| Objective: To compare the clinical characteristics and imaging differences between intraoperative computed tomography(ICT)and computer-assisted navigation system(CANS)applied in the operative treatment of unilateral zygomatic complex(ZMC)fractures,and to study the clinical effectiveness of both techniques in the treatment of ZMC fractures.Methods: The patients with unilateral ZMC fractures who underwent surgery at the Department of Oral and Maxillofacial Surgery in the 940 th Hospital of PLA from September 2016 to September 2020 were selected.Patients were divided into ICT group,CANS group and Control group according to the use of intraoperative auxiliary devices.At a follow-up time of 6 months,the operative time and intraoperative bleeding volume were recorded in each group,and the preoperative and postoperative clinical characteristics were evaluated in each group.The bilateral zygomatic prominence and width were measured in the corrected axial position of the zygomatic arch using the iplan CMF software(version 3.0,Brain LAB,Germany),and the difference of bilateral zygomatic prominence and width was calculated.Six bone tissue points [zygomatic frontal suture point(Fmo),infraorbital point(Or),infraorbital foramen point(K),zygomatic arch point(Zy),zygomatic prominence point(Zp)and zygomatic alveolar ridge point(Mx)] and nasion(N)on the3-dimensional reconstructed CT images were identified using Mimics software(version 21.0,Materialise,Belgium),and their 3D coordinate information was extracted.The difference in distance from each point on the healthy and affected side to nasion was calculated.The healthy and affected ZMC was segmented by 3-Matic software(version 13.0,Materialise,Belgium).The healthy side ZMC was mirrored to the affected side using the median sagittal plane as the reference plane.The chromatographic distances of the above six bone tissue points were measured on the chromatogram generated after bilateral ZMC were fitted.The postoperative clinical and imaging indexes of all patients were compared using the independent sample rank sum test.Results: A total of 42 patients were enrolled in this study,including 35 males and7 females,with a male to female ratio of 5:1.The age range was 18 to 64 years,and the mean age was 34.74 years [SD 13.48].The high incidence age group was 18-27 years old.The most common causes of injury were traffic accidents(19 cases,45.2%)and falls(14 cases,33.3%).There was a statistically difference in the bilateral zygomatic prominence and width difference value among the three groups(P < 0.05),while ICT group and CANS group had smaller prominence and width difference value than Control group.There was no statistically difference between the difference in distance from each point on the healthy and affected side to nasion among the three groups(P > 0.05).But in the comparison of the diffence in distance from zygomatic frontal suture point(Fmo),infraorbital point(Or),zygomatic arch point(Zy)and zygomatic prominence point(Zp)to nasion(N),ICT group and CANS group had smaller mean values than Control group.There was no statistically difference in the chromatographic value of all the bone markers on the healthy and affected side among the three groups(P > 0.05).But the average chromatographic values of ICT group and CANS group were smaller than those of Control group.There was no statistically difference in operative time and intraoperative bleeding volume among the three groups(P < 0.05),while ICT group and CANS group had longer operative time and more intraoperative bleeding volume than Control group.There was no statistically difference in all measured values in the ICT group and CANS group(P > 0.05).Conclusion: Both ICT and CANS are effective in the operative treatment of unilateral ZMC fractures compared to traditional surgery,but there is no significant difference in outcome between the two techniques. |
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