Clinical Follow-up on Sagittal Fracture at the Temporal Root of the Zygomatic Arch: Does It Need Open Reduction?

Cheon, Ji Seon; Seo, Bin Na; Yang, Jeong Yeol; Son, Kyung Min

doi:10.5999/aps.2013.40.5.546

Cited by 5 publications

(12 citation statements)

References 13 publications

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“…Therefore, the indications for coronal incisions should be considered. These conclusions indicate that reasonably satisfactory results can be obtained without direct reduction and fixation and through guided reduction of ZA in ZMC fractures (37).…”

Section: Radiographic Evaluationmentioning

confidence: 58%

Ultrasound Guided Closed Reduction Versus Open Reduction of Zygomatic Arch in Zygomaticomaxillary Fractures

Amer

Sharara

Mohamed

et al. 2020

Alexandria Dental Journal

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INTRODUCTION: trauma of the zygomaticomaxillary complex (ZMC) has functional and aesthetic consequences. Management of ZMC fractures is considered one of the most debatable issues regarding classification, diagnosis and surgical technique.Precise management of the ZMC fractures needs accurate diagnosis, accessible exposure, and precise rigid fixation OBJECTIVES: To compare between ultrasound guided closed reduction and open reduction of zygomatic arch in cases of ZMC fracture. MATERIALS AND METHODS:This study was conducted on a sample of twenty patients who had fracture repair of ZMC. Ten of them (study group) were treated via direct peri-orbital approach with the use of intra-operative ultrasound to guide zygomatic arch reduction. While the other ten patients (control group) via coronal approach with open reduction of zygomatic arch. Postoperative patient evaluation was performed with specific attention paid towards zygomatic arch reduction, nerve function, wound healing, and postoperative ocular complications. RESULTS: Radiographic follow up showed no statistical significant difference between normal side and reduced side of zygomatic arch which reflect satisfactory arch reduction among both groups. CONCLUSION: Ultrasonography is an effective method for guiding zygomatic arch reduction with other minimal incisions in cases of ZMC fracture. On the other hand, coronal incisions have advantages of giving excellent access to ZMC fracture with direct reduction of zygomatic arch but with considerable disadvantages.

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Section: Radiographic Evaluationmentioning

confidence: 58%

Ultrasound Guided Closed Reduction Versus Open Reduction of Zygomatic Arch in Zygomaticomaxillary Fractures

Amer

Sharara

Mohamed

et al. 2020

Alexandria Dental Journal

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“…However, large incisions and wide dissections can increase operative time and the risk of post-surgical complications (Ji et al, 2016). These invasive approaches may result in massive bleeding, scarring, persistent edema, and numbness (Cheon et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Closed reduction with minimal accesses for treating isolated zygomatic arch fractures: Case Series

Lôbo¹,

Nascimento²,

Andrade³

et al. 2021

RSD

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Following nasal fractures, zygomatic fractures (ZF) are the second most prevalent of maxillofacial fractures. Isolated fractures of the zygomatic arch (IZAF) are rare, corresponding to less than 10% of all fractures involving the zygomatic-maxillary complex (ZMC). The choice of treatment for IZAF is controversial, and there is no defined consensus in the literature. We seek to evaluate the advantages of closed reductions with minimal accesses over open reductions through a case series and a 10-year literature review. All patients in our study obtained a satisfactory final result in terms of aesthetics and function of the zygomatic arch, with no complications involved. There are criteria established in the current literature on the indication of open surgery or closed reduction. Open reduction with rigid fixation has the most significant number of studies proving its clinical efficacy. However, closed reduction with minimal accesses has proven to be a suitable therapeutic option for IZAF, presenting satisfactory aesthetic results and fewer surgical risks.

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“…Some ZAC fractures accompanying ZMC fractures have been treated using classic 3point fixation followed by a temporal (Gilles technique) or oral (Keen technique) approach. [9][10][11] However, the transmasseteric force continuously applied to ZAR in the posteroinferior direction following incomplete fixation sometimes results in malunion or nonunion. 12,13 Therefore, complex and unstable ZAR fractures, including sagittal fractures of the temporal root, often require open reduction.…”

mentioning

confidence: 99%

“…Thus, there is no consensus regarding the preference for the bicoronal approach over the indirect approach (and vice versa). [9][10][11][12][13][14][15][16] In this study, open reduction was performed at the temporal root via the preauricular approach, followed by fixation using a single screw to repair sagittal fractures of the temporal root of ZAR accompanying ZMC fractures. Patients whose sagittal fractures of ZAR were repaired via the indirect approach following 3-point fixation of a ZMC fracture or via the direct approach were compared to examine the efficacy of single-screw fixation using the preauricular approach.…”

mentioning

confidence: 99%

“…Zygoma depression, temporal protrusion, and bone gaps for sagittal fractures measured preoperatively and 6 months postoperatively were compared. 10 A questionnaire survey was conducted at an outpatient clinic preoperatively and postoperatively to investigate patients' subjective evaluation of the procedures. The survey was conducted 1 month postoperatively and included questions about overall satisfaction with the treatment, deformity, trismus, annoyance associated with incisions, and facial nerve damage.…”

mentioning

confidence: 99%

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Treatment of Sagittal Fracture of the Zygomatic Arch Root

Lee

Ryu

Lee

et al. 2023

Journal of Craniofacial Surgery

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A sagittal fracture at the temporal root of the zygomatic arch (ZAR) often occurs as a component of zygomaticomaxillary complex (ZMC) fractures. However, this area is difficult to access, and anchorage is limited due to the unstable structure around it. Therefore, a preauricular approach using single-screw fixation is proposed, and this study reports its results and usefulness. Forty-four patients with sagittal fractures of ZAR occurring with ZMC fractures were evaluated from 2012 to 2021. Open reduction and internal fixation were performed on all patients with ZMC fractures. Closed reduction using Dingman incision and external finger pressure in group A (indirect approach; 30 patients) and single-screw fixation using a preauricular approach in group B (direct approach; 14 patients) were performed to address sagittal fractures in ZAR. For single-screw fixation, the additional mean operation time was 11.34±3.25 minutes. On postoperative 3-dimensional computed tomography and plain radiographs, group B showed more accurate reduction and less deformity and trismus (P<0.05). Moreover, a normal diet was initiated more quickly in group B than in group A (P<0.05). Some cases in group A showed nonunion or malunion. This study revealed that a direct approach (group B) toward sagittal fractures of ZAR is recommended due to more accurate results and fewer complications than those observed with the indirect approach (group A). Moreover, the total operation time and complications may be lesser than those with the bicoronal approach.

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Clinical Follow-up on Sagittal Fracture at the Temporal Root of the Zygomatic Arch: Does It Need Open Reduction?

Cited by 5 publications

References 13 publications

Ultrasound Guided Closed Reduction Versus Open Reduction of Zygomatic Arch in Zygomaticomaxillary Fractures

Ultrasound Guided Closed Reduction Versus Open Reduction of Zygomatic Arch in Zygomaticomaxillary Fractures

Closed reduction with minimal accesses for treating isolated zygomatic arch fractures: Case Series

Treatment of Sagittal Fracture of the Zygomatic Arch Root

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