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Three-dimensional intraoperative computed tomography imaging for zygomatic fracture repair

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2021, v.47 no.5, pp.382-387
https://doi.org/10.5125/jkaoms.2021.47.5.382
Oren Peleg (Tel Aviv University)
Clariel Ianculovici1 (Tel Aviv University)
Amir Shuster (Tel Aviv University)
Eitan Mijiritsky (Tel Aviv University)
Itay Oz (Tel Aviv University)
Shlomi Kleinman (Tel Aviv University)

Abstract

Objectives: Zygomatic complex (ZMC) fractures comprise up to 40% of all facial fractures. Misaligned bone fragments and misplaced fixation hard-ware traditionally detected postoperatively on plain radiographs of the skull might require re-operation. The intraoperative O-Arm (Medtronic, USA) is a three-dimensional (3D) computed tomographic imaging system. Materials and Methods: This retrospective single-center study evaluated the utility of O-Arm scanning during corrective surgeries for ZMC and zygomatic arch (ZA) fractures from 2018 to 2020. Three females and 16 males (mean age, 31.52 years; range, 22-48 years) were included. Fracture instability (n=6) and facial deformity (n=15) were the most frequent indications for intraoperative 3D O-Arm scan. Results: The images demonstrated that all fracture lines were properly reduced and fixed. Another scan performed at the end of the fixation or reduc-tion stage, however, revealed suboptimal results in five of the 19 cases, and further reduction and fixation of the fracture lines were required. Conclusion: Implementation of an intraoperative O-Arm system in ZMC and ZA fracture surgeries assists in obtaining predictable and accurate re-sults and obviates the need for revision surgeries. The device should be considered for precise operations such as ZMC fracture repairs.

keywords
Zygomatic fractures, Maxillofacial injury, Maxillofacial procedure, X-ray computed tomography, CT X ray

Journal of the Korean Association of Oral and Maxillofacial Surgeons