Surgical treatment of orbital zygomatic complex fracture: Case report
Keywords:Zygomatic fractures; Fracture fixation; Comminuted fractures.
The cases of fracture of the orbital zygomatic complex have high rates, therefore, knowledge of its signs and symptoms is necessary, as it allows for an early diagnosis and a better prognosis. The present work is a clinical case report of a fracture in the orbital zygomatic complex, where the clinical signs and symptoms were described observing aesthetic and functional dysfunctions in order to provide a better diagnosis and surgical planning and to evaluate the techniques used, showing the importance of maxillofacial surgeon in the treatment of these types of fractures. Male patient sought the Maxillofacial Surgery and Traumatology service, victim of a car accident. On physical examination, were identified: palpebral ptosis, periorbital ecchymosis, hyposphagma, diplopia and ophthalmoplegia in the right eye, enophthalmia, loss of anteroposterior projection of the zygomaticus, diffuse edema in the middle third of the face, enlargement of the middle third of the face and mouth opening limitation. A tomographic exam was requested, which confirmed the fractures in the zygomatic complex and the presence of continuity solution compatible with a blow-out fracture, followed by the surgical procedure. The patient underwent 3 surgical approaches, 3 internal fixation points (with 1.5mm, 2.0mm fixation system plates and screws) and placement of an orbital mesh for reconstruction of the orbital floor. The treatment was successful, showing that the surgical procedure is safe and effective, resulting in aesthetic and functional gain.
Allareddy, V., Allareddy, V., & Nalliah, R. P. (2011). Epidemiology of facial fracture injuries. Journal of Oral and Maxillofacial Surgery, 69(10), 2613-2618.
Bagheri, S. C., Bell, R. B., & Khan, H. A. (2013). Terapias atuais em cirurgia bucomaxilofacial. In Terapias atuais em cirurgia bucomaxilofacial (pp. 1122-1122).
Baird, C., Kernohan, G., & Coates, V. (2004). Outcomes of advanced trauma life support training: questioning the role of observer. Accident and emergency nursing, 12(3), 131-135.
Bao, T., Yu, D., Luo, Q., Wang, H., Liu, J., & Zhu, H. (2019). Quantitative assessment of symmetry recovery in navigation-assisted surgical reduction of zygomaticomaxillary complex fractures. Journal of Cranio-Maxillofacial Surgery, 47(2), 311-319.
Batstone, M. D., Monsour, F. N., Pattel, P., & Lynham, A. (2007). The patterns of facial injury suffered by patients in road traffic accidents: a case controlled study. International Journal of Surgery, 5(4), 250-254.
Dakir, A., Muthumani, T., Prabu, N. P., Mohan, R., & Maity, A. (2015). One point fixation of zygomatic tripod fractures in the zygomatic buttress through Keen's intraoral approach: A review of 30 cases. Journal of pharmacy & bioallied sciences, 7(Suppl 1), S238.
El-Anwar, M. W., Elsheikh, E., Hussein, A. M., Tantawy, A. A., & Abdelbaki, Y. M. (2017). Transconjunctival versus subciliary approach to the infraorbital margin for open reduction of zygomaticomaxillary complex fractures: a randomized feasibility study. Oral and maxillofacial surgery, 21(2), 187-192.
Ellis, E., & Messo, E. (2004). Use of nonresorbable alloplastic implants for internal orbital reconstruction. Journal of oral and maxillofacial surgery, 62(7), 873-881.
Ellis III, E., & Zide, M. F. (2006). Acessos cirúrgicos ao esqueleto facial. In Acessos cirúrgicos ao esqueleto facial (pp. 252-252).
Erdmann, D., Follmar, K. E., DeBruijn, M., Bruno, A. D., Jung, S. H., Edelman, D., ... & Marcus, J. R. (2008). A retrospective analysis of facial fracture etiologies. Annals of plastic surgery, 60(4), 398-403.
Freire, E. (2001). Trauma: a doença dos séculos. In Trauma: a doença dos séculos (pp. 1456-1456).
Freitas, R. (2006). Tratado de Cirurgia Bucomaxilofacial, São Paulo, 1. Livraria Santos Editora Com. Imp.
Higgins, A., Hurrell, M., Harris, R., Findlay, G., David, M., & Batstone, M. (2019). A study protocol for a randomised controlled trial evaluating the effects of intraoperative computed tomography on the outcomes of zygomatic fractures. Trials, 20(1), 1-10.
Hwang, K., & Kim, D. H. (2011). Analysis of zygomatic fractures. Journal of Craniofacial Surgery, 22(4), 1416-1421.
Jardim, E. C. G., Lima, H. C., Pereira, T. T. M., Masocatto, D. C., Oliveira, M. M., & de Mendonça, J. C. G. (2014). Tratamento de fratura complexa de terço médio de face associada a ferimento extenso. Archives Of Health Investigation, 3(3).
Laverick, S., Patel, N., & Jones, D. C. (2008). Maxillofacial trauma and the role of alcohol. British journal of oral and maxillofacial surgery, 46(7), 542-546.
Lu, W., Zhou, H., Xiao, C., Shen, Q., Lin, M., & Fan, X. (2012). Late correction of orbital-zygomatic-maxillary fractures combined with orbital wall fractures. Journal of Craniofacial Surgery, 23(6), 1672-1676.
Mendonça, J. C. G., Gaetti-Jardim, E. C., dos Santos, M. A., Ximenes, W. L. A., dos Santos, C. M., de Quadros, D. C., ... & Macena, J. A. (2016). Tratamento cirúrgico de fratura do complexo zigomático orbital: relato de caso. Archives Of Health Investigation, 5(5).
Miloro, M., Ghali, G. E., Larsen, P. E., Waite, P. D., & Of, P. S. P. (2004). Oral and maxillofacial surgery.
Montovani, J. C., Campos, L. M. P. D., Gomes, M. A., Moraes, V. R. S. D., Ferreira, F. D., & Nogueira, E. A. (2006). Etiologia e incidência das fraturas faciais em adultos e crianças: experiência em 513 casos. Revista brasileira de otorrinolaringologia, 72(2), 235-241.
Peretti, N., & MacLeod, S. (2017). Zygomaticomaxillary complex fractures: diagnosis and treatment. Current opinion in otolaryngology & head and neck surgery, 25(4), 314-319.
Perry, M., & Morris, C. (2008). Advanced Trauma Life Support (ATLS) and facial trauma: can one size fit all? : Part 2: ATLS, maxillofacial injuries and airway management dilemmas. International journal of oral and maxillofacial surgery, 37(4), 309-320.
Potter, J. K., & Ellis, E. (2004). Biomaterials for reconstruction of the internal orbit. Journal of oral and maxillofacial surgery, 62(10), 1280-1297.
Raimundo, R. D., Guerra, L. A. P., Antunes, A. A., Carvalho, R. W. F., & Santos, T. S. (2008). Mandible fractures: a retrospective analysis of 27 cases. Rev Cir Traumatol Buco-maxilo-fac, 8(1), 57-62.
Rampa, S., Wilson, F. A., Tak, H. J., Roy, S., Wani, R. J., Markiewicz, M. R., & Allareddy, V. (2019). Patient characteristics and causes of facial fractures in the state of California. Journal of Oral and Maxillofacial Surgery, 77(9), 1855-1866.
Sassi, L. M., Dissenha, J. L., Bezeruska, C., Guebur, M. I., Hepp, V., Radaelli, R. L., ... & Cervantes, O. (2009). Fraturas de zigomático: revisão de 50 casos. Rev. bras. cir. cabeça pescoço.
SouzaI, E. M. R., & RochaII, R. S. (2009). Reconstrução orbitária com tela de titânio: relato de dois casos. TC, 8, 3.
Souza Rosa, F. C. L., Ferreira, P. H. S. G., Monteiro, N. G., Castro, T. A., Oliveira, D., Gonçalves, P. Z., ... & Okamoto, R. (2017). Redução cirúrgica de fratura complexa em terço médio da face. ARCHIVES OF HEALTH INVESTIGATION, 6.
Wahdini, S. I., Dachlan, I., Seswandhana, R., Hutagalung, M. R., Putri, I. L., & Afandy, D. (2019). Neglected orbitozygomaticomaxillary fractures with complications: A case report. International journal of surgery case reports, 62, 35-39.
Vasconcelos, B. G., Silva, L. A. C., Silva Júnior, A. F., Mohn Neto, C. R., & Pereira, C. M. (2014). Perfil epidemiológico dos pacientes com fraturas faciais atendidos em um hospital de Goiânia-Goiás. J Health Sci Inst, 32(3), 241-45.
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Copyright (c) 2021 Eugênia Leal de Figueiredo; Lucas Peron Cavalcanti; Jeanine Angelo da Silva; Davi Felipe Neves Costa; Jair Carneiro Leão; Alessandra de Albuquerque Tavares Carvalho
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