Closed reduction of zygomatic arch fractures using a Tubbs-Logan mitral valve dilator

Yıl 2020, , 278 - 283, 25.04.2020

Yalçın Yontar , Sedat Tatar , Halit Baykan

https://doi.org/10.32448/entupdates.709516

Öz

Objective: To present technical details and experiences regarding the use of a Tubbs-Logan mitral valve dilator for the closed reduction of zygomatic arch fractures.
Method: Over a period of about three years, closed reduction was indicated and performed in 22 patients with a zygomatic arch fracture. In all patients, depressed fracture segments were reduced using a Tubbs-Logan mitral valve dilator via the Gillies’ temporal approach.
Results: The majority of the injuries were due to motor vehicle collisions (n=8, 36.4%). The zygomatic arch fracture was isolated in 12 patients (54.5%). However, it was a component of a zygomatic complex fracture in 10 patients (45.5%). Of those, rigid internal fixation of the zygomatic body was performed in 8 and the zygomatic body was only closely reduced by a bone hook in 2 patients. Repair of a concomitant orbital floor fracture was performed in 2, a mandibular angle fracture in 1 and a frontal sinus fracture in 1 patient. The reduction status of the zygomatic arch was excellent in 12 (54.5%), good in 8 (36.4%) and fair in 2 patients (9.1%). During the follow-ups, no functional or cosmetic sequelae regarding repaired fractures of the zygomatic arch, zygomatic body or other facial bones were recorded.
Conclusion: We suggest that the Tubbs-Logan mitral valve dilator is a safe and effective alternative in terms of closed reduction of zygomatic arch fractures, whether they are isolated or not. We think that further ergonomic modifications would be beneficial to improve the positioning of the instrument in restricted areas observed due to severe depression of the zygomatic arch.

Anahtar Kelimeler

Maxillofacial injuries, facial injuries, zygomatic arch, closed fracture reduction

Kaynakça

• 1. Mundinger GS, Dorafshar AH, Gilson MM, et al. Analysis of radiograph-ically confirmed blunt-mechanism facial fractures. J Craniofac Surg 2014;25:321-7.
• 2. Gomes PP, Passeri LA, Barbosa JR. A 5-year retrospective study of zygo-matico-orbital complex and zygomatic arch fractures in Sao Paulo State, Brazil. J Oral Maxillofac Surg 2006;64:63-7.
• 3. Kiwanuka E, Smith SE, Frates MC, Caterson EJ. Use of high-frequency ultrasound guidance for intraoperative zygomatic arch fracture reduc-tion. J Craniofac Surg 2013;24:2036-8.
• 4. Yamamoto K, Murakami K, Sugiura T, et al. Clinical analysis of isolated zygomatic arch fractures. J Oral Maxillofac Surg 2007;65:457-61.
• 5. Hindin DI, Muetterties CE, Mehta C, Boukovalas S, Lee JC, Bradley JP. Treatment of Isolated Zygomatic Arch Fracture: improved Outcomes with External Splinting. Plast Reconstr Surg 2017;139:1162-71.
• 6. Ozyazgan I, Günay GK, Eskitaşçioglu T, Ozköse M, Coruh A. A new proposal of classification of zygomatic arch fractures. J Oral Maxillofac Surg 2007;65:462-9.
• 7. Gündeşlioğlu ÖA, Özen C, Inan I, et al. Closed reduction of zygoma tri-pod and isolated arch fractures with Volkmann bone hook. Kulak Burun Bogaz Ihtis Derg 2013;23:211-6.
• 8. Zingg M, Laedrach K, Chen J, et al. Classification and treatment of zygomatic fractures: a review of 1,025 cases. J Oral Maxillofac Surg 1992;50:778-90.
• 9. Podoshin L, Fradis M. The use of the foley balloon catheter in zygomat-ic-arch fractures. Br J Oral Surg 1974;12:246-8.
• 10. El-Hadidy AM. The use of a Foley catheter in isolated zygomatic arch fractures. Plast Reconstr Surg 2005;116:853-6.
• 11. Randall DA, Bernstein PE. Epistaxis balloon catheter stabilization of zy-gomatic arch fractures. Ann Otol Rhinol Laryngol 1996;105:68-9.
• 12. Mezitis M, Stathopoulos P, Rallis G. Use of a curved mosquito for reduc-ing isolated zygomatic arch fractures. J Craniofac Surg 2010;21:1281-3.
• 13. Hwang K, Lee SI. Reduction of zygomatic arch fracture using a towel clip. J Craniofac Surg 1999;10:439-41.
• 14. Baek JE, Chung CM, Hong IP. Reduction of Zygomatic Fractures Using the Carroll-Girard T-bar Screw. Arch Plast Surg 2012;39:556-60.
• 15. Giudice A, Colangeli W, Cristofaro MG. Percutaneous reduction of an isolated zygomatic fracture using a wire suture. Br J Oral Maxillofac Surg 2013;51:201-2.
• 16. Buhr J, Hürtgen M, Kelm C, Schwemmle K. Tumor dissemination after thoracoscopic resection for lung cancer. J Thorac Cardiovasc Surg 1955;110:855-6.
• 17. Rainer WG. Cardiac surgery before cardiopulmonary bypass. Perfusion 2003;18:139-44.