- Access to Zygomatic Arch.
- Access to Malar fractures.
- Localised hair loss around incision site.
- Weakness of temporal branch of facial nerve.
- Shaving hair from surgical incision area.
- Failure of procedure (this is a closed procedure at a distance from the injury site).
- Temporal incision in scalp 2.5-3cm anterior to the helix.
- Do at angle, right angles to direction the Rowe's goes into.
- Cut down through temperoparietal fascia and down to temporalis fascia and bipolar diathermy- open tissue planes with scissors.
- Cut through temporalis fascia and temporalis muscle will show through.
- Hold medial end of fascia with a clip.
- Slide Howarths under the fascia and under the zygoma.
- Exchange Howarths for Rowe's elevator.
- Lift zygoma while assistant holds the head of the patient.
- Monitor intraoperative ECG during zygoma lift for sudden bradycardia. (See Oculocardiac Reflex)
- Suture all layers of scalp as a whole unit with 3/0 vicryl.
Figure 1 - Demonstration of Rowe's elevator position. (Image courtesy of Mr Luis Bruzual)
Author: Johno Breeze
Last Update: 1/5/2015