Clinical Paper
TraumaIntraoperative imaging of zygomaticomaxillary complex fractures using a 3D C-arm system
Trauma
Section snippets
Materials and methods
Fourteen patients admitted to the Department of Oral and Maxillofacial Surgery of the University Hospital Hamburg-Eppendorf for surgical treatment of ZMC fractures were included in the study. Patients with isolated blowout fractures were not included. Eleven patients were male and three female. Patients’ age ranged from 21 to 83 years (average age 43.9 years). Preoperative diagnostics and surgical treatment involving open reduction and internal fixation under general anaesthesia were performed
Results
The intraoperative handling of the system proved to be uncomplicated (Fig. 1). One dataset was sufficient to visualize all fractures of the midface in all patients intraoperatively (Fig. 2, Fig. 3). The isocentre was placed at the level of the sinus floor, paranasal to the side of the fracture and median in cases of bilateral fractures. Conventional postoperative radiographs could therefore be omitted. Because of the full automatic aperture, radiation exposure varied depending especially on the
Discussion
This study was performed with the intention of evaluating the use of intraoperative CBCT in cases of ZMC fractures on the basis of a total of 14 intraoperative datasets. Because fluoroscopy is usually performed by the surgeons themselves, the 3D fluoroscopic datasets were evaluated by surgeons and not by radiologists. Comparison of intraoperative CBCTs with CT or conventional images of identical situations would have led to double examinations of patients, therefore, we evaluated this
Acknowledgments
The authors thank Doris Beckmann and Axel Hebecker from Siemens Medical Solutions for their technical support.
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