The Study Of The Sutura Zygomaticosphenoidalis In Malar Reduction

Objective: 1.To test the reliability of the sutura zygomaticosphenoidalis in the malar reduction,that is if the sutura zygomaticosphenoidalis can be as the reference in the malar reduction.2.the best way of the fixtion of the malar fracture, making a reasonable explanation to the arguable one point, two points, three points fixtion 3.the operative approach of the sutura zygomaticosphenoidalis: to select the best operative approach, to reduce the surgical trauma on the base of obtaining optimal effect. Methods:1.The ways of making malar fracture: punching the malar with external force, to produce the simple malar fracture (Zingg classification B kind)2.The reduction methods of the malar fracture: â‘  routine method,one-three points of zygomatico-maxillary buttress, zygomatico -frontal suture, zygomatico- temple suture as reduction reference;â‘¡ the sutura zygomaticosphenoidalis as reduction reference,first exploring and reducing sutura zygomaticosphenoidalis,then reducing the other fracture line.3.The means of exploring sutura zygomaticosphenoidalis:â‘ intraoral method,exposing zygomaticomaxillary suture and exploring sutura zygomaticosphenoidalis.â‘¡extraoral method, exposing orbit exterior margin or undermining orbit content lateral insertio lateralis for exploring sutura zygomaticosphenoidalis.4.Fixing method: â‘  one point fixation: zygomaticomaxillary suture â‘¡two points fixation: zygomaticomaxillary suture and orbital lateral â‘¢ three points fixation: zygomaticomaxillary suture, orbital lateral, zygomatic arch or infraorbital margin.5 detection:â‘  CT from plain scan and coronal plane to assess the reduction of the malar fractureâ‘¡the mechanics evaluation of different fixation methods. Result: The simple malar fracture model was achieved by punching method. Different proportion of model was not achieved anatomy reduction by routine method, and following the increasing of the fixation points, anatomy reduction rate was raised correspondingly .The model reduction by sutura zygomaticosphenoidalis exposing with intraoral method,the anatomy reduction rate was raised obviously compared with the routine method,and all model reduction by sutura zygomaticosphenoidalis exposing with extraoral method achieved anatomy reduction.The force resisiting re-displaced of the fixed malar bone is increasing following the increased fixing points.The majority of the sutura zygomaticosphenoidalis can be exposing and exploring through extraoral method(coronal incision or geisoma incision), which can be seen directly.the inferior portion of the sutura zygomaticosphenoidalis can be exploring through intraoral method (buccal groove incision)with finger, which can not be seen directly.Conclusions:1. Punching method is the reliable way of making simple malar fracture model.2. Sutura zygomaticosphenoidalis can be the reliable criteria for the reduction of the malar fracture, first reducing it and then reducing the other fracture line can achieve anatomy reduction.3. Extraoral method(coronal incision or geisoma incision) can be as reliably method for exposing sutura zygomaticosphenoidalis,because this method can see the sutura zygomaticosphenoidalis directly. intraoral method (buccal groove incision) can not be as the reliably way of exploring sutura zygomaticosphenoidalis,for which can be exploring only by finger (cannot be seen directly).4. One point mini-plate(2.0mm) fixation at the zygomatico-maxillary buttress and two points micro-plate(1.3mm) fixation at the zygomatico-maxillary buttress, zygomaticofrontal suture are the simplest way to achieving reliably fixation.