دورية أكاديمية
Critical Degree of Orbital Floor Displacement Drives Operative Repair of Zygomaticomaxillary Complex Fractures: Findings from a 10-Year Retrospective Study.
| العنوان: | Critical Degree of Orbital Floor Displacement Drives Operative Repair of Zygomaticomaxillary Complex Fractures: Findings from a 10-Year Retrospective Study. |
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| المؤلفون: | Obayemi A; Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, New York., Arunkumar A; Department of Otolaryngology-Head & Neck Surgery, Joan and Sanford I Weill Medical College of Cornell University, New York, New York., Long S; Department of Otolaryngology-Head & Neck Surgery, Joan and Sanford I Weill Medical College of Cornell University, New York, New York., Spielman D; Department of Otolaryngology-Head & Neck Surgery, Joan and Sanford I Weill Medical College of Cornell University, New York, New York., Pereira N; Department of Otolaryngology-Head & Neck Surgery, Joan and Sanford I Weill Medical College of Cornell University, New York, New York., Liu K; Department of Otolaryngology-Head & Neck Surgery, Joan and Sanford I Weill Medical College of Cornell University, New York, New York., Sclafani MS; Department of Otolaryngology-Head & Neck Surgery, Joan and Sanford I Weill Medical College of Cornell University, New York, New York., Kacker A; Department of Otolaryngology-Head & Neck Surgery, Joan and Sanford I Weill Medical College of Cornell University, New York, New York., Reeve G; Department of Surgery, Cornell University Joan and Sanford I Weill Medical College, New York, New York., Stewart MG; Department of Otolaryngology-Head & Neck Surgery, Joan and Sanford I Weill Medical College of Cornell University, New York, New York., Sclafani AP; Department of Otolaryngology-Head & Neck Surgery, Joan and Sanford I Weill Medical College of Cornell University, New York, New York. |
| المصدر: | Facial plastic surgery : FPS [Facial Plast Surg] 2023 Jun; Vol. 39 (3), pp. 317-322. Date of Electronic Publication: 2023 Mar 06. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Thieme Medical Publishers Country of Publication: United States NLM ID: 8405303 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-8793 (Electronic) Linking ISSN: 07366825 NLM ISO Abbreviation: Facial Plast Surg |
| أسماء مطبوعة: | Publication: New York : Thieme Medical Publishers Original Publication: [New York, NY : Thieme-Stratton Inc., c1983- |
| مواضيع طبية MeSH: | Zygomatic Fractures*/surgery , Maxillary Fractures*/surgery , Skull Fractures* , Orbital Fractures*/complications , Fractures, Comminuted*/complications, Humans ; Retrospective Studies |
| مستخلص: | Among zygomaticomaxillary complex (ZMC) fractures presenting to a tertiary urban academic center, the authors hypothesized the presence of both clinical and radiographic predictors of operative management. The investigators conducted a retrospective cohort study of 1,914 patients with facial fractures managed at an academic medical center in New York City between 2008 and 2017. The predictor variables were based on both clinical data and features of pertinent imaging studies, and the outcome variable was an operative intervention. Descriptive and bivariate statistics were computed and the p -value was set at 0.05. In total, 196 patients sustained ZMC fractures (5.0%) and 121 (61.7%) ZMC fractures were treated surgically. All patients who presented with globe injury, blindness, retrobulbar injury, restricted gaze, or enophthalmos and a concurrent ZMC fracture were managed surgically. The most common surgical approach was the gingivobuccal corridor (31.9% of all approaches), and there were no significant immediate postoperative complications. Younger patients (38.9 ± 18 years vs. 56.1 ± 23.5 years, p < 0.0001) and patients with greater than or equal to 4 mm of orbital floor displacement were more likely to receive surgical treatment than observation (82 vs. 56%, p = 0.045), as were patients with comminuted orbital floor fractures (52 vs. 26%, p = 0.011). In this cohort, patients more likely to undergo surgical reduction were young patients with ophthalmologic symptoms on presentation and at least 4 mm displacement of the orbital floor. Low kinetic energy ZMC fractures may warrant surgical management as often as high-energy ZMC fractures. While orbital floor comminution has been shown to be a predictor for operative reduction, in this study we also demonstrated a difference in the rate of reduction based on the severity of orbital floor displacement. This may have significant implications in both the triage and selection of patients most suitable for operative repair. Competing Interests: None declared. (Thieme. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20230306 Date Completed: 20230512 Latest Revision: 20230512 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1055/a-2047-6646 |
| PMID: | 36878678 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1098-8793 |
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| DOI: | 10.1055/a-2047-6646 |