title: Intraoperative imaging for the repair of zygomaticomaxillary complex fractures: a comprehensive review of the literature.
abstract: BACKGROUND
  Intraoperative imaging seems to be the next step to improve surgical outcome in the treatment of zygomaticomaxillary complex (ZMC) fractures. Many publications have appeared on intraoperative imaging for trauma surgery, but in most hospitals intraoperative imaging is not routinely performed for ZMC fracture repair. The goal of this review was to assess the value of intraoperative imaging in ZMC fracture repair.
  
  
  METHODS
  The literature was reviewed with focus on the effects of intraoperative imaging on facial symmetry, fracture reduction and the frequency of additional reduction after intraoperative imaging in ZMC fractures.
  
  
  RESULTS
  Six publications were found on the frequency of additional reduction after intraoperative imaging in ZMC fracture repair. Revision of the reduction of the zygoma was performed in 18% (95% CI 10.5%-29.0%), revision of the orbital floor was performed in 9% (95% CI 3.6%-17.2%). No publications were found on the effects of intraoperative imaging on facial symmetry or on the accuracy of fracture reduction.
  
  
  CONCLUSIONS
  Information obtained from intraoperative imaging often has consequences on the surgical management of ZMC fractures. However, the effect on restoration of facial symmetry and fracture reduction is yet to be established.
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: R. Koole, M.D., D.M.D., Ph.D), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, PO Box 85500, The Netherlands. Electronic address: w.m.m.vanhout@umcutrecht.nl.
authors.forename: Wouter M M T
authors.initials: WM
authors.lastname: van Hout
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: R. Koole, M.D., D.M.D., Ph.D), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, PO Box 85500, The Netherlands.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Van Cann
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: R. Koole, M.D., D.M.D., Ph.D), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, PO Box 85500, The Netherlands.
authors.forename: Marvick S M
authors.initials: MS
authors.lastname: Muradin
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: R. Koole, M.D., D.M.D., Ph.D), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, PO Box 85500, The Netherlands.
authors.forename: Michaël H
authors.initials: MH
authors.lastname: Frank
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: R. Koole, M.D., D.M.D., Ph.D), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, PO Box 85500, The Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: Koole
mesh_terms: D003952:Diagnostic Imaging / Q000379:methods*; D005592:Fracture Fixation / Q000379:methods; D006801:Humans; D007430:Intraoperative Care; D008440:Maxillary Fractures / Q000175:diagnosis* / Q000601:surgery; D015641:Radiography, Interventional / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods; D015051:Zygomatic Fractures / Q000175:diagnosis* / Q000601:surgery
keywords: Conebeam-CT; Fluoroscopy; Maxillofacial trauma; Spiral-CT; Ultrasonography; Zygomaticomaxillary complex fracture