AESTHETIC CONSIDERATIONS IN THE RECONSTRUCTION OF ORBITO-ZYGOMATIC FRACTURES
Aim: The purpose of this study is to present our experience regarding the aesthetic and functional reconstruction of zygomatic bone fractures. Material and methods: We retrospectively reviewed the medical charts of 19 patients diagnosed with orbito-zygomatic fractures needing surgical reduction and fixation, in between January 2016 and January 2018. Two of the patients presented late with cosmetic and functional sequelae of fracture malunion. A two-point fixation was performed in most cases. Titanium mesh was used in four comminuted fractures at the level of the zygomato-alveolar crest and for the reconstruction of orbito-zygomatic fracture sequelae. Reconstruction of the orbital floor was performed in five cases. Results: No significant complications were recorded. Good aesthetic outcomes were obtained in all cases regarding the reconstruction of the orbital walls and the restoration of facial symmetry. Because of the accurate anatomic reconstruction, functionality was resumed postoperatively, with diplopia resolving immediately after surgery and in only one case during the three weeks following the procedure. Conclusions: The most important aspect regarding the immediate restoration of facial symmetry in fractures of the zygomatic complex is the repositioning of the zygomatic prominence by ensuring adequate fixation and support at the level of the zygomato-alveolar crest. The restoration of the contour and volume of the orbital area is also important regarding facial aesthetics and with repercussions regarding functionality. The three-dimensional reconstruction of CT (computed tomography) images in complex cases helps understanding the fracture pattern, reduction pathway and selecting the most accurate fixation method.
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