Swift William M, Marston Alexander P, Tollefson Travis T
Department of Otolaryngology -Head and Neck Surgery, University of California Davis, Sacramento, California, USA.
Curr Opin Otolaryngol Head Neck Surg. 2025 Aug 1;33(4):199-205. doi: 10.1097/MOO.0000000000001052. Epub 2025 Apr 23.
Zygomaticomaxillary complex (ZMC) fractures pose both functional and aesthetic challenges, requiring careful surgical planning to optimize outcomes while minimizing morbidity. Recent advancements in surgical planning, fixation strategies, and implant technology have refined the approach to ZMC fracture repair. This review highlights these developments and discusses their implications for surgical decision-making, emphasizing strategies that balance reduction accuracy with the least invasive intervention.
Studies suggest that minimizing fixation points in properly selected ZMC fractures does not compromise patient satisfaction or postoperative symmetry. Intraoperative CT is increasingly utilized and has been shown to reduce unnecessary incisions and implants while improving reduction accuracy. Computer aided surgical planning has demonstrated improved surgical precision through preoperative planning, guiding plate placement, and enhancing anatomical symmetry. Additionally, patient specific implants (PSIs) have emerged as valuable tools in complex or revision cases, offering more precise reconstruction with reduced operative time. Augmented reality (AR) is a rapidly emerging technology that holds promise for surgical planning and navigation for ZMC fracture repair.
Wider adoption of intraoperative CT has improved surgical assessment, while advances in computer aided surgical planning and patient specific implants continue to refine surgical workflows and outcomes. As technology evolves, future research should focus on optimizing cost-effectiveness and further integrating digital planning tools. AR, still in its preliminary stages, may represent a significant innovation in enhancing surgical precision and visualization during ZMC fracture repair.
颧上颌复合体（ZMC）骨折在功能和美观方面都带来了挑战，需要精心的手术规划以优化治疗效果并将发病率降至最低。手术规划、固定策略和植入技术的最新进展改进了ZMC骨折修复的方法。本综述重点介绍了这些进展，并讨论了它们对手术决策的影响，强调了在将复位精度与微创干预相结合的策略。
研究表明，在适当选择的ZMC骨折中减少固定点不会影响患者满意度或术后对称性。术中CT的使用越来越普遍，已证明可减少不必要的切口和植入物，同时提高复位精度。计算机辅助手术规划通过术前规划、引导钢板放置和增强解剖对称性，提高了手术精度。此外，定制植入物（PSIs）已成为复杂或翻修病例中的重要工具，可实现更精确的重建并缩短手术时间。增强现实（AR）是一种迅速兴起的技术，有望用于ZMC骨折修复的手术规划和导航。
术中CT的更广泛应用改善了手术评估，而计算机辅助手术规划和定制植入物的进展继续优化手术流程和治疗效果。随着技术的发展，未来的研究应侧重于优化成本效益，并进一步整合数字规划工具。仍处于初步阶段的AR可能代表了ZMC骨折修复过程中提高手术精度和可视化的一项重大创新。
