Impact of intraoperative cone beam computed tomography in the management of zygomatic fractures - 17/09/21
, Jean-Christophe Lutz c, d, e, Brice Chatelain a, Elise Weber a, Aude Barrabé a, Christophe Meyer a, f, Nicolas Sigaux g, h, Aurélien Louvrier a, bBienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Aim |
To evaluate the impact of intraoperative cone beam computed tomography (CBCT) assessment for the surgical management of zygomatic bone fracture (ZF).
Methods |
A prospective study was conducted on patients operated on for unilateral ZF during a two-year period. Repositioning of the fractured zygoma was assessed intraoperatively by measuring the position of malar eminences in three dimensions on CBCT. A difference of more than 2 mm between both sides was considered significant and the reduction was judged inadequate. Surgical procedure was adapted to intraoperative imaging findings.
Results |
The surgical procedures of 47 patients treated for ZF were analyzed. In 15% of the cases (7 patients), the intraoperative CBCT showed an inadequate reduction while the morphological results seemed correct. Those patients benefited from an immediate correction of the reduction. From these 7 patients, reduction was optimized further without the need of osteosynthesis in one case, additional osteosynthesis was performed in 4 cases and 2 patients required both reduction and osteosynthesis revision.
Conclusion |
Intraoperative CBCT control helps to achieve anatomic repositioning in case of ZF. It may reduce the risk of under-treatment and possible reoperation, and of over-treatment meaning systematic ORIF in all fractures.
Le texte complet de cet article est disponible en PDF.Keywords : Intraoperative imaging, CBCT, Zygoma, Zygomatic fracture, Maxillofacial surgery, Traumatology
Plan
Vol 122 - N° 4
P. 349-354 - septembre 2021 Retour au numéro
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