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Does Intraoperative Computed Tomography Improve the Outcome in Zygomatico-Orbital Complex Fracture Reduction?

  • Clinical Paper
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Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Purpose

Zygomatico-orbital (ZMO) fractures pose considerable difficulty in intraoperative assessment during open reduction and internal fixation (ORIF), and this can be attributed to its three-dimensional complex anatomy and articulations. Recent advancements in the form of intraoperative imaging and navigation have led to an adequate assessment and correct reduction of these fractures minimizing chances of any revision surgery. The purpose of this study was to evaluate the advantage of intraoperative computerized tomography (CT) scan in the management of ZMO/isolated orbital complex fracture and further to develop a protocol for managing such fractures.

Methods

Twenty-three cases of ZMO/isolated orbital fractures were managed with ORIF, followed by an intraoperative CT scan. The evaluation was focused on the articulations of the zygoma and orbital wall reconstruction. The score of 0 and 1 was given for inadequate and adequate reduction, respectively. Necessary corrections were performed in case of improper reduction followed by a repeat CT scan if required. The reduction score was statistically correlated with number of incisions.

Results

In 8 (35%) out of 23 patients, clinical judgment was inaccurate when radiologically assessed with an intraoperative CT scan. In 6 out of 8 cases, a repeat CT scan was done after revision of reduction. The reduction score improved with additional incision and revision in the second CT scan.

Conclusion

Intraoperative CT has an important role in assessing the accuracy of reduction and confirming implant position in ZMO/isolated orbital fractures. This can avoid the need for secondary corrective surgery and postoperative imaging. Intraoperative CT is an important tool to improve surgical outcomes in the management of ZMO orbital fractures.

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Authors and Affiliations

  1. Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Preeti Sharma, Vidya Rattan & Sachin Rai

  2. Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Rajesh Chhabbra

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  1. Preeti Sharma
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  2. Vidya Rattan
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  3. Sachin Rai
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  4. Rajesh Chhabbra
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Correspondence to Sachin Rai.

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Sharma, P., Rattan, V., Rai, S. et al. Does Intraoperative Computed Tomography Improve the Outcome in Zygomatico-Orbital Complex Fracture Reduction?. J. Maxillofac. Oral Surg. 20, 189–200 (2021). https://doi.org/10.1007/s12663-020-01420-0

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  • DOI: https://doi.org/10.1007/s12663-020-01420-0

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