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Olivetto M, Testelin S. Use of intraoperative 3D imaging in the maxillofacial operating room: A French national survey. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101542. [PMID: 37394099 DOI: 10.1016/j.jormas.2023.101542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 06/18/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE To gain a comprehensive understanding of the utilization of intraoperative 3D imaging among maxillofacial surgeons practicing in France through a web-based questionnaire. METHODS An 18-point multiple-choice questionnaire was developed and distributed to participants. The questionnaire was divided into two sections, with the first section gathering general information about the respondents and the second section providing an overview of the utilization of 3D imaging techniques, such as cone-beam computed tomography (CBCT), computed tomography (CT) scan, and magnetic resonance imaging (MRI), including the conditions, frequencies, and indications for use, with a particular focus on the number of acquisitions per procedure and the other departments with whom the equipment is shared. RESULTS A total of 75 participants completed the survey, with 30% of university hospital departments and 0% of private clinics currently utilizing intraoperative 3D imaging systems. The main indications for 50% of the users were for temporomandibular joint surgery and orbital fractures. CONCLUSION The results of this survey indicate that the utilization of intraoperative 3D imaging in French maxillofacial surgery is limited to university centers, with poor utilization and a lack of standardization in indications for use.
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Affiliation(s)
- Matthieu Olivetto
- Department of Maxillofacial Surgery, Hospital Center of Annecy-Geneva, Annecy, France.
| | - Sylvie Testelin
- Department of Maxillofacial Surgery, University Hospital of Amiens-Picardy, Amiens, France
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Gong J, Zhao R, Zhang W, Li J, Yuan Z, Ma D. Role of Intraoperative Imaging in Improving Closed Reduction of Zygomatic Arch Fractures: A Systematic Review and Meta-analysis. J Oral Maxillofac Surg 2023; 81:1504-1516. [PMID: 37775088 DOI: 10.1016/j.joms.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/08/2023] [Accepted: 09/05/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE The use of intraoperative imaging (IOI) to improve the reduction adequacy of zygomatic arch (ZMA) fractures has been reported, but few systematic reviews have examined this topic. The aim of this review was to investigate and compare the value of IOI with conventional methods without IOI (N-IOI) for the closed reduction of ZMA fractures. METHODS Electronic retrieval of MEDLINE, Embase, Cochrane Library, Web of Science, Scopus, and citation search until December 2, 2022, was used to identify controlled clinical trials that employed IOI for improving adequacy in closed reduction of ZMA fractures. The predictor variable was the use of IOI-yes/no (IOI vs N-IOI). The covariates included imaging technique (ultrasound, C-arm, and cone beam computed tomography) and ZMA fracture type (M-shape fracture, mechanistic force in 1 direction; variable fracture, mechanistic force in 2 directions). The primary outcome variables were the reduction adequacy of ZMA fractures (the remaining cortical step and dislocation angle) compared with the ideal mirrored position. Weighted or mean differences, risk ratios, and corresponding 95% confidence intervals were calculated, where P >.05 and I2<50% fixed effect model was adopted, and a vice versa random effect model was adopted. RESULTS A total of 1250 studies were identified, of which 6 studies with 259 participants were included. The meta-analysis results indicated that compared with N-IOI, IOI yielded fewer cortical steps (-1.76 [-2.42, 1.10], P <.00001, fixed model) and dislocation angles (-5.60 [-8.08, 3.12], P<.00001, fixed model) in patients with variable ZMA fractures, while no significant difference was detected in the M-shape ZMA fracture (-0.72, [-2.93, 1.48], P = .52; -1.48, [-3.51, 0.55], P = .15). Although there was no significant difference in postoperative correction (0.35, [0.06, 2.01] P = .24, fixed model), all secondary revision cases occurred in the N-IOI group. Descriptive analysis showed that IOI yielded better symmetry and appearance satisfaction. CONCLUSION IOI improved the adequacy of the procedure and led to a better postoperative appearance, especially for patients with variable ZMA fractures. Furthermore, the use of IOI avoided the risk of secondary surgery. In future studies, researchers should standardize the scale and outcomes to facilitate the intuitive evaluation of reduction adequacy.
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Affiliation(s)
- Jiaming Gong
- Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou City, PR China; Department of Stomatology, Quzhou Hospital Affiliated to Wenzhou Medical University, PR China
| | - Ruimin Zhao
- Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou City, PR China; Department of Stomatology, Quzhou Hospital Affiliated to Wenzhou Medical University, PR China
| | - Wenlong Zhang
- Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou City, PR China; School of Stomatology, Lanzhou University, Lanzhou City, PR China
| | - Jianxue Li
- Department of Stomatology, The 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou City, PR China
| | - Zhenfei Yuan
- Department of Stomatology, Quzhou Hospital Affiliated to Wenzhou Medical University, PR China
| | - Dongyang Ma
- Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou City, PR China; School of Stomatology, Lanzhou University, Lanzhou City, PR China.
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Srivastava S, Tandon S, Verma V, Rashid M, Sharma NK. C-Arm a Useful Tool for Surgeons in Reduction of Zygomatic Complex Fracture: A Comparative Study: Article Type-Original Research. Indian J Otolaryngol Head Neck Surg 2023; 75:379-384. [PMID: 37275039 PMCID: PMC10235316 DOI: 10.1007/s12070-022-03221-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/24/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction Reduction of zygomaticomaxillary (ZMC) fracture is often difficult to evaluate intraoperatively because of it peculiar anatomy and limited accessibility. The purpose of this study is to evaluate the efficacy of use of C-arm as a tool for intraoperative monitoring of ZMC fracture reduction. Materials and Methods Group I (C-Arm) and Group II (control group) comprised of patients with isolated unilateral displaced Zygomatic complex (ZMC) fractures and having orbital volume change. The efficacy of use of C-arm intra-operatively was evaluated to analyse the reduction of fracture. Results It was observed that mean change in ocular volume was around 1.07cm2 for Group I and 1.51cm2 in Group II. Thus post-operative eye volume was near to normal in Group I than Group II. The change in ocular volume post-operatively was observed to be statistically significant (p-value < 0.05) in both the groups. Post HOC Tukey statistical analysis determined the intergroup relation in change in eye volume between normal, pre- and post-operative and was found to be statistically significant (p-value < 0.05). The intergroup comparison between Group I and Group II was done using ANOVA statistical analysis and was found to be statistically significant (p-value < 0.05). Discussion Our study revealed that C-arm is definitively an effective tool in the oral and maxillofacial surgery armamentarium, giving better results with minimal surgical exposure and by eliminating operator related error. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03221-y.
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Affiliation(s)
| | - Sapna Tandon
- Dept. Of Oral And Maxillofacial Surgery, Trauma Centre,IMS, BHU, Varanasi, India
| | - Vishal Verma
- Dept. Of Otorhinolaryngology, Era Medical College, Lucknow, India
| | - Mohd Rashid
- Dept. Of Otorhinolaryngology, Era Medical College, Lucknow, India
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Kumar J, Kumar S, Kapoor S, Thakker R, Bhatnagar A, Singh M. Use of intraoperative C-arm fluoroscopy in open reduction and internal fixation of mandibular condyle fracture - A case report. Ann Maxillofac Surg 2022; 12:114-116. [PMID: 36199452 PMCID: PMC9527832 DOI: 10.4103/ams.ams_40_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
The Rationale: Condyle fractures are a common type of mandibular fracture that can result in malocclusion. Open reduction and internal fixation (ORIF) in condylar fracture is considered as the most acceptable treatment modality. Patient Concerns: The patient complained of pain and difficulty in the jaw while chewing. Diagnosis: An orthopantomogram and reverse Towne’s view can lead to diagnosis of the condylar fracture. Treatment: Open reduction and internal fixation using intraoperative real-time visualisation of subcondylar fracture reduction utilising the C-arm fluoroscopic approach were used to allow for adequate anatomical repositioning and fast restoration of function to meet the patient’s concerns. Outcomes: We were able to achieve correct reduction of the fracture fragments with restoration of function and occlusion. Take-away Lessons: When this procedure is used to treat condylar fractures, surgeons can get a better view of the fracture segments while eliminating the need for postoperative intermaxillary fixation and also reduces the complications from inappropriate reduction and fixation.
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Acharya P, Dongol A, Yadav AK, Bhattarai N, Jaisani MR. Intra-operative application of ultrasonography (USG) for reduction of zygomatic arch fracture. Clin Case Rep 2021; 9:e05067. [PMID: 34795898 PMCID: PMC8582023 DOI: 10.1002/ccr3.5067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 10/17/2021] [Accepted: 10/26/2021] [Indexed: 11/26/2022] Open
Abstract
Zygomatic arch fractures are the most common facial fractures or second in frequency after the nasal fractures. The high incidence of zygomatic fractures probably relates to its prominent position in the facial skeleton; hence, it is frequently exposed to fractures. This case report presents an left-sided isolated zygomatic arch fracture after subjected to routine investigations and radiographs like submentovertex and CT scans. The patient was operated under general anesthesia for the reduction of zygomatic arch by Gille's temporal approach with the use of Ultrasound intra-operatively. Recommendation for the use of ultrasonography in the identification of zygomatic arch fractures intra-operatively operatively.
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Affiliation(s)
| | - Ashok Dongol
- B.P. Koirala Institute of Health SciencesDharanNepal
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Singh A, Dhungel S, Kayastha P, Roychoudhury A, Jose A. Does additional intraoperative imaging improves outcomes in isolated zygomatic arch fractures: Systematic review. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Singh AK, Dhungel S, Yadav M. Intraoperative ultrasound imaging in the closed reduction of zygomatic arch fracture: Getting it right the first time. ORAL AND MAXILLOFACIAL SURGERY CASES 2020. [DOI: 10.1016/j.omsc.2020.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Sharma P, Rattan V, Rai S, Chhabbra R. Does Intraoperative Computed Tomography Improve the Outcome in Zygomatico-Orbital Complex Fracture Reduction? J Maxillofac Oral Surg 2020; 20:189-200. [PMID: 33927486 DOI: 10.1007/s12663-020-01420-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/10/2020] [Indexed: 12/01/2022] Open
Abstract
Purpose Zygomatico-orbital (ZMO) fractures pose considerable difficulty in intraoperative assessment during open reduction and internal fixation (ORIF), and this can be attributed to its three-dimensional complex anatomy and articulations. Recent advancements in the form of intraoperative imaging and navigation have led to an adequate assessment and correct reduction of these fractures minimizing chances of any revision surgery. The purpose of this study was to evaluate the advantage of intraoperative computerized tomography (CT) scan in the management of ZMO/isolated orbital complex fracture and further to develop a protocol for managing such fractures. Methods Twenty-three cases of ZMO/isolated orbital fractures were managed with ORIF, followed by an intraoperative CT scan. The evaluation was focused on the articulations of the zygoma and orbital wall reconstruction. The score of 0 and 1 was given for inadequate and adequate reduction, respectively. Necessary corrections were performed in case of improper reduction followed by a repeat CT scan if required. The reduction score was statistically correlated with number of incisions. Results In 8 (35%) out of 23 patients, clinical judgment was inaccurate when radiologically assessed with an intraoperative CT scan. In 6 out of 8 cases, a repeat CT scan was done after revision of reduction. The reduction score improved with additional incision and revision in the second CT scan. Conclusion Intraoperative CT has an important role in assessing the accuracy of reduction and confirming implant position in ZMO/isolated orbital fractures. This can avoid the need for secondary corrective surgery and postoperative imaging. Intraoperative CT is an important tool to improve surgical outcomes in the management of ZMO orbital fractures.
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Affiliation(s)
- Preeti Sharma
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Vidya Rattan
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Sachin Rai
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Rajesh Chhabbra
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
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Assouline SL, Meyer C, Weber E, Chatelain B, Barrabe A, Sigaux N, Louvrier A. How useful is intraoperative cone beam computed tomography in maxillofacial surgery? An overview of the current literature. Int J Oral Maxillofac Surg 2020; 50:198-204. [PMID: 32605822 DOI: 10.1016/j.ijom.2020.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 03/29/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
Intraoperative imaging is increasingly used by surgeons and has become an integral part of many surgical procedures. This study was performed to provide an overview of the current literature on the intraoperative use of cone beam computed tomography (CBCT) imaging in maxillofacial surgery. A bibliographic search of PubMed was conducted in March 2020, without time limitation, using "intraoperative imaging" AND "maxillofacial surgery" AND "cone beam computed tomography" as key words. Ninety-one articles were found; after complete reading, 16 articles met the eligibility criteria and were analysed. The results showed that the majority of the indications were related to maxillofacial trauma, particularly zygomaticomaxillary complex fractures. Final verification with intraoperative CBCT before wound closure was the most common use of this device. However, innovative uses of intraoperative CBCT are expanding, such as CBCT coupling with mirror computational planning, and even the combined use of initial intraoperative CBCT acquisition with navigation. Immediate, fast, and easy evaluation of bone repositioning to avoid the need for further surgical revision is the main advantage of this technique. Imaging quality is comparable to that of multi-slice computed tomography, but with lower radiation exposure. Nevertheless, CBCT is still not widely available in maxillofacial centres, probably because of its cost, and perhaps because not everyone is aware of its advantages and versatility, which are reported in this review.
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Affiliation(s)
- S L Assouline
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; Department of Oral and Maxillofacial Surgery, University Hospital of Strasbourg, Strasbourg, France.
| | - C Meyer
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France; NanomedicineLab, Imagery and Therapeutics, EA 4662, Medical Faculty, University of Franche-Comté, Besançon, France
| | - E Weber
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - B Chatelain
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France
| | - A Barrabe
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France
| | - N Sigaux
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude-Bernard Lyon 1 University, Pierre-Bénite, France; 3d.FAB platform, ICBMS, CNRS 5246 Claude-Bernard Lyon 1 University, Villeurbanne, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, France; University of Bourgogne Franche- Comté, UFR SMP, Besançon, France; University of Bourgogne Franche- Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon- Tumeur/Ingénierie Cellulaire et Génique, Besançon, France
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Johner JP, Wiedemeier D, Hingsammer L, Gander T, Blumer M, Wagner ME. Improved Results in Closed Reduction of Zygomatic Arch Fractures by the Use of Intraoperative Cone-Beam Computed Tomography Imaging. J Oral Maxillofac Surg 2020; 78:414-422. [DOI: 10.1016/j.joms.2019.10.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/28/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
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Hsu SY, Shih PK. Feasibility of a craniometry in a comminuted zygomaticomaxillary complex fracture. Medicine (Baltimore) 2019; 98:e15839. [PMID: 31192913 PMCID: PMC6587586 DOI: 10.1097/md.0000000000015839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Few studies have reported on using craniometry for comminuted zygomaticomaxillary complex (ZMC) fracture management. We present our experiences with this procedure and a review of the related literature.From September 2011 to October 2018, 43 patients with comminuted ZMC fracture receiving open reduction internal fixation under coronal incision were enrolled. Data on gender, age, operation time, hospital stay, duration of follow-up, vertical/horizontal differences, and complications were collected. Between-group differences (C-arm imaging vs craniometry) were evaluated using nonparametric Mann-Whitney test for continuous data and chi-square test for categorical data.No significant difference were found between the groups regarding gender, age, hospital duration, follow-up duration, and postoperative complications, except for operation time. The averaged operation time was significantly shorter in the C-arm imaging group (4.217 h) than in the craniometry group (6.193 h). The C-arm imaging group had two cases with horizontal differences >3 mm and one case with vertical differences >3 mm. The craniometry group had four cases with horizontal differences >3 mm and four cases with vertical differences >3 mm. There were no significant differences between the two groups in horizontal differences and vertical differences.Craniometry may achieve the same outcomes as C-arm imaging in comminuted ZMC fracture management; however, the former requires more time than the latter.
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Affiliation(s)
- Shao-Yun Hsu
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital
- China Medical University, Taichung
| | - Pin-Keng Shih
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital
- China Medical University, Taichung
- Department of Cosmetics and Health Care, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chiayi City, Taiwan
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Intraoperative Ultrasound Control of Zygomatic Arch Fractures: Does Additional Imaging Improve Reduction Quality? J Oral Maxillofac Surg 2019; 77:769-776. [DOI: 10.1016/j.joms.2018.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/11/2018] [Accepted: 11/12/2018] [Indexed: 01/23/2023]
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Buller J, Zirk E, Kreppel M, Grandoch A, Maus V, Zirk M, Zöller JE. Radiomorphometric analysis of isolated zygomatic arch fractures: A comparison of classifications and reduction outcomes. J Craniomaxillofac Surg 2018; 46:1252-1257. [PMID: 29884318 DOI: 10.1016/j.jcms.2018.05.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/05/2018] [Accepted: 05/09/2018] [Indexed: 10/16/2022] Open
Abstract
PURPOSE Although different proposals have been made to categorize isolated zygomatic arch fractures (ZAF), an investigation about fracture type and clinical outcome has not been published. In this study, we analyzed the geometric fracture morphology in isolated ZAF and provide a survey of reduction outcomes in accordance with 4 independent classifications. MATERIALS AND METHODS Geometric measurements were performed in radiologic images of 94 patients with isolated ZAF, which were consecutively treated by closed reduction over transbuccal approach. Fracture types were allocated to the classifications of Rowe and Williams, Honig and Merten, Yamamoto et al., and Ozyazgan et al. The odds of achieving a satisfactory outcome were calculated for all categories. RESULTS Wide preoperative dislocation angles of more than 22° presented in M-type fractures (77.1%) more frequently compared to 2 fragments without the M-shape (33.3%) and one fragment (14.8%, p < 0.001). Favorable reduction outcome was significantly higher for M-shaped fractures than for differently configured fractures (83.3% vs. 30.4%, odds ratio 11.43, confidence interval 4.27-30.61). The rate of reduction in 100%-75% was most frequent for the Honig and Merten type I as well as Ozyazgan type IBV (both 85.4%, p < 0.001) and Yamamoto type II (84.2%, p < 0.001). CONCLUSION The classifications of Honig and Merten, Yamamoto et al., and Ozyazgan were quite applicable, and subgroups showed significant increments in reduction outcome. Our analysis emphasizes that the differentiation of two clinical relevant groups, M-shaped and variable arch fractures, is feasible to manage and efficient to determine the odds of reduction outcome.
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Affiliation(s)
- Johannes Buller
- Department of Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany.
| | - Elisa Zirk
- Department of Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany
| | - Matthias Kreppel
- Department of Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany
| | - Andrea Grandoch
- Department of Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany
| | - Volker Maus
- Department of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany; Department of Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | - Matthias Zirk
- Department of Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany
| | - Joachim E Zöller
- Department of Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany
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Kim JS, Park YJ, Lee YJ, Kim NG, Lee KS. Reduction of Zygomatic Arch Isolated Fracture Using Ultra Sound and Needle Marking. Arch Craniofac Surg 2017; 17:198-201. [PMID: 28913283 PMCID: PMC5556836 DOI: 10.7181/acfs.2016.17.4.198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/10/2016] [Accepted: 12/10/2016] [Indexed: 12/03/2022] Open
Abstract
Background Zygomatic arch is a bony arch constituting the lateral midface, which consists of 25% of all midface fractures. There are a number of ways to evaluate the extent of zygomatic arch fracture. Some authors have reported successful treatment outcomes using ultrasound (U/S). To add to the previous methods, we have considered ways to accurately display the location of the fracture line while using U/S with 23 gauge needle marking. We introduce our method, which provided satisfactory results for reduction using a portable U/S, and it can evaluate the fracture line simultaneously when reduction of an isolated zygomatic arch fracture is necessary, and needle marking, which can easily point out the fracture line on U/S. Methods We studied 21 patients with an isolated zygomatic arch fracture who underwent closed reduction using U/S and needle marking between 2013 and 2015. Results We achieved satisfactory results in all our cases with respect to reduction by using the Dingman elevator after performing a temporal approach incision, while confirming relative positioning between needle marking and zygomatic fracture at the same time, after insertion of a 23 gauge needle in the skin above the zygomatic arch fracture line parallel to it. Conclusion We treated 21 patients with an isolated zygomatic arch fracture using U/S and the needle marking method, which provided satisfactory results because the extent of reduction of the fracture could be evaluated in real-time during the operation and exposure to radiation was reduced.
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Affiliation(s)
- Jun Sik Kim
- Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, College of Medicine and Hospital, Gyeongsang National University, Jinju, Korea
| | - Young Ji Park
- Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, College of Medicine and Hospital, Gyeongsang National University, Jinju, Korea
| | - Yoon Jung Lee
- Department of Plastic and Reconstructive Surgery, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Nam Gyun Kim
- Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, College of Medicine and Hospital, Gyeongsang National University, Jinju, Korea
| | - Kyung Suk Lee
- Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, College of Medicine and Hospital, Gyeongsang National University, Jinju, Korea
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