Evaluation of soft tissue asymmetry using cone-beam computed tomography after open reduction and internal fixation of zygomaticomaxillary complex fracture

Abstract

ObjectivesIn this study, we assessed soft tissue asymmetry that occurred after open reduction of unilateral zygomaticomaxillary complex (ZMC) fractures. We proposed a simple method to assess soft tissue asymmetry after reduction surgery by evaluating the symmetry between the affected and the unaffected sides. The factors affecting soft tissue contour after surgery were also analyzed.Materials and MethodsSubjects included patients admitted to Wonkwang University Dental Hospital from 2008 to 2013. Cone-beam computed tomography (CBCT) images of asymmetric patients who underwent open reduction at least 3 months prior were compared with healthy patients.ResultsThe degree of asymmetry was measured in both the open reduction and control groups. Landmarks that showed a statistically significant difference between the two groups were zygion (1.73±0.24 mm), bucclae (1.08±0.26 mm), point of cheek (2.05±0.33 mm) and frontozygomatic point (1.30±0.31 mm).ConclusionWhen compared with the normal group, asymmetry can occur in the affected side, which usually shows depression of overlying soft tissue and is statistically significantly different. Evaluation of soft tissue asymmetry with CBCT images after open reduction of ZMC fracture is useful.

Efficacy of multidetector computed tomography in Quantitative and Qualitative Analysis Of Facial Symmetry After Zygomaticomaxillary Complex Fractures Management

“…explanation of this, type of fracture was unilateral ZMC feature in our study .This matched with Khaqani et al (15) who reported that the type of ZMC fracture greatly influences the outcome of ZMC fracture treatment. In the same side with the present results, and Kim et al (27) also reported a higher degree of asymmetry for comminuted ZMC fractures Madkour (28) reported that MDCT is the principle diagnostic imaging tool in maxillofacial trauma. Multiplanar reformatted (MPR) and three-dimensional (3D)-reconstructed images provide a detailed analysis for midfacial fractures and assessment of their severity.…”

Three-dimensional analysis of facial asymmetry after zygomaticomaxillary complex fracture reduction: a retrospective analysis of 101 East Asian patients

“…In the detailed description of malar asymmetry including soft tissue reported by Kim et al [ 12 ], a statistically significant malar depression was observed even after surgery in anteroposterior dimension. Kim et al [ 12 ] reported no significant difference in bilateral position of hard tissue landmarks after open reduction and internal fixation in patients with ZMC fracture, but soft tissue depression was confirmed after surgery. Soft tissue depression around zygoma would be more noticeable if reduction were not accurate and was more noticeable when titanium was used in comparison to biodegradable plates [ 12 ].…”

“…Kim et al [ 12 ] reported no significant difference in bilateral position of hard tissue landmarks after open reduction and internal fixation in patients with ZMC fracture, but soft tissue depression was confirmed after surgery. Soft tissue depression around zygoma would be more noticeable if reduction were not accurate and was more noticeable when titanium was used in comparison to biodegradable plates [ 12 ]. Considering the results of our study and the occurrence of soft tissue depression after surgery, we carefully suggest an overcorrection surgical technique and follow-up studies about the methods of overcorrection technique are needed.…”

“…In this context, ZMC reduction poses a continuing challenge for maxillofacial surgeons because of its significant position in facial esthetics and symmetry, requiring skills and expertise. Numerous studies have demonstrated quantitative and qualitative evaluations of the adequacy of facial symmetry recovery after ZMC fracture reduction surgery [2,[11][12][13]. However, there are few quantitative studies on postoperative symmetry recovery after ZMC reduction in East Asian populations with characteristic zygoma shapes.…”

The Management of Zygomatic Complex Fractures: A Review

“…It is noteworthy that the zygomaticomaxillary complex fracture type significantly impacts its treatment outcome. Kim et al [30]. also showed that comminuted zygomaticomaxillary complex fractures have a higher level of asymmetry.…”