Maxillary sinus volume and facial asymmetry after unilateral zygomaticomaxillary complex fracture reduction with 2, 3, and 4 fixation points: CBCT-based investigation - 22/10/23

Doi : 10.1016/j.jormas.2023.101537

Eissa Abdo Al-shujaa ^a,^b,^c, Hebah Hasan Al-awdi ^c,^d, Saddam Noman Al-wesabi ^a,^e, Grace Paka Lubamba ^b, Bassam A. Altayar ^e, Karim Ahmed Sakran ^c, Wael Telha ^b, Xin Xia ^a, Bin Liu ^a, Fuqiang Xie ^a,^⁎
^a Department of Oral and Maxillofacial Surgery, School of Stomatology, Lanzhou University, Lanzhou, Gansu, China
^b 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
^c Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
^d Department of Orthodontics, Xiangya Stomatological Hospital, School of Stomatology, Central South University, Changsha, China
^e State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China

^⁎Corresponding author.

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Sunday 22 October 2023

Abstract

Purpose

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.

Materials and methods

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).

Results

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.

Conclusions

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.

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Keywords : Zygomaticomaxillary complex, Maxillary sinus volume, Chronic sinusitis, Asymmetry