Simultaneous Reduction of Contralateral Malar Complex in Cases of Unilateral Zygoma Bone Fracture

편측 관골 골절에서 동시 반대측 관골 축소술

  • Kim, Peter Chan-Woo (Department of Plastic and Reconstructive Surgery, School of Medicine, Catholic University of Daegu) ;
  • Lee, Byung-Kwon (Department of Plastic and Reconstructive Surgery, School of Medicine, Catholic University of Daegu) ;
  • Bae, Ji-Suk (Department of Preventive Medicine, School of Medicine, Catholic University of Daegu)
  • 김찬우 (대구가톨릭대학교 의과대학교 성형외과학교실) ;
  • 이병권 (대구가톨릭대학교 의과대학교 성형외과학교실) ;
  • 배지숙 (대구가톨릭대학교 의과대학교 예방의학교실)
  • Received : 2011.09.01
  • Accepted : 2011.10.18
  • Published : 2011.11.10

Abstract

Purpose: Reduction by simply assembling bones is recognized as treatment for a zygoma fracture. However, in patients who originally had a protruding zygoma, the fractured parts look like malarplasty after the edema subsides, giving a soft impression which patients notice. Thus, we created symmetry through simultaneous contralateral malar reduction in a unilateral zygoma fracture. Methods: In this study, the patients who had surgery between July, 2008 and December, 2009 with admission were object. In 76 patients with a zygoma fracture, the patients with bilateral zygoma fractures were excluded. Among 48 patients who had a reduction only after a unilateral zygoma fracture, the patients hoping for a reduction of their rough protruding zygoma were analyzed with front cephalometry. The study progressed on 22 patients who had simultaneous contralateral malar reduction in a unilateral zygoma fracture with consent. After fixing the fracture, we did a straight zygoma osteotomy through a 1.5 cm intraoral incision. After that, we created symmetry with a special ruler and fixed the broken zygomatic arch with a screw and plate. We evaluated the facial index and satisfaction with a statistical analysis before and after the surgery. Results: In 22 patients, there was no reoperation except for 1 patient who had a zygoma fracture. None of the patients were treated for infection or hematoma. Two patients complained of paresthesia after the malar reduction operation, but this subsided in 4 months. Most of them were satisfied with the malar reduction, especially the women, and we obtained a better mid facial contour with decreased facial width ($p$ <0.05). Conclusion: Existing zygoma fracture surgery focuses on anatomical reduction. However, we need to have a cosmetic viewpoint in fractures as interests of face contour arise. Thus, contralateral malar reduction got a 4.7 (range 0~5) from patients who had malar reduction surgery in our hospital. Although adjusting to all zygoma fractures has limitations, it can be a new method in zygoma fractures when there are limited indications of protruding zygoma and careful attention is given to patients' high demands.

Keywords

References

  1. Park BI, Shim HS, Yang SJ, Park JS: A clinical and statistical analysis of the maxillofacial trauma. J Korean Soc Plast Reconstr Surg 15: 513, 1988
  2. Hahm JW, Baek RM, Oh KS, Baek SM: 10-year experience on reduction malarplasty. J Korean Soc Plast Reconstr Surg 24: 1478, 1997
  3. Whitaker LA: Aesthetic augmentation of the malar-midface structures. Plast Reconstr Surg 80: 337. 1987 https://doi.org/10.1097/00006534-198709000-00001
  4. Oh SH, Han KH, Kang JS: Osteotomy and ostectomy in facial deformities. J Korean Soc Plast Reconstr Surg 16: 811, 1989
  5. Yoon YI, Lee DL, Yoo JS, Rhee SC, Hur GY, Kim JY: A study on preferred morphologic feature and proportion of facial aesthetic subunit by korean general public. J Korean Soc Plast Reconstr Surg 37: 351, 2010
  6. Onizuka T, Watanabe K, Takasu K, Keyama A: Reduction malar plasty. Aesth Plast Surg 7: 121, 1983 https://doi.org/10.1007/BF01571117
  7. Kim YH, Seul JH: Reduction malarplasty through an intraoral incision: a new method. Plast Reconstr Surg 106: 1514, 2000 https://doi.org/10.1097/00006534-200012000-00011
  8. Lee JS, Kang S, Kim YW: Endoscopically assisted malarplasty: one incision and two dissection planes. Plast Reconstr Surg 111: 461, 2003 https://doi.org/10.1097/00006534-200301000-00083
  9. Kim DH, Lee HB, Son MB, Jung YG, Park BY, Lee YH: Direct transcutaneous reduction of zygoma fracture with threaded K-wire. J Korean Soc Plast Reconstr Surg 22: 517, 1995
  10. Kelley P, Hopper R, Gruss J: Evaluation and treatment of zygomatic fractures. Plast Reconstr Surg 120: 5S, 2007
  11. Kim SR, Park JH, Han YS, Ye BJ: A survey of patient satisfaction after treating zygomatic complex fractures using a coronal approach. J Korean Cleft Palate-Craniofac Assoc 12: 17, 2011