OMFS Board Exam Review #3 - Zygomatic Arch Fracture, Gillies Approach, Key Anatomy & Complications

Top 5 Topics:

- Zygomatic Arch Fracture Diagnosis – clinical signs, imaging choice, treatment approach

- Gillies Approach Surgical Technique – step-by-step breakdown with incision placement, anatomy, and reduction method

- Key Anatomical Landmarks – protecting the superficial temporal artery and avoiding facial nerve injury

- Post-Op Complications – trismus, temporalis muscle scarring, coronoid impingement, and how to assess them

- Intraoperative Imaging & Layer Dissection – Waters view vs. CT, and the precise layers to reach deep temporalis fascia

*** These are live recordings of my review sessions for the oral OMFS boards that I’ll be taking in January 2025 - I can get answers and concepts wrong! Please comment, DM me, or text me with any corrections, additions, or your own board prep tips on these topics so we can learn from my mistakes. ***

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Questions:

00:00 – What’s the most likely diagnosis for a patient with facial asymmetry, crepitus, and trauma to the zygomatic arch?

01:37 – Why is a non-contrast facial CT preferred over other x-rays for diagnosing complex facial fractures?

02:53 – How is the Gillies approach performed for a displaced zygomatic arch fracture?

04:18 – What’s the key anatomical landmark to avoid during dissection and why?

06:55 – Can Waters view be used intraoperatively to confirm fracture reduction, and when is it appropriate?

08:24 – Step-by-step review of the layers of dissection from skin to deep temporalis fascia in the Gillies approach.

10:12 – Where does the temporal branch of the facial nerve run in relation to the surgical planes?

11:26 – What instrument is used to elevate the zygomatic arch during Gillies, and what’s a key complication to avoid?

13:12 – How to prevent facial nerve injury and ensure stable fracture reduction post-surgery.

Now available on:

- Dr. Gallagher’s Podcast & YouTube Channel

My watch in this episode = Citizen Promaster Diver Day Date

- 8.2025

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