Chepurnyi Yurii, Kustro Tatiana, Chernogorskyi Denis, Zhukovtseva Olena, Kanura Oleksandr, Kopchak Andrii
Department of Stomatology, Bogomolets National Medical University, Kyiv, Ukraine.
Center for Maxillo-Facial Surgery and Stomatology, Kyiv Regional Hospital, Kyiv, Ukraine.
Ann Maxillofac Surg. 2021 Jan-Jun;11(1):91-96. doi: 10.4103/ams.ams_294_20. Epub 2021 Jul 24.
Zygoma defects are a challenging clinical problem and are frequently connected with the alteration of facial harmony, horizontal asymmetry of the face, and significant functional deficit. The application of patient-specific implants (PSIs) has the potential to improve the effectiveness of zygoma defect management. The aim of this study was to evaluate the anatomic, esthetic, and functional outcomes of PSI application for zygoma reconstruction.
A retrospective study was conducted on data from 11 patients with zygoma defects who underwent a reconstruction procedure in which a PSI was applied and was followed for >1 year after surgery with the evaluation of esthetic and functional outcomes. Precision of PSI position and anatomy reconstruction was estimated by superimposition of the models with automatic point-to-point measurement and determination of the existing deviations between models.
The mean follow-up period in our study was 21.6 ± 6.2 months (range 14-39 months). No major complications occurred in the postoperative period: There were no clinical or computed tomography symptoms of maxillary sinusitis, implant-related infection, or implant exposure. The mean deviation between the planned and real positions of PSIs in our series was 0.72 ± 0.41 mm. The mean deviation between the reconstructed zygomatic complex and the mirrored intact side in our series was 1.45 ± 0.7 mm. The mean volume difference between the intact and damaged orbits was 1.7 ± 0.8 mm.
The results of the present study support the wider clinical application of PSIs in orbital and zygoma reconstructions, as it is an effective option to achieve precise reconstruction of the complex zygoma anatomy.
颧骨缺损是一个具有挑战性的临床问题，常与面部和谐度改变、面部水平不对称及严重功能缺陷相关。定制植入物（PSI）的应用有可能提高颧骨缺损治疗的效果。本研究的目的是评估PSI在颧骨重建中的解剖学、美学和功能效果。
对11例颧骨缺损患者的数据进行回顾性研究，这些患者接受了使用PSI的重建手术，并在术后随访1年以上，评估美学和功能效果。通过自动点对点测量叠加模型并确定模型间的现有偏差，来估计PSI位置和解剖结构重建的精度。
本研究的平均随访期为21.6±6.2个月（范围14 - 39个月）。术后未发生重大并发症：无上颌窦炎、植入物相关感染或植入物暴露的临床或计算机断层扫描症状。本系列中PSI计划位置与实际位置的平均偏差为0.72±0.41毫米。本系列中重建的颧骨复合体与镜像完整侧之间的平均偏差为1.45±0.7毫米。完整眼眶与受损眼眶之间的平均体积差为1.7±0.8毫米。
本研究结果支持PSI在眼眶和颧骨重建中更广泛的临床应用，因为它是实现复杂颧骨解剖结构精确重建的有效选择。
