Re-Examination of the Maxillary Vestibular Approach with Emphasis on Facial Mimetic Muscle Preservation

J Maxillofac Oral Surg. 2024 Jun;23(3):534-537. doi: 10.1007/s12663-023-02055-7. Epub 2023 Nov 17.

Abstract

Introduction: The standard Keen's or the maxillary vestibular incision allows direct access to the zygomatico-maxillary complex with inadvertent transection of the facial muscles and more laborious visualisation of the zygoma.

Materials and methods: We describe modifications to the vestibular and Keen's technique, based on identification and re-orientation of the facial muscles as well as utilisation of anatomical gaps between the facial mimetic muscles.

Conclusion: Our modifications are based on the principle of facial mimetic muscle identification, preservation and re-orientation to near normal anatomy.

Keywords: Facial muscles; Modified Keen’s approach; Modified maxillary vestibular approach; Zygoma.