OBJECTIVEA study was conducted to investigate the relevant applied technique and clinical value of endoscope-assisted repair of zygomatic arch fracture.

METHODSA total of 10 cases of unilateral zygomatic arch fracture and 8 cases ofunilateral zygomatic fracture were included. Reduction and fixation of the zygomatic arch in all cases were performed via asmall face incision by an endoscope. Endoscope-assisted repair allowed exposure of zygomatic arch fracture and ended the anatomy of the reset. Zygomatic arch was stabilized with titanium plates.

RESULTSSymmetric malar was achieved in allcases after operation. Patients did not show difficulty in opening the mouth. No chewing problems or severe complicationswere evident. This method had the advantage of hidden incision, and it did not leave scars on the face. Postoperative CT examination showed excellent reduction of zygomatic arch fracture and good fixed position of titanium plate.

CONCLUSIONEndoscope-assisted repair of zygomatic arch fracture via a small face incision can be an alternative operation for zygomaticarch fracture. Patients are less traumatized. There are fewer complications. A good reduction of fracture is achieved.

Bone Plates ; Endoscopes ; Endoscopy ; methods ; Facial Bones ; Fracture Fixation, Internal ; methods ; Fractures, Closed ; surgery ; Humans ; Titanium ; Tomography, X-Ray Computed ; Treatment Outcome ; Wound Healing ; Zygoma ; injuries ; Zygomatic Fractures ; diagnostic imaging ; surgery

Zygomatic fracture is one of the most common mid-facial fractures. Zygomatic fracture often leads to open-mouth and chewing dysfunctions, which are often associated with pronounced zygomatic facial deformity, causing psychological and physiological problems in patients. The complicated anatomical structures associated with zygomatic fracture often make treatment difficult. Surgical navigation technology provides a new auxiliary method for improving the treatment results for zygomatic fracture. This review aims to provide a comprehensive overview of the application of surgical navigation technology in the treatment of zygomatic fracture.
Face ; Fracture Fixation, Internal ; Humans ; Mastication ; Mouth ; Skull Fractures ; Surgery, Computer-Assisted ; Zygomatic Fractures ; surgery

Bone Plates ; Computer-Aided Design ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Radiography ; Surgery, Computer-Assisted ; Zygomatic Fractures ; diagnostic imaging ; surgery

OBJECTIVETo investigate the value of computer aided navigation system (CANS) in the treatment of post traumatic maxillofacial deformation.

METHODSFifty-four patients (M = 37, F = 17) were included in the study, including 31 cases of zygomatic fracture, 7 cases of pure orbital fracture, 11 cases of temporal mandibular joint ankylosis, 1 case of foreign body and 4 cases of defect reconstruction with custom implant. Data acquisition was done through CT scan, and DICOM data was transferred into workstation. Computer assisted design, including osteotomy, reposition, fibula flap design, orbital implant construction was performed using Surgicase CMF and Brain Lab Iplan system. The virtual design was transferred to Brain Lab navigation system, and the osteotomy, reduction, location of bone graft and custom implant were guided by navigation. Postoperative CT scan was required 48 - 72 hours after surgery. Preoperative and postoperative CT images were superimposed automatically in BrainLab Iplan system, and compared both in 3D objects and 2D slices.

RESULTSAll the cases achieved good results without serious complication. The error of important corresponding points in zygomatic fracture reduction, orbital reconstruction and defect reconstruction was 0.2 - 3.5 mm, 0.8 - 2.0 mm and 0.2 - 2.2 mm respectively.

CONCLUSIONSComputer assisted design is of considerable value for the systematic and accurate planning for complicated post traumatic deformation. Virtual plan could be carried out accurately with the assistance of CANS.

Adult ; Computer Simulation ; Computer-Aided Design ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Orbital Fractures ; diagnostic imaging ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgery, Computer-Assisted ; methods ; Tomography, X-Ray Computed ; Tooth Ankylosis ; diagnostic imaging ; surgery ; Young Adult ; Zygomatic Fractures ; diagnostic imaging ; surgery

OBJECTIVETo compare the efficacy of computer-navigated surgery and the 3-D skull models and guide plates for the treatment of unilateral delayed zygomatic fractures.

METHODSEleven patients with unilateral delayed zygomatic fractures were treated by computer-navigated surgery (test group) and another 12 patients were treated by 3-D skull models and guide plates as the control group. Quality of reduction was assessed by examination of postoperative axial CT scans through zygomatic arch, the malar prominence and the width of zygomatic arch were measured in both groups.

RESULTSThe difference between bilateral malar prominence was (0.94 ± 0.73) mm in the test group and (1.88 ± 1.82) mm in the control group, there was no significant difference between the two groups (P > 0.05). The difference between bilateral width of zygomatic arch was (0.77 ± 0.51) mm in the test group, less than (3.00 ± 1.81) mm in the control group (P < 0.05). Excessive malar prominence was observed in 6 cases (6/11) in the test group and in 7 cases (7/12) in the control group, whereas malar depression was observed in 5 cases (5/11) in the test group and in 5 cases (5/12) in the control group. Overcorrection of the width of zygomatic arch was observed in 6 cases (6/11) in the test group and in 12 cases (12/12) in the control group, whereas under correction was observed in 5 cases (5/11) in the test group and in 0 cases (0/12) in the control group.

CONCLUSIONSIn the treatment of unilateral delayed zygomatic fractures, symmetry of malar prominence can be achieved by application of computer-navigated surgery or the 3-D skull models and guide plates. Symmetry of the width of zygomatic arch achieved with the computer-navigated surgery is better than that achieved with 3-D skull models and guide plates.

Adult ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed ; Young Adult ; Zygoma ; diagnostic imaging ; surgery ; Zygomatic Fractures ; diagnostic imaging ; surgery

OBJECTIVETo evaluate the effect of computer assisted navigation system in the treatment of unilateral zygomatic complex fractures.

METHODSFive patients with unilateral zygomatic complex fractures were included in this study.Preoperative design, intraoperative real-time navigation and postoperative evaluation with chromatogram were executed in the unaffected and affected side.

RESULTSUsing computer assisted navigation system, the position and direction of the affected side of the unilateral zygomatic complex fracture were confirmed and shown real-time on the screen. The global maximal deviation was less than 2 mm between the affected side and the mirror side of the healthy side with chromatogram.

CONCLUSIONSComputer assisted navigation system can instruct the treatment of unilateral zygomatic complex fractures effectively. The global comparison with chromatogram is more objective for the unilateral zygomatic complex fractures.

Adult ; Female ; Humans ; Male ; Surgery, Computer-Assisted ; methods ; Tomography, X-Ray Computed ; Young Adult ; Zygomatic Fractures ; diagnostic imaging ; surgery

OBJECTIVETo evaluate the effectiveness of the rigid internal fixation for comminuted and redisplaced zygomatic arch fractures by modified preauricular-temporal approach with the resorbable bone fixation.

METHODSTotally twenty patients aged from 14 to 68 years and admitted to our hospital between September 2006 and June 2011 were reviewed, of whom seventeen had a unilateral comminuted zygomatic arch fracture and three re-displaced arch fracture after failed closed reduction. The fracture segments were aligned to restore the preinjury form of the arch by rigid fixation with resorbable plates and screws through a modified preauricular-temporal incision.

RESULTSThe fractures were well reduced, preauricular-temporal scar and lateral facial contour were aesthetically satisfying, and no case had limited mouth opening as well as facial palsy. The resorbable plates were not palpated one year after the operation.

CONCLUSIONThe rigid internal fixation through the preauricular-temporal approach with the resorbable bone is an effective method for the comminuted and redisplaced zygomatic arch fractures.

Bone Plates ; Fracture Fixation, Internal ; Fractures, Comminuted ; surgery ; Humans ; Zygoma ; Zygomatic Fractures

OBJECTIVETo discuss the application of 3-D skull models and guide plates in treatment of unilateral orbitozygomatic deformity after fracture.

METHODSEach patient underwent CT scan and DICOM data was obtained preoperatively. Two 3-D resin skull models were produced by rapid prototyping technique. The first model was produced based on the patient's original data and the second was the reshaped model by mirroring the unaffected facial side to the traumatic side. The original model was used for measurement of the fracture displacement in three directions and model surgery. On the second model, one 2.0 mm miniplate (Synthes Inc) was bended along the orbital rim as the repositioning guide plate. During the operation, osteotomy and reduction of zygomatic and the periorbital fractures was guided by prepared repositioning guide plate, following by orbital wall reconstruction and bone grafting.

RESULTSFrom March 2007 to February 2009, 7 cases (6 males and 1 female) were treated successfully with no infection or graft extrusion. One week after operation, the patient received CT examination again. The shape and location of zygomatic bone and arch was good. Three cases were followed up for 3 months. Among them, facial symmetry was achieved in 2 cases. Cicatricial contracture and temporal soft tissue atrophy occurred in one case.

CONCLUSIONSReliable therapeutic effect can be achieved by application of rapid prototyping technique and repositioning guide plate in the treatment of complicated posttraumatic orbitozygomatic deformity.

Adult ; Bone Plates ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Models, Anatomic ; Orbital Fractures ; surgery ; Osteotomy ; methods ; Retrospective Studies ; Treatment Outcome ; Zygomatic Fractures ; surgery

OBJECTIVETo investigate the change of zygomatic and temporal soft tissue after coronal incision.

METHODSA retrospective analysis was performed in 33 patients who received firm fixation for unilateral zygomatic comminuted fracture through semi-coronal incision. All the patients were followed up for more than one year. Craniofacial anthropometric measurement through 3D-CT reconstruction and facial profile was performed. The difference between the operated side and healthy side was analyzed.

RESULTSAt the temporal concave point, the soft tissue thickness at healthy side was (1.60 +/- 0. 97) mm more than that at operated side, showing a significant difference between them (P < 0.01). While the soft tissue thickness was not statistically different between two sides at zygion, malar prominence, zygomaxillare, and temporal convex point (P > 0.05).

CONCLUSIONSThe soft tissue atrophy may happen at temporal fat pad after semi-coronal incision, but not at zygomatic area. Intraoperative precise dissection and less stretch of soft tissue may be helpful to avoid the postoperative facial asymmetry.

Adipose Tissue ; anatomy & histology ; Adult ; Female ; Follow-Up Studies ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Scalp ; surgery ; Young Adult ; Zygomatic Fractures ; surgery

OBJECTIVETo study the surgical management of enophthalmos after severe malar maxillary complex fracture.

METHODSThe X-ray and CT examination were performed before operation to diagnose the orbital fracture and intraorbital tissue displacement. The fractured orbital rim was repositioned intraoperatively, followed by implantation of shaped titanium mesh to rebuild the orbital floor. The Medpor was inserted above the titanium mesh to correct the enophthalmos.

RESULTSFrom Sept. 2007 to Jan. 2009, 6 cases of enophthalmos after severe malar-maxillary complex fracture were treated. The enophthalmos was corrected or improved obviously in all the patients.

CONCLUSIONSThe enophthalmos after severe malar-maxillary complex fracture can be corrected or obviously improved. Shaped titanium mesh can be used to rebuild the orbital floor with the Medpor to reconstruct the intraorbital tissue volume.

Adolescent ; Adult ; Enophthalmos ; etiology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Maxillary Fractures ; complications ; Middle Aged ; Orbit ; surgery ; Polyethylenes ; Surgical Mesh ; Titanium ; Treatment Outcome ; Young Adult ; Zygomatic Fractures ; complications