Ellis E, Kittidumkerng W
Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, 75235-9109, USA.
J Oral Maxillofac Surg. 1996 Apr;54(4):386-400; discussion 400-1. doi: 10.1016/s0278-2391(96)90107-x.
The purpose of this study was to evaluate the adequacy of reduction and stability of fixation of isolated zygomaticomaxillary complex (ZMC) fractures treated by various methods over a 5-year period.
Forty-eight patients with isolated, unilateral ZMC fractures that had at least 6 weeks' clinical follow-up were studied. Demographic information and methods of treatment were obtained from the medical records. Quality of reduction was assessed by examination of postoperative images. Stability of the repositioned ZMC was assessed by comparing immediate postoperative images with those obtained at least 5 weeks later. Cosmetic outcomes were assessed by clinical assessment and examination of photographs.
A variety of surgical approaches and fixation sites were used in the sample. All patients but five had satisfactory reductions performed during surgery. In two of the latter, no noticeable facial deformity was apparent. No patient showed postsurgical change in position of the reduced ZMC. Three patients showed postsurgical enophthalmos at longest follow-up. Approximately 20% of those having lower eyelid incisions had some amount of scleral show at longest follow-up.
A variety of techniques can be used to produce a satisfactory outcome. Based on the results and a review of the literature, recommendations for treatment are proposed.
本研究旨在评估在5年期间采用多种方法治疗的孤立性颧上颌复合体（ZMC）骨折的复位充分性和固定稳定性。
对48例孤立性单侧ZMC骨折且临床随访至少6周的患者进行研究。从病历中获取人口统计学信息和治疗方法。通过术后影像检查评估复位质量。通过比较术后即刻影像与至少5周后获取的影像来评估复位后的ZMC的稳定性。通过临床评估和照片检查评估美容效果。
样本中使用了多种手术入路和固定部位。除5例患者外，所有患者手术期间的复位效果均令人满意。后5例患者中有2例无明显面部畸形。没有患者出现复位后的ZMC术后位置改变。在最长随访期时，3例患者出现了术后眼球内陷。在最长随访期时，约20%接受下睑切口的患者有一定程度的巩膜外露。
可以采用多种技术取得满意的治疗效果。基于研究结果和文献综述，提出了治疗建议。
