2^nd International conference on
Craniofacial Surgery

Biography:

Abstract:

Introduction: The zygomaticomaxillary complex (ZMC) with its prominent convexity in the face is highly vulnerable to injury. Its fractures are inherently unstable due to superficial muscular aponeurotic system (SMAS) and strong masseteric muscle attachment. The ZMC is also called beauty or cheek bone. Less than optimal results of restoration of form and function after fixing it back to the pre-injury state have resulted in variety of techniques. In this study, we evaluated a novel approach to the reduction, fixation and stabilization of ZMC fractures with optimum aesthetic results in order to prevent post traumatic malar depression, the cause of unaesthetic appearance and restricted jaw function. Aim: The purpose of this study was to fix the (Midface fractures) ZMC fractures  with open reduction and fixation using trans facial fixation technique and  then evaluating pre and post management malar depression along with mouth opening along with conventional methods of ORIF. Materials and Methods: We report a case series of patients who were treated by open reduction and internal fixation of zygomatic- maxillary complex fractures by a single surgeon in the maxillofacial department at the Armed Forces Institute of Dentistry Rawalpindi. We utilized lateral eyebrow and transoral incision for reduction and fixation of ZMC fractures. A 10.5 cm long mini/micro titanium plate was adapted and fixed by passing it below the arch through lateral eye brow incision and brining it behind the zygomatic buttress to the front of maxilla. Then its both ends are fixed at frontozygomatic bone above and nasomaxillary buttress of anterior maxilla after optimal reduction of ZMC. Both fixing areas define the prominence of face and are well placed ahead of ZMC in the face. It gives advantage for addressing projection, the most important aspect required during reduction and fixation, along with post management stability. Patients were evaluated and compared for preoperative findings of malar depression and mouth opening with post op finding. During the follow-up, the patients were routinely evaluated using computed tomography. Results: Treatment was successful in all cases; there were no complications at surgery or postoperatively. During follow-up, all patients had satisfactory facial symmetry, no noticeable scar,and no functional impairment. However due to limited number of patients and follow up time, further large scale, multicenter studies are recommended.