Does Zygomatic Complex Symmetry Differ Between Healthy Individuals and Surgically Treated Patients Using Intraoperative 3-Dimensional Cone Beam Computed Tomographic Imaging?

Hingsammer, Lukas; Seier, Thomas; Johner, Jean-Pierre; Blumer, Michael; Gander, Thomas; Rücker, Martin; Wagner, Maximilian

doi:10.1016/j.joms.2019.11.027

Cited by 16 publications

(11 citation statements)

References 28 publications

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“…The population of our study was 101 individuals. Considering the literature that deals with facial bony symmetry, there are reports of the same size [ 14 – 17 ], of smaller [ 11 , 18 , 19 ], as well as larger study populations [ 20 , 21 ]. Except for HINGSAMMER, all of the studies mentioned above were cross-sectional of character, which is also the case in our work.…”

Section: Discussionmentioning

confidence: 99%

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Probing real-world Central European population midfacial skeleton symmetry for maxillofacial surgery

et al. 2023

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Objectives Symmetry is essential for computer-aided surgical (CAS) procedures in oral and maxillofacial surgery (OMFS). A critical step for successful CAS is mirroring the unaffected side to create a template for the virtual reconstruction of the injured anatomical structure. The aim was to identify specific anatomical landmarks of the midfacial skeleton, to evaluate the symmetry in a group of the real-world Central European population, and to use these landmarks to assess midfacial symmetry in CT scans. Material and methods The retrospective cross-sectional study defined landmarks of the midface’s bony contour using viscerocranial CT data. The distances of the skeletal landmarks (e.g., the frontozygomatic suture and temporozygomatic suture) of the left and right sides from the midline were measured and statistically compared. Midfacial symmetry for reference points was defined as a difference within 0 mm and their mean difference plus one standard deviation. Results We examined a total of 101 CT scans. 75% of our population shows symmetrical proportions of the midface. The means of the differences for the left and right sides ranged from 0.8 to 1.3 mm, averaging 1.1 ± 0.2 mm for all skeletal landmarks. The standard deviations ranged from 0.6 to 1.4 mm, with a computed mean of 0.9 ± 0.3 mm. Conclusion We established a methodology to assess the symmetry of the bony midface. If the determined differences were equal to or lower than 2.5 mm in the mentioned midfacial skeletal landmarks, then the symmetry of the bony midface was considered present, and symmetry-based methods for CAS procedures are applicable. Clinical relevance Many CAS procedures require facial symmetry. We provide an easy-to-apply method to probe for symmetry of the midface. The method may be used for population-based research, to check for proper reduction of fractures after reposition or to screen for symmetry prior to CAS planning.

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Section: Discussionmentioning

confidence: 99%

“…A similar proportion was ascertained by other authors [ 15 , 16 , 21 , 22 ]. Other works included a higher amount of either female [ 14 , 20 ] or male [ 17 , 19 ] patients. One study even reported males only [ 11 ], rendering a comparison to a general population obsolete.…”

Section: Discussionmentioning

confidence: 99%

Probing real-world Central European population midfacial skeleton symmetry for maxillofacial surgery

et al. 2023

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“…Some studies suggested that intraoral incisions and small local incisions can meet the surgical requirements. 32,33 However, bilateral ZMC fractures are usually accompanied by full-face fractures, which are often complicated with comminuted fractures. For the ZMC fracture with obvious displacement and comminuted fractures, the fracture site cannot be fully exposed at the small incision, and the fracture site can be maximally exposed at the coronal incision combined with other incisions, which is one of the foundations of accurate reduction.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies suggested that intraoral incisions and small local incisions can meet the surgical requirements 32,33 . However, bilateral ZMC fractures are usually accompanied by full-face fractures, which are often complicated with comminuted fractures.…”

Section: Discussionmentioning

confidence: 99%

Application of Computer-Aided Design and Individualized Templates for Bilateral Zygomaticomaxillary Complex Fractures

Zhou

Chen

et al. 2021

Journal of Craniofacial Surgery

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Purpose: Reduction of the bilateral zygomaticomaxillary complex (ZMC) fracture with individualized templates based on computeraided surgical simulation system. To evaluate the practicality and accuracy of this approach in the treatment of bilateral ZMC fracture. Methods: Sixteen patients with bilateral ZMC fractures were collected to create a study model. The authors reconstruct the ZMC on one side via the three-dimensional (3D) model, and then mirrored to the opposite side. Multiple individualized templates were made based on the 3D model, and used as intraoperative guidance to reduce fractures. After surgery, the facial symmetry and the position of zygoma were observed. The mouth opening, pupil level, and sensation of infraorbital nerve were evaluated. Some mark points on zygoma were measured and the postoperative horizontal asymmetry rate (H) was calculated. Besides, orbital height and width were measured. Results: For all patients, the position of bilateral ZMC was basically restored. The patients with restriction of mouth opening all recovered to normal. The H values were less than 3.0% at all mark points. There was almost no difference in bilateral orbital width and height. Meanwhile, there was no significant difference between the preoperative measurements of the ideal virtual 3D model and the postoperative measurements of patients. Conclusions: The study proves that application of computer-aided design and individualized templates can accurately guide the reduction operation of ZMC fracture, restore the ideal shape of ZMC, and obtain good facial symmetry.

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“…[27][28][29] Postoperative outcomes such as diplopia following orbital reconstruction and need for revision surgery have been shown to be significantly improved by the use of intraoperative CT. [29][30][31] Interestingly, in the repair of isolated unilateral zygomaticomaxillary complex fractures, intraoperative CT has even been found to facilitate repair such that malar symmetry in repaired patients is no different than in patients with no trauma history. 32 The safety of intraoperative CT has also improved in recent years, as advances in imaging modalities such as improved resolution of cone beam CT have enabled detailed intraoperative imaging with reductions in radiation dose, minimal increases in operative time, and subsequent exposure to general anesthetic. 28,29…”

Section: Imaging Modalitiesmentioning

confidence: 99%

Implications of Applying New Technology in Cosmetic and Reconstructive Facial Plastic Surgery

et al. 2020

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The field of facial plastic and reconstructive surgery is privy to a myriad of technological advancements. As innovation in areas such as imaging, computer applications, and biomaterials progresses at breakneck speed, the potential for clinical application is endless. This review of recent progress in the implementation of new technologies in facial plastic surgery highlights some of the most innovative and impactful developments in the past few years of literature. Patient-specific surgical modeling has become the gold standard for oncologic and posttraumatic reconstructive surgery, with demonstrated improvements in operative times, restoration of anatomical structure, and patient satisfaction. Similarly, reductions in revision rates with improvements in learner technical proficiency have been noted with the use of patient-specific models in free flap reconstruction. In the cosmetic realm, simulation-based rhinoplasty implants have drastically reduced operative times while concurrently raising patient postoperative ratings of cosmetic appearance. Intraoperative imaging has also seen recent expansion in its adoption driven largely by reports of eradication of postoperative imaging and secondary—often complicated—revision reconstructions. A burgeoning area likely to deliver many advances in years to come is the integration of bioprinting into reconstructive surgery. Although yet to clearly make the translational leap, the implications of easily generatable induced pluripotent stem cells in replacing autologous, cadaveric, or synthetic tissues in surgical reconstruction are remarkable.

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Does Zygomatic Complex Symmetry Differ Between Healthy Individuals and Surgically Treated Patients Using Intraoperative 3-Dimensional Cone Beam Computed Tomographic Imaging?

Cited by 16 publications

References 28 publications

Probing real-world Central European population midfacial skeleton symmetry for maxillofacial surgery

Probing real-world Central European population midfacial skeleton symmetry for maxillofacial surgery

Application of Computer-Aided Design and Individualized Templates for Bilateral Zygomaticomaxillary Complex Fractures

Implications of Applying New Technology in Cosmetic and Reconstructive Facial Plastic Surgery

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