Application Of Intraoperative CT In The Surgical Treatment Of Zygomatic Complex Fractures

Part 1: Preliminary application of intraoperative CT in the surgical treatment of zygomatic complex fracturesObjective: To compare the effects of intraoperative CT and traditional methods in the treatment of zygomatic complex fractures,and to explore the clinical application value of intraoperative CT in the diagnosis and treatment of zygomatic complex fractures.Methods: A retrospective analysis of the clinical and imaging data of 60 patients with unilateral zygomatic complex fractures who underwent surgical treatment in the Department of Oral and Maxillofacial Surgery,the 940 Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army from July 2016 to March 2020.According to whether CT scan assisted surgery was used during the operation,the patients were divided into an intraoperative CT group(30 cases)and a traditional group(30 cases).The postoperative CT examination data of all patients were imported into MIMICS 19.0 software for segmentation and reconstruction.11 anatomical landmark points were selected on the surface of the virtual three-dimensional model of the bilateral zygomatic complex.The corresponding 5 segments of distance and three angles between the bilateral landmark points were measured and recorded.The SPSS 26.0 software package was used to analyze and statistically process each measurement index of the two groups.Results: The difference in the vertical displacement index of the bilateral zygomatic complex and the difference in the subfrontal angle of the bilateral zygomatic complex were not statistically significant between the two groups(P>0.05);while the horizontal direction of the bilateral zygomatic complex The difference of the displacement distance index,the difference of the displacement distance index of the bilateral zygomatic complex in the anteroposterior direction,the difference of the horizontal angle index of the bilateral zygomatic arch and the difference of the horizontal angle index of the bilateral zygomatic process.the intraoperative CT group was smaller than the traditional control group(P <0.05).8 patients in the intraoperative CT group received intraoperative correction,and the correction rate was about 26.7%.There was no significant difference in the operation time and other postoperative evaluation indicators(face symmetry,diplopia,restricted mouth opening,numbness in the infraorbital area)between the two groups(P>0.05).Conclusion: Intraoperative CT assisted surgery can improve the treatment effect of unilateral zygomatic complex fractures,and it is worthy of promotion and use in clinical treatment.Part 2: Research on Intraoperative CT in Replacement of Postoperative CT Examination after Treatment of Unilateral Zygomatic Complex FractureObjective: To investigate the feasibility of intraoperative CT in the diagnosis and treatment of unilateral zygomatic complex fractures instead of postoperative CT examinations by measuring and analyzing the intraoperative and postoperative CT examination data of patients with unilateral zygomatic complex fractures.Methods: From January 2018 to March 2020,patients who were admitted to the Department of Oral and Maxillofacial Surgery,the 940 Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army due to unilateral zygomatic complex fractures and applied intraoperative CT to assist in completing the surgical treatment were collected.The intraoperative and postoperative results of each patient were collected.After the CT data is imported into MIMICS 19.0 software for segmentation and reconstruction,11 anatomical landmark points are selected on the surface of the virtual three-dimensional model of the bilateral zygomatic complex,and the 5 distances and 3 angles between the corresponding landmark points are measured,using t Test and compare the differences of various indexes on the healthy side during and after operation.Results: A total of 30 patients were enrolled.The paired t-test results showed that there was a significant difference in the horizontal angle D1 of the zygomatic arch protrusion between the unhealthy side and the affected side during and after the operation(P <0.05).And there was no difference in other indicators.Statistically significant(P> 0.05).There was no statistically significant difference between the intraoperative and postoperative indexes of the affected side(P>0.05).Conclusion: Intraoperative CT can be used in the diagnosis and treatment of unilateral zygomatic complex fractures and can replace postoperative CT review.Intraoperative CT is also of clinical significance in evaluating the postoperative curative effect of zygomatic complex fractures.