Postoperative imaging of zygomaticomaxillary complex fractures using digital volume tomography.
OBJECTIVE
Three-dimensional imaging using digital volume tomography after reduction of zygomaticomaxillary complex fractures was performed and evaluated.


METHODS
Ten patients admitted for surgical treatment of zygomaticomaxillary complex fractures were included in the study. All patients were male, aged 17 to 81 years (average, 43.8 years). Preoperative diagnostics and surgical treatment involving open reduction under general anesthesia were performed as usual. One to 3 days (average, 1.6 days) postoperatively, a digital volume tomography data set was generated using the NewTom 9000 (NIM s.r.l., Verona, Italy). After DICOM-import in eFilm Workstation 1.8.3 (Merge Technologies Inc, Milwaukee, WI), axial, coronal, and sagittal reconstructions were evaluated by 6 examiners with the help of 5 defined criteria.


RESULTS
One data set was sufficient to visualize all fracture sites of the midface in all patients. Postprocessing using eFilm was successfully performed in all cases. Best scoring results were found regarding bony anchorage of screws and fitting of plates. Remarkable was the low level of metal artifacts in primary and secondary reconstructions, even in close proximity of the material. Most difficulty was encountered during the identification of the medial orbital wall, especially next to poorly ventilated ethmoidal cells. Osseous structures of older patients with decreased bone density proved difficult to visualize.


CONCLUSIONS
Digital volume tomography using the NewTom 9000 is suitable for assessment of postoperative results after zygomaticomaxillary complex reduction.
Heiland
Max
M
Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Germany. heiland@uke.uni-hamburg.de
Schulze
Dirk
D
Rother
Uwe
U
Schmelzle
Rainer
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D001860:Bone Plates; D001863:Bone Screws; D005004:Ethmoid Bone / Q000000981:diagnostic imaging; D005593:Fracture Fixation, Internal; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008440:Maxillary Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging; D011182:Postoperative Care; D014056:Tomography, X-Ray / Q000379:methods*; D015051:Zygomatic Fractures / Q000000981:diagnostic imaging* / Q000601:surgery