel vein, zygomatic complex, facial nerve injury, temporal depression

HE Zuwu, TIAN Tian. Clinical Application of Middle Temporal Vein in Scalp Coronal Incision[J]. Journal of Oral Science Research, 2023, 39(5): 406-411.

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