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

Publication date: Available online 7 May 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Thomas Gander, Michael Blumer, Claudio Rostetter, Maximilian Wagner, Daniel Zweifel, Paul Schumann, Daniel B. Wiedemeier, Martin Rücker, Harald Essig
ObjectiveFractures of the zygoma and orbit are common facial skeleton injuries. Inadequate reduction and internal fixation may result in functional and esthetic impairment. Herein, the use of intraoperative three-dimensional (3D) cone beam computed tomographic (CBCT) imaging for determining the intraoperative revision rate and need for additional reconstruction of the orbit were assessed.Study DesignA retrospective analysis was conducted of 48 consecutive patients (15 females, 33 males) suffering from simple or complex zygomatic fractures seen between June 2015 and October 2016. Intraoperative 3D CBCT imaging (Xoran Technologies, Ann Arbor, MI, USA) was performed and the intraoperative result was overlaid on the preoperative plan 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.ResultsIn 6 out of 48 patients, intraoperative revision was necessary based on the superimposition with the preoperative planning. Five of these six patients had comminuted fractures (p=0.001). In seven patients, the indication for orbital reconstruction was revised after the intraoperative 3D CBCT imaging.ConclusionsIntraoperative 3D CBCT imaging allows for immediate revision and prevents unnecessary orbital reconstruction.



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