Management of Zygomaticomaxillary Complex Fractures

Strong, E. Bradley; Gary, Celeste

doi:10.1016/j.fsc.2017.06.006

Cited by 61 publications

(78 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The main indication of 3D virtual planning and printing in cranio-maxillofacial surgery include orthognathic surgery, planning vectors and osteotomies in distraction ostiogenesis, acute and chronic traumatic maxillofacial fractures and deformities, cranioplasty, facial skeletal contouring and augmentation [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. The study included 11 patients with acute and 14 patients with chronic deformities all of which are due to road traffic accidents.…”

Section: Discussionmentioning

confidence: 99%

Improving Aesthetic Outcome in Managing Acute and Chronic Upper and Midface Deformities Using Computer Assisted Planning

Saleh

Ghanem

Hamad

et al. 2020

The Egyptian Journal of Plastic and Reconstructive Surgery

View full text Add to dashboard Cite

Surgical procedures in the facial region are associated by a variety of difficulties. The anatomy of the maxillofacial region, the complexity of the bony architecture as well as the esthetic implications. The three dimensional imaging and 3D printing, have been applied for the restoration the complex anatomy of craniofacial structures. In addition, mirror-imaging techniques advocating 3D computed tomographic (CT) scanning and 3D printing can maximize the surgical outcome on both the functional and esthetic reconstruction levels. A synthetic scaffold can be pre-molded to the individual prototype skull model to resemble the anatomic contour before applying it to cover the orbital defects. Our aim is to show the importance and present our experience with three-dimensional virtual planning in solving a variety of acute and chronic clinical deformities within the scope of trauma in the cranio maxillofacial region. 25 patients were retrospectively recruited. Mean age was 33.5 years (range 13-59), male: female ratio = 2.6:1 (18:7). Eleven patients had acute injuries (44%) while the remaining 14 patients (56%) had chronic (malunited) fractures performed in 2 different centers treating maxillofacial deformities operated utilizing 3D planning protocols. The advocation of the virtual planning techniques, three dimension printing and printed custom implant enabled an accurate reduction and fixation procedure of complex acute and chronic complex upper and midface fracture, which is reflected in very satisfactory aesthetic outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Improving Aesthetic Outcome in Managing Acute and Chronic Upper and Midface Deformities Using Computer Assisted Planning

Saleh

Ghanem

Hamad

et al. 2020

The Egyptian Journal of Plastic and Reconstructive Surgery

View full text Add to dashboard Cite

show abstract

“…Zygomaticomaxillary complex (ZMC) fractures are one of the most common occurring facial fractures. [1][2][3] The ZMC is defined by the zygoma along with its interface with the frontal bone (ZF), temporal bone (ZT), sphenoid bone (ZS), and with the maxilla. The zygomaticomaxillary suture can be further subdivided into the infraorbital rim (ZM1) and the lateral maxillary buttress (ZM2).…”

Section: Introductionmentioning

confidence: 99%

“…This is in part dictated by patient age, as young, healthy patients may be less accepting of mild deformity in comparison to elderly patients. 3 Functional impairments can include trigeminal nerve paresthesias, facial motor weakness, and trismus related to interference of the depressed arch with the mandibular coronoid process. ZMC fractures frequently have concomitant orbital floor fractures because of the contribution to the lateral orbital floor and its fragility.…”

Section: Introductionmentioning

confidence: 99%

A Novel Classification Method of Zygomaticomaxillary Complex Fractures by Suture Comminution to Better Predict Clinical Outcomes

Prabhu

Rudolph

Hemal

et al. 2020

FACE

View full text Add to dashboard Cite

Purpose: To assess a novel technique for classifying zygomaticomaxillary complex (ZMC) fractures by its ability to predict clinical outcomes and reoperations when compared to a well-established classification method. Methods: The investigators conducted a retrospective cohort study over a 7-year period composed of patients with unilateral and bilateral fractures of the ZMC. Fractures were graded according to the Zingg method and a CT-based comminution method. Outcomes were classified into 3 groups: orbital complications, facial complications, and reoperation. Orbital complications consisted of enophthalmos and diplopia. Facial complications consisted of lagophthalmos, ectropion, ptosis, facial motor weakness, trismus, and malar depression. Other variables included demographics, mechanism of injury, and preoperative symptoms. Results: A total of 159 patients were identified producing a total of 204 ZMC fractures. The mean age was 40.2 ± 16.5 years and the most common mechanism of injury was motor vehicle accidents in 49.7% of patients. By the Zingg classification, B-type fractures were the most common in 46% of patients. The average total comminution score was 2.9 ± 2.4. Univariate analysis showed an association between increased age and reoperation ( P = .01). After adjusting for demographic and clinical variables on multivariate analysis, total comminution score was a significant predictor of facial complications and reoperation. The Zingg method did not demonstrate significance as a predictor for facial complications or reoperation. Neither classification method was predictive of orbital complications. Conclusion: The results of this study suggest that total comminution scoring is a viable method for categorizing ZMC fractures to better predict clinical outcomes.

show abstract

“…Orbital wall fractures, especially in concert with ICH and other cranial fractures, are among the most complex to reconstruct. Operative strategies are dictated by the portion of orbit involved, with the coronal approach often maximizing exposure of zygomaticofrontal, zygomaticosphenoidal, and zygomaticotemporal regions [5][6][7]. Maximal access to the fracture is vital for open reduction and stabilization with fixation, especially in the context of concomitant ICH [5].…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of Complex Cranial and Orbit Fractures with Associated Hemorrhages: Case Report and Review of the Literature

Caras

Alexander

Young

et al. 2020

Cureus

View full text Add to dashboard Cite

We present our experience following a unique case of coincident intracranial hemorrhage and comminuted fractures of both the squamous temporal bone and zygomaticofrontal orbit. Surgical techniques and outcome for this presentation have yet to be sufficiently described. A 55-year-old male presented following trauma with Glasgow Coma Scale score of 7. Radiographic evaluation revealed comminuted fractures of the squamous temporal bone with extension into the lateral orbit, along with zygomatic process fracture extending 2.5 cm medially into the orbital roof. Zygomaticofrontal orbital roof fragments reached superiorly into the middle cranial fossa and inferiorly into the orbit. Surgical intervention was deemed necessary to address underlying epidural hematoma, subarachnoid hemorrhage, correction of cranial bone defects, and decompression of the optic nerve and other intraorbital nerves. A frontotemporal approach was employed. Repair of temporal and orbital fractures was accomplished using a combination of wire mesh screws and titanium miniplates. Postoperative imaging demonstrated bony approximation and successful evacuation of traumatic hemorrhage. The patient remains functionally and neurologically intact apart from a sluggishly responsive left eye presumed to result from a left optic nerve or ciliary ganglion lesion. Although rapid reconstruction of complex cranial-orbital trauma and hematoma evacuation can permit acceptable gross functional neurological outcome following massive trauma, orbital fracture and subsequent hemorrhagic processes may be the nidus of neurological sequelae in this complex traumatic constellation. Thus, alterations in surgical approach and reconstruction are appropriate in order to maximize neurological function while supporting restoration of cosmetic space.

show abstract

Management of Zygomaticomaxillary Complex Fractures

Cited by 61 publications

References 39 publications

Improving Aesthetic Outcome in Managing Acute and Chronic Upper and Midface Deformities Using Computer Assisted Planning

Improving Aesthetic Outcome in Managing Acute and Chronic Upper and Midface Deformities Using Computer Assisted Planning

A Novel Classification Method of Zygomaticomaxillary Complex Fractures by Suture Comminution to Better Predict Clinical Outcomes

Reconstruction of Complex Cranial and Orbit Fractures with Associated Hemorrhages: Case Report and Review of the Literature

Contact Info

Product

Resources

About