Intraoperative ultrasound imaging in the closed reduction of zygomatic arch fracture: Getting it right the first time

Abstract

PurposeTo determine the feasibility and efficacy of intraoperative ultrasound imaging in maxillofacial surgery of depressed zygomatic arch fractures. To ensure the accurate and adequate reduction of the depressed zygomatic arch using high frequency ultrasound linear probe and provide a reproducible technique. MethodsThe authors evaluated 10 consecutive adult patients with zygomatic arch fractures who required a closed reduction of the fractured zygomatic arch between January 2019 and June 2020. The fractures were diagnosed with a CT scan and clinical findings of reduced mouth opening with visible depression were the most common indication. Intraoperative Ultrasound imaging was used for our patients who underwent closed surgical reduction of zygomatic arch fractures to visualize and confirm accurate reduction. Postoperative CT scan was done to evaluate the reduction. ResultsAn intraoral approach was used to reduce the fractures with an elevator. In Nine cases the achieved reduction was a mirror image of the contralateral unfractured arch as evaluated with postoperative CT scan. In One case the posterior third of arch was found to be minimally displaced. Mouth opening and facial symmetry were improved and satisfactory in all the cases. ConclusionsIntraoperative ultrasound assisted reduction of zygomatic arch improves the assessment of reduction and provides real time feedback to the surgeon. The results are promising and this modality is recommended for similar cases.