Al-Watary Mohammed Qasem, Libin Song, Yingyou He, Heyou Gao, Abotaleb Bassam M, Sakran Karim, Li Jihua
State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Center of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Department of Oral and Maxillofacial surgery, Faculty of Dentistry, Ibb University, Yemen; Ibb University, Yemen.
J Stomatol Oral Maxillofac Surg. 2023 Dec;124(6):101454. doi: 10.1016/j.jormas.2023.101454. Epub 2023 Mar 23.
Reduction malarplasty (RM) is a common facial contouring procedure among Orientals. Currently, fixation methods selection and placement vectors are controversial. Therefore, this study aimed to evaluate the effect of different zygomatic complex fixation methods on surgical outcomes stability after RM.
In this retrospective study, 60 consented patients (120 operated zygoma) who met inclusion criteria were included. ITK-SNAP and 3D Slicer software were used to measure the displacement of the zygomatic complex using postoperative CTs (T1: one week and T2: six months). The region of interest included zygomatic body fixation methods (ZBFm), namely: two bicortical screws (2LS); an l-shaped plate with one bicortical screw (LPLS); an l-shaped plate with short-wing on the zygoma (LPwZ) and on the maxilla (LPwM), combined with zygomatic arch fixation methods (ZAFm), including Mortice-Tenon (MT); 3-hole plate (3HP); and short screw (SS). ANOVA test was used to compare the displacement values among ZBFm/ZAFm combinations.
The 2LS and LPLS groups showed lower displacement than the single l-shaped plate (P< 0.001, P = 0.001), which performed better when the short-wing was fixated on the maxilla (0.9 ± 0.4 mm and 1.2 ± 0.6 mm respectively).
After RM, the two-bridge fixation methods (2LS and LPLS) provide better stability than the single l-shaped plate. All ZAF methods showed similar stability when combined with 2LS or LPLS as zygomatic body fixation methods.
颧骨缩小整形术（RM）是东方人常见的面部轮廓整形手术。目前，固定方法的选择和放置向量存在争议。因此，本研究旨在评估不同颧骨复合体固定方法对RM术后手术效果稳定性的影响。
在这项回顾性研究中，纳入了60名符合纳入标准并同意参与的患者（120侧颧骨接受手术）。使用ITK-SNAP和3D Slicer软件，通过术后CT（T1：术后一周；T2：术后六个月）测量颧骨复合体的移位情况。感兴趣的区域包括颧骨体固定方法（ZBFm），即：两枚双皮质螺钉（2LS）；带有一枚双皮质螺钉的L形钢板（LPLS）；在颧骨上带有短翼的L形钢板（LPwZ）和在上颌骨上带有短翼的L形钢板（LPwM），以及颧骨弓固定方法（ZAFm），包括榫卯（MT）；三孔钢板（3HP）；和短螺钉（SS）。采用方差分析测试比较ZBFm/ZAFm组合之间的移位值。
2LS和LPLS组的移位低于单L形钢板组（P<0.001，P = 0.001），当短翼固定在上颌骨时表现更好（分别为0.9±0.4毫米和1.2±0.6毫米）。
RM术后，双桥固定方法（2LS和LPLS）比单L形钢板提供更好的稳定性。当所有ZAF方法与2LS或LPLS作为颧骨体固定方法联合使用时，显示出相似的稳定性。
