title: Quantitative Determination of Zygomaticomaxillary Complex Position Based on Computed Tomographic Imaging.
abstract: BACKGROUND
  The zygomaticomaxillary complex (ZMC) is frequently involved in craniofacial fractures. We propose an objective approach for defining the ZMC position on skeletal and soft tissue by using Amira to process 3-dimensional (3D) facial computed tomography (CT) images.
  
  
  OBJECTIVE
  In this study, we aim to propose 1 anthropometric system, facilitated based on CT images, which can be used in quantitative analysis of ZMC position and examine the symmetry of skeletal and soft tissue of the ZMC with high reliability and validity.
  
  
  METHODS
  Twenty Taiwanese trauma patients with pure mandibular fracture but bilateral intact ZMCs were recruited to participate in this study. The head position was adjusted in 3D planes during the examinations. The distances between the zygion and nasion and maxillozygion and nasion were defined as the x plane. The y plane was defined as the distance between the maxillozygion to the vertex and orbitale to the vertex. The distance between the maxillozygion and opisthocranion was defined as the z plane.
  
  
  RESULTS
  The results indicated that the intrasubject variability was 0.7 to 1.6 and 0.1 to 1.8 mm in skeletal and soft tissue, respectively. The intersubject variability ranged from 3.1 to 9.2 and 1.8 to 9.3 mm in skeletal and soft tissue, respectively. The proposed anthropometric system demonstrated high validity and reliability in ZMC measurements. No significant difference was observed among bilateral ZMCs, indicating the feasibility of the mirroring technique during surgical processes.
  
  
  CONCLUSIONS
  We conclude that the anthropometric system for processing 3D facial CT images facilitated by Amira has potential implication in the assessment and reconstruction of the ZMC in both skeletal and soft tissue.
authors.affiliation: From *Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taoyuan; and †Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan, Republic of China.
authors.forename: Shih-Hsuan
authors.initials: SH
authors.lastname: Mao
authors.forename: Yu-Hsuan
authors.initials: YH
authors.lastname: Hsieh
authors.forename: Pang-Yun
authors.initials: PY
authors.lastname: Chou
authors.forename: Victor Bong-Hang
authors.initials: VB
authors.lastname: Shyu
authors.forename: Chien-Tzung
authors.initials: CT
authors.lastname: Chen
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008337:Mandibular Fractures / Q000000981:diagnostic imaging*; D008437:Maxilla / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012984:Software; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult; D015050:Zygoma / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D015051:Zygomatic Fractures / Q000000981:diagnostic imaging*