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Intraoperative 3-dimensional cone beam computed tomographic imaging during reconstruction of the zygoma and orbit


Gander, Thomas; Blumer, Michael; Rostetter, Claudio; Wagner, Maximilian; Zweifel, Daniel; Schumann, Paul; Wiedemeier, Daniel B; Rücker, Martin; Essig, Harald (2018). Intraoperative 3-dimensional cone beam computed tomographic imaging during reconstruction of the zygoma and orbit. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 126(2):192-197.

Abstract

OBJECTIVE Fractures of the zygoma and orbit are common facial skeleton injuries. Inadequate reduction and internal fixation may result in functional and aesthetic impairment. The aim of this study was to assess the use of intraoperative 3-dimensional (3-D) cone beam computed tomography (CBCT) for determining the intraoperative revision rate and the need for additional reconstruction of the orbit. STUDY DESIGN We conducted a retrospective analysis of 48 consecutive patients (15 females, 33 males) suffering from simple or complex zygomatic fractures, seen between June 2015 and October 2016. Intraoperative 3-D CBCT (Xoran Technologies, Ann Arbor, MI) was performed, and the intraoperative image was overlaid on the preoperative image by using iPlan software (Brainlab, Feldkirchen, Germany) for quality control. Categorical variables were cross-tabulated and compared using Fisher's exact test. P values and 95% confidence intervals were assessed. RESULTS In 6 of 48 patients, intraoperative revision was deemed necessary on the basis of the superimposition on the preoperative images. Five of these 6 patients had comminuted fractures (P = .001). In 7 patients, the indication for orbital reconstruction was revised after intraoperative 3-D CBCT. CONCLUSIONS Intraoperative 3-D CBCT allows for immediate revision and prevents unnecessary orbital reconstruction.

Abstract

OBJECTIVE Fractures of the zygoma and orbit are common facial skeleton injuries. Inadequate reduction and internal fixation may result in functional and aesthetic impairment. The aim of this study was to assess the use of intraoperative 3-dimensional (3-D) cone beam computed tomography (CBCT) for determining the intraoperative revision rate and the need for additional reconstruction of the orbit. STUDY DESIGN We conducted a retrospective analysis of 48 consecutive patients (15 females, 33 males) suffering from simple or complex zygomatic fractures, seen between June 2015 and October 2016. Intraoperative 3-D CBCT (Xoran Technologies, Ann Arbor, MI) was performed, and the intraoperative image was overlaid on the preoperative image by using iPlan software (Brainlab, Feldkirchen, Germany) for quality control. Categorical variables were cross-tabulated and compared using Fisher's exact test. P values and 95% confidence intervals were assessed. RESULTS In 6 of 48 patients, intraoperative revision was deemed necessary on the basis of the superimposition on the preoperative images. Five of these 6 patients had comminuted fractures (P = .001). In 7 patients, the indication for orbital reconstruction was revised after intraoperative 3-D CBCT. CONCLUSIONS Intraoperative 3-D CBCT allows for immediate revision and prevents unnecessary orbital reconstruction.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic of Cranio-Maxillofacial Surgery
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Surgery
Health Sciences > Oral Surgery
Health Sciences > Pathology and Forensic Medicine
Health Sciences > Dentistry (miscellaneous)
Health Sciences > Radiology, Nuclear Medicine and Imaging
Language:English
Date:August 2018
Deposited On:23 Jan 2019 15:26
Last Modified:29 Jul 2020 08:57
Publisher:Elsevier
ISSN:2212-4403
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.oooo.2018.04.008
PubMed ID:29886068

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