Purpose: To present the treatment of zygomaticomaxillary complex (ZMC) fractures with closed-reduction Steinmann-pin fixation and to compare it to the reduction and aesthetic outcomes of open-reduction techniques (ORI...Purpose: To present the treatment of zygomaticomaxillary complex (ZMC) fractures with closed-reduction Steinmann-pin fixation and to compare it to the reduction and aesthetic outcomes of open-reduction techniques (ORIF). Materials and Methods: Case series. Charts for 23 patients with ZMC fractures presenting to the Head and Neck Surgery Department at Harbor-UCLA Medical Center from 2005 to 2009 were reviewed. Pre- and post-operative computed tomography (CT) scans were analyzed. Follow up ranged from 3 to 55 months. Interviews were conducted to evaluate the patient’s satisfaction. Patients were placed in two groups: those treated with ORIF and those treated with closed-reduction Steinmann-pin fixation. Results: Twelve patients had complete data for analysis. Average operative time was significantly lower for patients treated with closed-reduction as compared to open-reduction: 65.3 minutes vs. 162.5 minutes (p = 0.02). Bony realignment and aesthetic results were comparable in both groups. Additionally, only one 1cm facial incision was required with this repair system versus several incisions using traditional methods. Conclusions: Closed-reduction Steinmann-pin fixation of ZMC fractures provides adequate bony alignment and aesthetics. Our study supports this system in the repair of ZMC fractures as it requires significantly less operating time, one small incision, and excellent patient outcomes.展开更多
BACKGROUND Pain of the zygomatic arch region is common among patients with orofacial pain,especially in those with temporomandibular disorder-related pain of a myogenic origin.Since zygomatic arch pain may occur due t...BACKGROUND Pain of the zygomatic arch region is common among patients with orofacial pain,especially in those with temporomandibular disorder-related pain of a myogenic origin.Since zygomatic arch pain may occur due to various causes other than muscle pain,appropriate diagnosis and treatment planning is essential to ensure its successful management.Unfortunately,zygomatic arch pain has not been handled as an independent clinical feature until now,and studies have mainly focused on pain resulting from trauma and surgical procedures.CASE SUMMARY We describe 7 independent cases,all of which presented with the identical chief complaint of pain in the zygomatic arch region.However,the underlying causes were different for each,being myofascial pain,myositis,tooth crack,dental caries,sinusitis,neuropathic pain,and salivary gland tumor respectively.In this case report,the clinical features of each case are investigated and diseases to be considered in the diagnostic process are suggested,along with the diagnostic modalities(including computed tomography and magnetic resonance imaging)that can lead to the appropriate final diagnosis.CONCLUSION Zygomatic arch pain is a common complaint encountered in the orofacial pain clinic but may lead to misdiagnosis.Clinicians must have in-depth knowledge of the possible differential diagnoses and evaluation tools.展开更多
Background: Zygomatic fracture is one of the most prevalent one among facial fractures caused by vehicle accident, motorcycle accident, fighting, fall and sport injuries. Materials & Methods: This study was a retr...Background: Zygomatic fracture is one of the most prevalent one among facial fractures caused by vehicle accident, motorcycle accident, fighting, fall and sport injuries. Materials & Methods: This study was a retrospective study of our patients during past 6 years. Results: We had 1277 facial fractures, of whom 9 patients had blindness. We had 193 patients with Zygomatic fracture. 98 patients had pure zygomatic fracture and other had complicated fractures. Frequency of blindness due to zygomatic fracture in a period of six years was 4.7% in all and in pure zygomatic fractures was 2.04%. Blindness was most prevalent in age group 20 - 29 years old (55.6%). The most prevalent cause of zygomatic fracture which causes blindness, was motor vehicle accident (77.8%). Blindness was more common in males (77.8%) than females (22.2%). Discussion and Conclusions: One of the most disastrous complication of zygomatic fracture is transection of optic nerve. Very careful examination of fractured bones careful examination of optic nerve and visual acuity and urgent operation and decompression of optic nerve must be performed. About 4% - 5% will have blindness purely due to fracture.展开更多
Fractures of the zygomaticomaxillary complex are among the most common face traumas. Based upon the complexity and great variety of reported diagnoses and treatments, the proposal of this study was to evaluate, clinic...Fractures of the zygomaticomaxillary complex are among the most common face traumas. Based upon the complexity and great variety of reported diagnoses and treatments, the proposal of this study was to evaluate, clinically and radiographically, unilateral zygomatic fractures treated through internal rigid fixation with miniplates and screws of 1.5 mm. Material and Method: 15 patients with unilateral fractures of the zygomaticomaxillary complex were analyzed, and compared with 15 patients without fractures so that a comparative analysis of the area and the perimeter of the orbital cavities could be made, as well as the distance from the nasal point to the zygomatic prominence between both groups. Results: In the radiographic analysis, the both groups presented similarity in the perimeter and in the area of the orbital cavities. Concerning the distance from the nasal point to the zygomatic prominence, only the operated group showed a significant difference between the sides, even though clinically the observation of the asymmetry had been absent or discreet. Conclusion: The treatment of unilateral fractures of the zygomaticomaxillary complex with the use of plates and screws of the 1.5 mm system proved to be effective, showing good esthetic results and low complication rates.展开更多
The oral rehabilitation of edentulous patients can be done in different ways depending on the alveolar ridge morphology and patient expectations. The objective of this clinical case was to report prosthetic and functi...The oral rehabilitation of edentulous patients can be done in different ways depending on the alveolar ridge morphology and patient expectations. The objective of this clinical case was to report prosthetic and functional adaptation difficulties when conventional complete denture was changed to a zygomatic implant-supported prosthesis. We report a 52-year-old male singer with an atrophic maxilla who was rehabilitated with zygomatic implant-supported prosthesis using 4 implants. However, the thickness of the prosthesis in the palatal region and the space between the prosthesis and soft tissue caused difficulty in speaking and singing. The palatal region of the prosthesis was trimmed and the anterior region of the prosthesis was relined. These procedures were performed to make room for the tongue and minimize the passage of air during speech. Adaptations in the shape of the prosthesis must be made to enable its use, without compromising its strength.展开更多
Aim: To analyse the epidemiology, aetiology, and surgical management of zygomatic complex (ZMC) fractures in our major trauma centre, and to compare the number and location of fixation points and surgical access in ou...Aim: To analyse the epidemiology, aetiology, and surgical management of zygomatic complex (ZMC) fractures in our major trauma centre, and to compare the number and location of fixation points and surgical access in our patient cohort with the literature. Methods: Retrospective analysis of all operative cases (Open Reduction and Internal Fixation) of zygomatic complex fractures over a one year period (2016). Results: A greater proportion of patients in our cohort (54%) were treated with one-point fixation compared to the literature, with the zygomaticomaxillary (ZM) buttress being the most popular fixation point (90%). ZM buttress and frontozygomatic (FZ) suture were the commonest choices for two-point fixations (70%). Buccal sulcus incision was used for ZM access in all cases. For FZ access, upper blepharoplasty incision was the most common (56%). For infra-orbital margin access, transconjunctival incision was the most common (75%). There was no significant association between number of fixation points and presence of associated injuries, impact of injury, or time to operation. There were no post-operative complications. Conclusion: A greater proportion of patients in our cohort were successfully treated with one point fixation compared to the literature, and fewer patients underwent orbital floor exploration and repair in our cohort compared to the literature. This study highlights the ongoing variation in the surgical management of ZMC fractures.展开更多
Patients suffering from zygomatic complex fractures always present facial deformity and dyslunctions, and thereafter develop psychological and physiological problems. It is really hard to get an ideal prog- nosis for ...Patients suffering from zygomatic complex fractures always present facial deformity and dyslunctions, and thereafter develop psychological and physiological problems. It is really hard to get an ideal prog- nosis for the zygomatic complex fractures because of the complicated anatomical structures. Computer- assisted surgery techniques, as the new emerging auxiliary methods, can optimize the surgical protocol, predict operation outcomes, and improve the accuracy and quality of the operation. Meanwhile the postoperative complications can be reduced effectively. This review aims to provide a comprehensive overview of the application of computer-assisted surgery techniques in the management of zygomatic complex fractures.展开更多
Background:Hemangiopericytoma and solitary fibrous tumor are considered related variants on the same spectrum and both may essentially be the same tumor.They are infrequently encountered in the orbital region while th...Background:Hemangiopericytoma and solitary fibrous tumor are considered related variants on the same spectrum and both may essentially be the same tumor.They are infrequently encountered in the orbital region while the zygomatic bone is an extremely rare location for these neoplasms to occur.Case presentation:A 14-year-old boy presented with complaint of deformity of left infraorbital area and a firm,regular mass in the region.Orbital CT scan revealed a well-defined round isodense intraosseous lesion in the lowermost portion of the lateral orbital wall(zygomatic bone),expanding the bone and protruding anteriorly and medially.MRI showed the mass to be heterogenous and strongly enhancing with contrast medium.Inferior transconjunctival orbitotomy was performed and the mass was removed.The histopathologic examination and immunohistochemistry staining results(positive for CD34,CD31 and smooth muscle actin,but negative for CD99,S100,B-cell lymphoma 2(bcl-2)and desmin)confirmed the diagnosis of hemangiopericytoma.The postoperative course was uneventful,with no evidence of recurrence after 5 years follow up.Conclusions:This case represents the second hemangiopericytoma reported in the zygomatic bone.Although extremely rare,hemangiopericytoma/solitary fibrous tumor might be considered in the differential diagnosis of intraosseous lesions of the orbital and zygomatic region.展开更多
Objective: To introduce the technique of subciliary incision and lateral cantholysis with tri-dimension reduction and rigid internal fixation to treat zygomatic complex fractures. Methods: The subciliary incision and ...Objective: To introduce the technique of subciliary incision and lateral cantholysis with tri-dimension reduction and rigid internal fixation to treat zygomatic complex fractures. Methods: The subciliary incision and lateral cantholysis combined with tri-dimension reduction and rigid internal fixation of zygomatic complex fractures with titanium microplates were applied in 56 patients with zygomatic complex fractures. Another lateral eyebrow incision or sublabial incision was used to simplify the operation. Results: The postoperative follow-up period ranged from 6 months to 5 years. During the follow-up period, all the patients had satisfying postoperative results. All clinical symptoms disappeared except the numbness in the infraorbital region in 2 patients. In 94.6% patients no complications such as obvious scar, ectropion, entropion or blepharoedema were found, only 5.4% of the patients had slight ectropion 6 months after operation. Conclusions: The subciliary incision and lateral cantholysis have many advantages such as invisible scar, sufficient exposure, minimal injury, and few complications and combined with rigid internal fixation with titanium microplates this technique could be used as one of the routine operation methods to treat zygomatic complex fractures.展开更多
Aim:Fractures of the zygomatico maxillary complex(ZMC)are commonly seen after traumatic injuries to the facial skeleton.The aim of the study was to review the outcome of individualized treatment approach in the manage...Aim:Fractures of the zygomatico maxillary complex(ZMC)are commonly seen after traumatic injuries to the facial skeleton.The aim of the study was to review the outcome of individualized treatment approach in the management of isolated ZMC fractures.Methods:A retrospective analysis of 25 patients was conducted to assess the outcomes of isolated ZMC(iZMC)fracture treatment at a multi specialty hospital(Punjab,India)over a 3–year period.Results:Out of the 25 patients reviewed,4 patients required no surgical intervention and 21 patients underwent surgical reduction via the buccal sulcus approach.An individualized treatment plan was formulated for each patient to decide mini plate fixation at one–two–or three–point with or without orbital rim exploration.Two patients required removal of mini plates from the buttress area on postoperative follow up.Conclusion:Our review shows that an individualized treatment approach produces the most favorable results in the management of iZMC fractures.展开更多
Malignant tumors located in the infratemporal fossa are rare diseases.When all entities are combined,such tumors account for approximately 0.5%of all head and neck tumors.1 The complex anatomy of this region makes the...Malignant tumors located in the infratemporal fossa are rare diseases.When all entities are combined,such tumors account for approximately 0.5%of all head and neck tumors.1 The complex anatomy of this region makes these tumors difficult to diagnose and treat.Bordered laterally by the zygomatic arch and the mandible and medially by the maxilla and the pterygoid process of the sphenoid bone,this area is located beneath the greater wing of the sphenoid bone.It contains significant structures such as the maxillary artery,the venous pterygoid plexus,the mandibular nerve,and the otic ganglion2.展开更多
文摘Purpose: To present the treatment of zygomaticomaxillary complex (ZMC) fractures with closed-reduction Steinmann-pin fixation and to compare it to the reduction and aesthetic outcomes of open-reduction techniques (ORIF). Materials and Methods: Case series. Charts for 23 patients with ZMC fractures presenting to the Head and Neck Surgery Department at Harbor-UCLA Medical Center from 2005 to 2009 were reviewed. Pre- and post-operative computed tomography (CT) scans were analyzed. Follow up ranged from 3 to 55 months. Interviews were conducted to evaluate the patient’s satisfaction. Patients were placed in two groups: those treated with ORIF and those treated with closed-reduction Steinmann-pin fixation. Results: Twelve patients had complete data for analysis. Average operative time was significantly lower for patients treated with closed-reduction as compared to open-reduction: 65.3 minutes vs. 162.5 minutes (p = 0.02). Bony realignment and aesthetic results were comparable in both groups. Additionally, only one 1cm facial incision was required with this repair system versus several incisions using traditional methods. Conclusions: Closed-reduction Steinmann-pin fixation of ZMC fractures provides adequate bony alignment and aesthetics. Our study supports this system in the repair of ZMC fractures as it requires significantly less operating time, one small incision, and excellent patient outcomes.
文摘BACKGROUND Pain of the zygomatic arch region is common among patients with orofacial pain,especially in those with temporomandibular disorder-related pain of a myogenic origin.Since zygomatic arch pain may occur due to various causes other than muscle pain,appropriate diagnosis and treatment planning is essential to ensure its successful management.Unfortunately,zygomatic arch pain has not been handled as an independent clinical feature until now,and studies have mainly focused on pain resulting from trauma and surgical procedures.CASE SUMMARY We describe 7 independent cases,all of which presented with the identical chief complaint of pain in the zygomatic arch region.However,the underlying causes were different for each,being myofascial pain,myositis,tooth crack,dental caries,sinusitis,neuropathic pain,and salivary gland tumor respectively.In this case report,the clinical features of each case are investigated and diseases to be considered in the diagnostic process are suggested,along with the diagnostic modalities(including computed tomography and magnetic resonance imaging)that can lead to the appropriate final diagnosis.CONCLUSION Zygomatic arch pain is a common complaint encountered in the orofacial pain clinic but may lead to misdiagnosis.Clinicians must have in-depth knowledge of the possible differential diagnoses and evaluation tools.
文摘Background: Zygomatic fracture is one of the most prevalent one among facial fractures caused by vehicle accident, motorcycle accident, fighting, fall and sport injuries. Materials & Methods: This study was a retrospective study of our patients during past 6 years. Results: We had 1277 facial fractures, of whom 9 patients had blindness. We had 193 patients with Zygomatic fracture. 98 patients had pure zygomatic fracture and other had complicated fractures. Frequency of blindness due to zygomatic fracture in a period of six years was 4.7% in all and in pure zygomatic fractures was 2.04%. Blindness was most prevalent in age group 20 - 29 years old (55.6%). The most prevalent cause of zygomatic fracture which causes blindness, was motor vehicle accident (77.8%). Blindness was more common in males (77.8%) than females (22.2%). Discussion and Conclusions: One of the most disastrous complication of zygomatic fracture is transection of optic nerve. Very careful examination of fractured bones careful examination of optic nerve and visual acuity and urgent operation and decompression of optic nerve must be performed. About 4% - 5% will have blindness purely due to fracture.
文摘Fractures of the zygomaticomaxillary complex are among the most common face traumas. Based upon the complexity and great variety of reported diagnoses and treatments, the proposal of this study was to evaluate, clinically and radiographically, unilateral zygomatic fractures treated through internal rigid fixation with miniplates and screws of 1.5 mm. Material and Method: 15 patients with unilateral fractures of the zygomaticomaxillary complex were analyzed, and compared with 15 patients without fractures so that a comparative analysis of the area and the perimeter of the orbital cavities could be made, as well as the distance from the nasal point to the zygomatic prominence between both groups. Results: In the radiographic analysis, the both groups presented similarity in the perimeter and in the area of the orbital cavities. Concerning the distance from the nasal point to the zygomatic prominence, only the operated group showed a significant difference between the sides, even though clinically the observation of the asymmetry had been absent or discreet. Conclusion: The treatment of unilateral fractures of the zygomaticomaxillary complex with the use of plates and screws of the 1.5 mm system proved to be effective, showing good esthetic results and low complication rates.
文摘The oral rehabilitation of edentulous patients can be done in different ways depending on the alveolar ridge morphology and patient expectations. The objective of this clinical case was to report prosthetic and functional adaptation difficulties when conventional complete denture was changed to a zygomatic implant-supported prosthesis. We report a 52-year-old male singer with an atrophic maxilla who was rehabilitated with zygomatic implant-supported prosthesis using 4 implants. However, the thickness of the prosthesis in the palatal region and the space between the prosthesis and soft tissue caused difficulty in speaking and singing. The palatal region of the prosthesis was trimmed and the anterior region of the prosthesis was relined. These procedures were performed to make room for the tongue and minimize the passage of air during speech. Adaptations in the shape of the prosthesis must be made to enable its use, without compromising its strength.
文摘Aim: To analyse the epidemiology, aetiology, and surgical management of zygomatic complex (ZMC) fractures in our major trauma centre, and to compare the number and location of fixation points and surgical access in our patient cohort with the literature. Methods: Retrospective analysis of all operative cases (Open Reduction and Internal Fixation) of zygomatic complex fractures over a one year period (2016). Results: A greater proportion of patients in our cohort (54%) were treated with one-point fixation compared to the literature, with the zygomaticomaxillary (ZM) buttress being the most popular fixation point (90%). ZM buttress and frontozygomatic (FZ) suture were the commonest choices for two-point fixations (70%). Buccal sulcus incision was used for ZM access in all cases. For FZ access, upper blepharoplasty incision was the most common (56%). For infra-orbital margin access, transconjunctival incision was the most common (75%). There was no significant association between number of fixation points and presence of associated injuries, impact of injury, or time to operation. There were no post-operative complications. Conclusion: A greater proportion of patients in our cohort were successfully treated with one point fixation compared to the literature, and fewer patients underwent orbital floor exploration and repair in our cohort compared to the literature. This study highlights the ongoing variation in the surgical management of ZMC fractures.
文摘Patients suffering from zygomatic complex fractures always present facial deformity and dyslunctions, and thereafter develop psychological and physiological problems. It is really hard to get an ideal prog- nosis for the zygomatic complex fractures because of the complicated anatomical structures. Computer- assisted surgery techniques, as the new emerging auxiliary methods, can optimize the surgical protocol, predict operation outcomes, and improve the accuracy and quality of the operation. Meanwhile the postoperative complications can be reduced effectively. This review aims to provide a comprehensive overview of the application of computer-assisted surgery techniques in the management of zygomatic complex fractures.
文摘Background:Hemangiopericytoma and solitary fibrous tumor are considered related variants on the same spectrum and both may essentially be the same tumor.They are infrequently encountered in the orbital region while the zygomatic bone is an extremely rare location for these neoplasms to occur.Case presentation:A 14-year-old boy presented with complaint of deformity of left infraorbital area and a firm,regular mass in the region.Orbital CT scan revealed a well-defined round isodense intraosseous lesion in the lowermost portion of the lateral orbital wall(zygomatic bone),expanding the bone and protruding anteriorly and medially.MRI showed the mass to be heterogenous and strongly enhancing with contrast medium.Inferior transconjunctival orbitotomy was performed and the mass was removed.The histopathologic examination and immunohistochemistry staining results(positive for CD34,CD31 and smooth muscle actin,but negative for CD99,S100,B-cell lymphoma 2(bcl-2)and desmin)confirmed the diagnosis of hemangiopericytoma.The postoperative course was uneventful,with no evidence of recurrence after 5 years follow up.Conclusions:This case represents the second hemangiopericytoma reported in the zygomatic bone.Although extremely rare,hemangiopericytoma/solitary fibrous tumor might be considered in the differential diagnosis of intraosseous lesions of the orbital and zygomatic region.
文摘Objective: To introduce the technique of subciliary incision and lateral cantholysis with tri-dimension reduction and rigid internal fixation to treat zygomatic complex fractures. Methods: The subciliary incision and lateral cantholysis combined with tri-dimension reduction and rigid internal fixation of zygomatic complex fractures with titanium microplates were applied in 56 patients with zygomatic complex fractures. Another lateral eyebrow incision or sublabial incision was used to simplify the operation. Results: The postoperative follow-up period ranged from 6 months to 5 years. During the follow-up period, all the patients had satisfying postoperative results. All clinical symptoms disappeared except the numbness in the infraorbital region in 2 patients. In 94.6% patients no complications such as obvious scar, ectropion, entropion or blepharoedema were found, only 5.4% of the patients had slight ectropion 6 months after operation. Conclusions: The subciliary incision and lateral cantholysis have many advantages such as invisible scar, sufficient exposure, minimal injury, and few complications and combined with rigid internal fixation with titanium microplates this technique could be used as one of the routine operation methods to treat zygomatic complex fractures.
文摘Aim:Fractures of the zygomatico maxillary complex(ZMC)are commonly seen after traumatic injuries to the facial skeleton.The aim of the study was to review the outcome of individualized treatment approach in the management of isolated ZMC fractures.Methods:A retrospective analysis of 25 patients was conducted to assess the outcomes of isolated ZMC(iZMC)fracture treatment at a multi specialty hospital(Punjab,India)over a 3–year period.Results:Out of the 25 patients reviewed,4 patients required no surgical intervention and 21 patients underwent surgical reduction via the buccal sulcus approach.An individualized treatment plan was formulated for each patient to decide mini plate fixation at one–two–or three–point with or without orbital rim exploration.Two patients required removal of mini plates from the buttress area on postoperative follow up.Conclusion:Our review shows that an individualized treatment approach produces the most favorable results in the management of iZMC fractures.
文摘Malignant tumors located in the infratemporal fossa are rare diseases.When all entities are combined,such tumors account for approximately 0.5%of all head and neck tumors.1 The complex anatomy of this region makes these tumors difficult to diagnose and treat.Bordered laterally by the zygomatic arch and the mandible and medially by the maxilla and the pterygoid process of the sphenoid bone,this area is located beneath the greater wing of the sphenoid bone.It contains significant structures such as the maxillary artery,the venous pterygoid plexus,the mandibular nerve,and the otic ganglion2.
