title: The zygomaticomaxillary complex fracture - an anthropometric appraisal of surgical outcomes.
abstract: Before undergoing repair of zygomaticomaxillary complex fractures, most patients are worried about their postoperative appearance. Furthermore, there is an ongoing discussion about the selection of the surgical approach to the inferior orbita and resulting eyelid deformities. We present a photo-assisted postoperative evaluation of zygomaticomaxillary complex fracture repair based on reference anthropometric data. Two hundred and twenty-one patients underwent zygomaticomaxillary complex fracture repair. An analysis of standardized postoperative photographs included measurements of eye fissure width and height, lid sulcus height, upper lid height, upper and lower coverage, position of cornea to palpebra inferior, canthal tilt, scleral show, ectropion and entropion. It was clearly distinguished between operated and contralateral eyelid, and whether a transconjunctival or a subciliary approach was performed. Surgery per se significantly influenced eyelid deformities as measured by its impact on eye fissure index, lower iris coverage and rate of scleral show and ectropion. The surgical approach selected significantly affected eye fissure index, lower iris coverage and rate of scleral show, indicating distortion of the lower eyelid. Investigations regarding orbital fractures should clearly differentiate the type of fracture. The subciliary approach included the highest risk of postoperative lower eyelid deformity in zygomaticomaxillary complex fracture repair. The standardized measurements described here are accurate and objective to evaluate postoperative results.
authors.affiliation: Department of Cranio-Maxillofacial Surgery & Plastic Surgery, Friedrich Schiller University Jena, Erlanger Allee 101, 07747 Jena, Germany. raschke.gregor@googlemail.com
authors.forename: Gregor F
authors.initials: GF
authors.lastname: Raschke
authors.forename: Ulrich M
authors.initials: UM
authors.lastname: Rieger
authors.forename: Rolf-Dieter
authors.initials: RD
authors.lastname: Bader
authors.forename: Oliver
authors.initials: O
authors.lastname: Schaefer
authors.forename: Arndt
authors.initials: A
authors.lastname: Guentsch
authors.forename: Christoph
authors.initials: C
authors.lastname: Hagemeister
authors.forename: Stefan
authors.initials: S
authors.lastname: Schultze-Mosgau
mesh_terms: D000328:Adult; D059925:Anatomic Landmarks / Q000473:pathology; D002508:Cephalometry / Q000379:methods*; D003228:Conjunctiva / Q000601:surgery; D003315:Cornea / Q000473:pathology; D004483:Ectropion / Q000473:pathology; D004774:Entropion / Q000473:pathology; D004954:Esthetics; D005141:Eyelid Diseases / Q000517:prevention & control; D005143:Eyelids / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007498:Iris / Q000473:pathology; D008297:Male; D008440:Maxillary Fractures / Q000473:pathology / Q000601:surgery*; D009915:Orbit / Q000473:pathology; D009917:Orbital Fractures / Q000473:pathology / Q000601:surgery*; D010781:Photography / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012590:Sclera / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult; D015051:Zygomatic Fractures / Q000473:pathology / Q000601:surgery*