Department of Oral and Maxillofacial Surgery, School of Stomatology, Lanzhou University, Lanzhou, Gansu, China; State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen; Department of Orthodontics, Xiangya Stomatological Hospital, School of Stomatology, Central South University, Changsha, China.
J Stomatol Oral Maxillofac Surg. 2024 Jun;125(3S):101537. doi: 10.1016/j.jormas.2023.101537. Epub 2023 Jun 17.
This study aimed to assess the maxillary sinus volume (MSV), Chronic Sinusitis incidence, and asymmetry of the zygomaticomaxillary complex (ZMC) following ZMC fracture surgery with various numbers of fixation points.
In a prospective non-randomized cohort, 50 adults with unilateral ZMC fractures who treated by open reduction and internal fixation (ORIF) between November 2019 and October 2021 were assigned to accomplish this study. They distributed into three groups as per fixation points (2, 3, or 4 Points). Preoperative (T1), Immediate postoperative (T2), and follow-up (T3) cone beam computed topography were analyzed using the Mimics software. The main measures were MSV and asymmetry indexes (ASI) of six paired bilateral anatomical landmarks (Orbital, Suprajugal, Jugale, Zygon, Maxillozygion 1, and Maxillozygion 2).
MSV decreased significantly on the affected sides postoperatively in 2P and 3P groups, both in T2 and T3. Further, the T2-T3 comparisons showed a significant MSV change (p = 0.001). ASI reduced considerably to clinically tolerated levels (<3 mm) on landmarks near the fixation sites postoperatively. The ASI on the Zygon and Maxillozygion 1 landmarks showed significant changes among the three groups in both T2 and T3. Interestingly, only five cases had reported postoperative sinusitis symptoms.
Although the MSV was changed among the different fixation point groups, the incidence of chronic sinusitis was uncommon. Bilateral asymmetry affected by number and position of the fixation points, fixation with 4 points provide more symmetry.
本研究旨在评估不同固定点数的颧骨复合体（ZMC）骨折手术后上颌窦容积（MSV）、慢性鼻窦炎发生率和 ZMC 不对称性。
在一项前瞻性非随机队列研究中，将 2019 年 11 月至 2021 年 10 月期间接受切开复位内固定术（ORIF）治疗的 50 例单侧 ZMC 骨折患者分为三组，分别为 2 点、3 点或 4 点固定。使用 Mimics 软件分析术前（T1）、即刻术后（T2）和随访（T3）的锥形束 CT。主要测量指标为六个配对双侧解剖标志（眶、上颊、颊、颧、上颌第一颌突和上颌第二颌突）的 MSV 和不对称指数（ASI）。
2P 和 3P 组术后患侧 MSV 均明显减少，T2 和 T3 时均如此。此外，T2-T3 比较显示 MSV 有显著变化（p=0.001）。术后近固定点标志处 ASI 显著降低至临床可耐受水平（<3mm）。T2 和 T3 时，Zygon 和上颌第一颌突标志处的 ASI 在三组之间均有显著变化。有趣的是，只有 5 例报告有术后鼻窦炎症状。
尽管不同固定点数组的 MSV 有所改变，但慢性鼻窦炎的发生率并不常见。双侧不对称受固定点数和位置的影响，4 点固定更对称。
