title: Radiological evaluation of sphenozygomatic suture fixation for restoration of orbital volume: A retrospective study.
abstract: OBJECTIVE
  Lateral displacement of fracture zygomaticomaxillary complex (ZMC) can cause significant increase in orbital volume leading to enophthalmos. The aim of this study was to radiologically evaluate the efficacy of sphenozygomatic (SZ) suture fixation for restoration of orbital volume after elevation of the temporalis in cases of fracture ZMC where the fixation of zygomatic arch (ZA) was deemed necessary through latero-posterior approach.
  
  
  METHODS
  43 operated cases of fracture ZMC using 4-point fixation were divided into two groups. Group I (n = 24) cases had undergone reduction and fixation of SZ suture as fourth point of fixation by elevating temporalis muscle using hemicoronal approach. Group II (n = 19) cases had undergone reduction and fixation of Infraorbital (IO) rim as fourth point of fixation using preseptal transconjunctival approach. Both the groups were analyzed separately and compared for restoring the increased orbital volume on CT.
  
  
  RESULTS
  Difference in the pre-surgical orbital volume of both the groups was found to be statistically insignificant [p = .678]. In group I, the average bony orbital volume significantly reduced by 3.6 cc from 25.5 cc to 21.9 cc [p = .000] post-surgically. In group II, the average bony orbital volume reduced by 1.5 cc from 25.6 cc to 24.1 cc post-surgically There was a significant difference in the reduction of the increased orbital volume among the 2 groups (Group I: 3.6 cc, group II: 1.5 cc). The amount of reduction was more and statistically significant [p = .000] in the group I than group II.
  
  
  CONCLUSIONS
  SZ suture fixation is reliable in reducing fractures ZMC and restoring the increased orbital volume where the fixation of zygomatic arch (ZA) was deemed necessary through latero-posterior approach.
authors.affiliation: Dept of Oral & Maxillofacial Surgery, Armed Forces Medical College, Pune, India. Electronic address: capt_rohit7@yahoo.com.
authors.forename: Rohit
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Dept of Radiodiagnosis & Imaging, Command Hospital, Southern Command, Pune, India.
authors.forename: Chiyyarath Gopalan
authors.initials: CG
authors.lastname: Muralidharan
authors.affiliation: Dept of Oral & Maxillofacial Surgery, Command Military Dental Centre, Southern Command, Pune, India.
authors.forename: Indranil Deb
authors.initials: ID
authors.lastname: Roy
authors.affiliation: Dept of Radiodiagnosis & Imaging, Command Hospital, Southern Command, Pune, India.
authors.forename: Narendra Kumar
authors.initials: NK
authors.lastname: Jain
authors.affiliation: Dept of Preventive & Social Medicine, Armed Forces Medical College, Pune, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Patrikar
mesh_terms: D000328:Adult; D003393:Cranial Sutures / Q000601:surgery; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D008297:Male; D008440:Maxillary Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000601:surgery*; D055815:Young Adult; D015050:Zygoma / Q000601:surgery; D015051:Zygomatic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Enophthalmos; Fixation; Orbital volume; Sphenozygomatic suture; Temporalis