Evaluation of one-point fixation surgery with computer-aided root mean square deviation in zygomaticomaxillary complex fractures

Year 2023, Volume: 6 Issue: 6, 1393 - 1397, 29.10.2023

Mehmet Fatih Okyay

https://doi.org/10.32322/jhsm.1354661

Abstract

Aims: Our paper aimed to present the results of the one-point fixation method in zygomaticomaxillary fractures by computer-aided mirror image superimposition with root mean square (RMS) deviation.
Methods: One-point fixation performed zygomaticomaxillary complex fracture patients (n=18) by one surgeon were included in our study. Virtual 3D data of preoperative and postoperative CT-scan images was obtained by Slicer software. Sagittal plan mirror image superpositioning were used to obtain RMS data by Slicer. Mirror image superimposition of the undamaged side to the broken side in preoperative CT-scan imaging was referred as group B or broken group. Superposition of the repaired side’s postoperative imaging to the preoperative broken side was measured as group R or repair group in order to examine zygomatic bone’s postoperative spatial location. Superpositioned mirror 3D images of the non-traumatic side onto post-fixation 3D in postoperative data was measured as group M or mirror group. RMS deviation values of the groups obtained by Slicer were statistically compared.
Results: Shapiro-Wilk test of groups were demonstrated normal distribution of the data for each group with no difference (p>0.05). In order to compare between groups, paired t-test covariance analysis were shown statistically similar data distrubition between experimental groups (p>0.05).
Conclusion: Considering the nature of maxillofacial surgery, which disapproves even millimetric errors, we believe that the mean square root deviation will become standard as it allows three-dimensional evaluation and precise mathematical measurements. Besides, in accordance with the recent literature, this study might pay the way for future studies that would increase the usage of the one-point fixation method conducted on larger case series, as this method prevents lower eyelid complications without a visible scar.

Keywords

Maxillofacial surgery, facial fractures, 3D imaging, 3D segmentation, root mean square, RMS

References

• Schneider M, Besmens IS, Luo Y, et al. Surgical management of isolated orbital floor and zygomaticomaxillary complex fractures with focus on surgical approaches and complications. J Plast Surg Hand Surg. 2020;54(4):200-206. doi: 10.1080/2000656X.2020.1746664.
• Wang HD, Dillon J. Contemporary management of zygomaticomaxillary complex fractures. Semin Plast Surg. 2021;35(4):256-262. doi: 10.1055/s-0041-1735812.
• Gadkari N, Bawane S, Chopra R, et al. Comparative evaluation ofpoint vs 3-point fixation in the treatment of zygomaticomaxillary complex fractures - a systematic review. J Craniomaxillofac Surg. 2019;47(10):1542-1550. doi: 10.1016/j.jcms.2019.07.009.
• Knoops PG, Beaumont CA, Borghi A, et al. Comparison of three-dimensional scanner systems for craniomaxillofacial imaging. J Plast Reconstr Aesthet Surg. 2017;70(4):441-449. doi: 10.1016/j. bjps.2016.12.015.
• Sozzi D, Gibelli D, Canzi G, et al. Assessing the precision of posttraumatic orbital reconstruction through "mirror" orbital superimposition: a novel approach for testing the anatomical accuracy. J Craniomaxillofac Surg. 2018;46(8):1258-1262. doi: 10.1016/j.jcms.2018.05.040.
• Moghaddam MB, Brown TM, Clausen A, et al. Outcome analysis after helmet therapy using 3D photogrammetry in patients with deformational plagiocephaly: the role of root mean square. J Plast Reconstr Aesthet Surg. 2014;67(2):159-65. doi: 10.1016/j. bjps.2013.09.036.
• Linden OE, He JK, Morrison CS, et al. The relationship between age and facial asymmetry. Plast Reconstr Surg. 2018;142(5):1145-1152. doi: 10.1097/PRS.0000000000004831.
• Shokri T, Sokoya M, Cohn JE, et al. Single-point fixation for noncomminuted zygomaticomaxillary complex fractures-a 20-year experience. J Oral Maxillofac Surg. 2020;78(5):778-781. doi: 10.1016/j.joms.2019.12.030.
• Lee KS, Do GC, Shin JB, et al. One-point versus two-point fixation in the management of zygoma complex fractures. Arch Craniofac Surg. 2022;23(4):171-177. doi: 10.7181/acfs.2022.00164.
• Kim JH, Lee JH, Hong SM, et al. The effectiveness of 1-point fixation for zygomaticomaxillary complex fractures. Arch Otolaryngol Head Neck Surg. 2012;138(9):828-832. doi: 10.1001/archoto.2012.1815.
• Hsu PJ, Denadai R, Pai BCJ, et al. Outcome of facial contour asymmetry after conventional two-dimensional versus computer-assisted three-dimensional planning in cleft orthognathic surgery. Sci Rep. 2020;10(1):2346. doi: 10.1038/s41598-020-58682-4.
• Bengtsson M, Wall G, Greiff L, Rasmusson L. Treatment outcome in orthognathic surgery-a prospective randomized blinded case-controlled comparison of planning accuracy in computer-assisted two- and three-dimensional planning techniques (part II). J Craniomaxillofac Surg. 2017;45(9):1419-1424. doi: 10.1016/j.jcms.2017.07.001.
• Philip MR, AlFotawi R. The accuracy of soft tissue movement using virtual planning for non-syndromic facial asymmetry cases-a systematic review. Oral Maxillofac Surg. 2023;27(2):187-200. doi: 10.1007/s10006-022-01059-w.
• Choi KY, Ryu DW, Yang JD, Chung HY, Cho BC. Feasibility of 4-point fixation using the preauricular approach in a zygomaticomaxillary complex fracture. J Craniofac Surg. 2013;24(2):557-62. doi: 10.1097/SCS.0b013e3182700d23.
• Jazayeri HE, Khavanin N, Yu JW, et al. Fixation points in the treatment of traumatic zygomaticomaxillary complex fractures: a systematic review and meta-analysis. J Oral Maxillofac Surg. 2019;77(10):2064-2073. doi: 10.1016/j.joms.2019.04.025.
• Panesar K, Susarla SM. Mandibular fractures: diagnosis and management. Semin Plast Surg. 2021;35(4):238-249. doi: 10.1055/s-0041-1735818.
• Dreizin D, Nam AJ, Hirsch J, Bernstein MP. New and emerging patient-centered CT imaging and image-guided treatment paradigms for maxillofacial trauma. Emerg Radiol. 2018;25(5):533-545. doi: 10.1007/s10140-018-1616-9.
• Fernandes R, DiPasquale J. Computer-aided surgery using 3D rendering of maxillofacial pathology and trauma. Int J Med Robot. 2007;3(3):203-6. doi: 10.1002/rcs.137.
• Nilsson J, Nysjö J, Carlsson AP, Thor A. Comparison analysis of orbital shape and volume in unilateral fractured orbits. J Craniomaxillofac Surg. 2018;46(3):381-387. doi: 10.1016/j.jcms.2017.12.012.
• Morgan N, Shujaat S, Jazil O, Jacobs R. Three-dimensional quantification of skeletal midfacial complex symmetry. Int J Comput Assist Radiol Surg. 2023;18(4):611-619. doi: 10.1007/s11548-022-02775-0.
• van der Gaast N, Dunning H, Huitema JM, et al. The symmetry of the left and right tibial plateau: a comparison of 200 tibial plateaus. Eur J Trauma Emerg Surg. 2023;49(1):69-74. doi: 10.1007/s00068-022-02043-5.