期刊论文详细信息
INTERNATIONAL JOURNAL OF SURGERY 卷:33
Zygomatic fractures: Technical modifications for better aesthetic and functional results in older patients
Article
Cortese, Antonio1  Caggiano, Mario2  Carlino, Franco3  Pantaleo, Giuseppe4 
[1] Univ Salerno, Unit Maxillofacial Surg, Dept Med & Surg, Salerno, Italy
[2] Univ Salerno, Dept Med & Surg, Salerno, Italy
[3] Casa Cura Villa Pini, Dept Surg, Sect Maxillofacial Surg, Civitanova Marche, MC, Italy
[4] Univ Naples Federico II, Dept Neurosci Reprod & Odontostomatol Sci, Naples, Italy
关键词: Fracture;    Zygoma;    PRF;    Elderly patients;   
DOI  :  10.1016/j.ijsu.2016.05.057
来源: Elsevier
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【 摘 要 】

Introduction: The zygomaticomaxillary complex, with its intrinsically prominent convexity, is highly vulnerable to injury. In this study, we evaluated a novel combined approach to the reduction and stabilization of frontozygomatic dislocated fractures without aesthetic damage. Materials and Methods: Ten patients (mean age, 52 years) were referred for complex frontozygomatic dislocated fractures. Five patients underwent a transconjunctival approach without canthotomy in association with a transoral maxillary approach and lateral-rim skin incision, also without canthotomy. The other five patients underwent a traditional subciliary incision at the lower eyelid and a vertical lateral incision at the lateral orbital margin. Orbital floor reconstruction was achieved using two to three fixation points and autologous platelet-rich fibrin (PRF). During the 6-month follow-up, the patients were routinely evaluated using computed tomography. Results: Treatment was successful in all cases; there were no problems at surgery or postoperatively. During follow-up, all patients had satisfactory facial symmetry, no noticeable scar, ectropion, or lower-eyelid drop, and no functional impairment. Discussion: Aesthetic considerations are an important aspect of treatment planning in patients with orbitozygomatic fractures, because of the importance of the eye and lid areas to facial aesthetics. In our patients, good aesthetic results were achieved using a novel combined approach. In patients with a large orbital floor dislocation, the reconstructive titanium mesh can be covered by autologous PRF membranes to improve vascularization of the surgical site. By preventing aesthetic damage and functional impairment, our conservative approach is of particular utility in older individuals due to age-related tissue laxity. (C) 2016 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

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