Evaluation of Treatment of Zygomaticomaxillary Complex Fractures and Isolated Zygomatic Arch Fractures Using Intraoperative Ultrasonography

Background: Intraoperative ultrasonography (IOU) is an easy and quick image tool with no radiation hazard. Although it may be used in zygomaticomaxillary complex fracture(ZMC), there was no postoperative evaluation of reliability. In this paper, the authors aimed to compare the patients who used IOU in ZMC and are not using it, and confirmed its usefulness and reliability. Methods: This study was conducted on 126 patients who had a ZMC and zygomatic arch fracture(only) from March 2010 to May 2017. The authors performed postoperative 3D facial computed tomography on 60 patients who did not use IOU and 66 patients who used it. The authors compared the height of the both orbit, zygoma angle(a), distance(b) from midline and gap(c) of the temporal process. Arch fracture(only) measures gap and dimension discrepancy by overlapping the fracture side with the normal side. Results: In ZMC, the ratio of orbital height(A/A’) in CT was not significantly different. Angle and distance from the Midline were also not different, but in the gap, which IOU was used, showed significantly decreased asymmetry. In the arch fracture(only), the gap was 0.75 mm, the dimension discrepancy was 6.2 mm² using IOU, 0.99 mm, 10.2 mm² not using it. In patients using an IOU showed significantly decreased asymmetry of the arch ( P <0.05). Conclusion: IOU can be used easily and quickly and showed better results in symmetry. In addition, it is also possible to reduce the need for direct fixation of the zygomatic arch for more accurate reduction. In conclusion, IOU can be a reliable option for the surgical correction of ZMC.