Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou.
Stomatology Clinical Center of Zhongshan City People' s Hospital, Zhongshan, Guangdong, China.
J Craniofac Surg. 2022 Jun 1;33(4):1230-1235. doi: 10.1097/SCS.0000000000008418. Epub 2021 Dec 14.
Reduction of the bilateral zygomaticomaxillary complex (ZMC) fracture with individualized templates based on computer- aided surgical simulation system. To evaluate the practicality and accuracy of this approach in the treatment of bilateral ZMC fracture.
Sixteen patients with bilateral ZMC fractures were collected to create a study model. The authors reconstruct the ZMC on one side via the three-dimensional (3D) model, and then mirrored to the opposite side. Multiple individualized templates were made based on the 3D model, and used as intraoperative guidance to reduce fractures. After surgery, the facial symmetry and the position of zygoma were observed. The mouth opening, pupil level, and sensation of infraorbital nerve were evaluated. Some mark points on zygoma were measured and the postoperative horizontal asymmetry rate (H) was calculated. Besides, orbital height and width were measured.
For all patients, the position of bilateral ZMC was basically restored. The patients with restriction of mouth opening all recovered to normal. The H values were less than 3.0% at all mark points. There was almost no difference in bilateral orbital width and height. Meanwhile, there was no significant difference between the preoperative measurements of the ideal virtual 3D model and the postoperative measurements of patients.
The study proves that application of computer-aided design and individualized templates can accurately guide the reduction operation of ZMC fracture, restore the ideal shape of ZMC, and obtain good facial symmetry.
利用基于计算机辅助手术模拟系统的个体化模板减少双侧颧骨复合体（ZMC）骨折。评估这种方法在治疗双侧 ZMC 骨折中的实用性和准确性。
收集了 16 例双侧 ZMC 骨折患者来建立研究模型。作者通过三维（3D）模型重建一侧的 ZMC，然后镜像到对侧。根据 3D 模型制作了多个个体化模板，并用作术中引导以减少骨折。手术后，观察面部对称性和颧骨位置。评估张口度、瞳孔水平和眶下神经感觉。测量颧骨上的一些标记点，并计算术后水平不对称率（H）。此外，测量眶高和眶宽。
所有患者的双侧 ZMC 位置基本恢复。所有张口受限的患者均恢复正常。所有标记点的 H 值均小于 3.0%。双侧眶宽和眶高几乎没有差异。同时，理想虚拟 3D 模型的术前测量值与患者的术后测量值之间没有显著差异。
本研究证明，计算机辅助设计和个体化模板的应用可以准确指导 ZMC 骨折的复位操作，恢复 ZMC 的理想形状，并获得良好的面部对称性。
