Status of the internal orbit after reduction of zygomaticomaxillary complex fractures.
OBJECTIVE
We sought to determine the status of the internal orbit before and after reduction of zygomaticomaxillary complex (ZMC) fractures when treated without internal orbital reconstruction.


METHODS
We conducted a retrospective study of preoperative and postoperative computed tomography (CT) scans in 65 patients with unilateral ZMC fractures who were treated by reduction of the ZMC complex without internal orbital reconstruction. The size and location of the internal orbital defects, orbital soft tissue displacement, and orbital volume were assessed in the preoperative and postoperative CT scans.


RESULTS
Reduction in the ZMC fractures was considered ideal in 58 of the 65 patients. Only minor malpositions occurred in the remaining 7 patients. The size of the internal orbital defects increased slightly with ZMC reduction but the internal orbital fractures were realigned, and few had increases in orbital volume or soft tissue sagging into the sinuses. Examination of follow-up CT scans in several patients taken weeks to months later showed that the residual defects became smaller and that none of these patients had an increase in orbital volume or soft tissue sagging.


CONCLUSIONS
The preoperative CT scan can be used to assess the amount of internal orbital disruption for purposes of developing a treatment plan in patients with ZMC fractures. When there is minimal or no soft tissue herniation and minimal disruption of the internal orbit, ZMC reduction is adequate treatment.
Ellis
Edward
E
Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas 75390-9109, USA. Edward.Ellis@UTSouthwestern.edu
Reddy
Likith
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation; D006547:Hernia / Q000000981:diagnostic imaging; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging; D008297:Male; D016555:Matched-Pair Analysis; D008440:Maxillary Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008443:Maxillary Sinus / Q000000981:diagnostic imaging; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging*; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D015051:Zygomatic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*