ULTRASOUND GUIDED CLOSED REDUCTION VERSUS OPEN REDUCTION OF ZYGOMATIC ARCH IN ZYGOMATICOMAXILLARY FRACTURES

Abstract

Introduction: trauma of the zygomaticomaxillary complex (ZMC) has profound functional as well as aesthetic implications. Treatment of ZMC fractures remains one of the most controversial issues in maxillofacial trauma with regard to the classification, diagnosis, surgical approach and treatment.Precise management of the ZMC fractures needs accurate diagnosis, accessible exposure, and precise rigid fixation Objectives: To compare between ultrasound guided closed reduction and open reduction of zygomatic arch in cases of ZMC fracture. Materials and methods: This study was conducted on a sample of twenty patients who had fracture repair of ZMC. Ten of them (study group) were treated via direct peri-orbital approach with the use of intra-operative ultrasound to guide zygomatic arch reduction. While the other ten patients (control group) via coronal approach with open reduction of zygomatic arch. Postoperative patient evaluation was performed with specific attention paid towards zygomatic arch reduction, nerve function, wound healing, and postoperative ocular complications. Results: Radiographic follow up showed no statistical significant difference between normal side and reduced side of zygomatic arch which reflect satisfactory arch reduction among both groups. Conclusion: From the results of this study it was concluded that ultrasonography is an effective method for guiding zygomatic arch reduction with other minimal incisions in cases of ZMC fracture. On the other hand, coronal incisions have advantages of giving excellent access to ZMC fracture with direct reduction of zygomatic arch but with considerable disadvantages.