Computer-Assisted Evaluation of Zygomatic Fracture Outcomes: Case Series and Proposal of a Reproducible Workflow
Background: Zygomatico-maxillary complex (ZMC) fractures are prevalent facial injuries with significant functional and aesthetic implications. Computer-assisted surgery (CAS) offers precise surgical planning and outcome evaluation. The study aimed to evaluate the application of CAS in the analysis o...
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MDPI AG
2025-02-01
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| Series: | Tomography |
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| Online Access: | https://www.mdpi.com/2379-139X/11/2/19 |
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| author | Simone Benedetti Andrea Frosolini Flavia Cascino Laura Viola Pignataro Leonardo Franz Gino Marioni Guido Gabriele Paolo Gennaro |
| author_facet | Simone Benedetti Andrea Frosolini Flavia Cascino Laura Viola Pignataro Leonardo Franz Gino Marioni Guido Gabriele Paolo Gennaro |
| author_sort | Simone Benedetti |
| collection | DOAJ |
| description | Background: Zygomatico-maxillary complex (ZMC) fractures are prevalent facial injuries with significant functional and aesthetic implications. Computer-assisted surgery (CAS) offers precise surgical planning and outcome evaluation. The study aimed to evaluate the application of CAS in the analysis of ZMC fracture outcomes and to propose a reproducible workflow for surgical outcome assessment using cephalometric landmarks. Methods: A retrospective cohort study was conducted on 16 patients treated for unilateral ZMC fractures at the Maxillofacial Surgery Unit of Siena University Hospital (2017–2024). Inclusion criteria included ZMC fractures classified as Zingg B or C, treated via open reduction and internal fixation (ORIF). Pre- and post-operative CT scans were processed for two- and three-dimensional analyses. Discrepancies between CAS-optimized reduction and achieved surgical outcomes were quantified using cephalometric landmarks and volumetric assessments. Results: Out of the 16 patients (69% male, mean age 48.1 years), fractures were predominantly on the right side (81%). CAS comparison between the post-operative and the contralateral side revealed significant asymmetries along the X and Y axes, particularly in the fronto-zygomatic suture (FZS), zygo-maxillary point (MP), and zygo-temporal point (ZT). Computer-assisted comparison between the post-operative and the CAS-simulated reductions showed statistical differences along all three orthonormal axes, highlighting the challenges in achieving ideal symmetry despite advanced surgical techniques. CAS-optimized reductions demonstrated measurable improvements compared to traditional methods, underscoring their utility in outcome evaluation. Conclusions: CAS technology enhances the precision of ZMC fracture outcome evaluation, allowing for detailed comparison between surgical outcomes and virtual simulations. Its application underscores the potential for improved surgical planning and execution, especially in complex cases. Future studies should focus on expanding sample size, refining workflows, and integrating artificial intelligence to automate processes for broader clinical applicability. |
| format | Article |
| id | doaj-art-a07f5f4c67054d20a68a615f0bc3e935 |
| institution | OA Journals |
| issn | 2379-1381 2379-139X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
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| series | Tomography |
| spelling | doaj-art-a07f5f4c67054d20a68a615f0bc3e9352025-08-20T02:03:42ZengMDPI AGTomography2379-13812379-139X2025-02-011121910.3390/tomography11020019Computer-Assisted Evaluation of Zygomatic Fracture Outcomes: Case Series and Proposal of a Reproducible WorkflowSimone Benedetti0Andrea Frosolini1Flavia Cascino2Laura Viola Pignataro3Leonardo Franz4Gino Marioni5Guido Gabriele6Paolo Gennaro7Maxillofacial Surgery Unit, Department of Medical Biotechnology, S. Maria alle Scotte University Hospital of Siena, 53100 Siena, ItalyMaxillofacial Surgery Unit, Department of Medical Biotechnology, S. Maria alle Scotte University Hospital of Siena, 53100 Siena, ItalyMaxillofacial Surgery Unit, Department of Medical Biotechnology, S. Maria alle Scotte University Hospital of Siena, 53100 Siena, ItalyMaxillofacial Surgery Unit, Department of Medical Biotechnology, S. Maria alle Scotte University Hospital of Siena, 53100 Siena, ItalyPhoniatrics and Audiology Unit, Department of Neuroscience DNS, Univeristy of Padova, 31100 Treviso, ItalyPhoniatrics and Audiology Unit, Department of Neuroscience DNS, Univeristy of Padova, 31100 Treviso, ItalyMaxillofacial Surgery Unit, Department of Medical Biotechnology, S. Maria alle Scotte University Hospital of Siena, 53100 Siena, ItalyMaxillofacial Surgery Unit, Department of Medical Biotechnology, S. Maria alle Scotte University Hospital of Siena, 53100 Siena, ItalyBackground: Zygomatico-maxillary complex (ZMC) fractures are prevalent facial injuries with significant functional and aesthetic implications. Computer-assisted surgery (CAS) offers precise surgical planning and outcome evaluation. The study aimed to evaluate the application of CAS in the analysis of ZMC fracture outcomes and to propose a reproducible workflow for surgical outcome assessment using cephalometric landmarks. Methods: A retrospective cohort study was conducted on 16 patients treated for unilateral ZMC fractures at the Maxillofacial Surgery Unit of Siena University Hospital (2017–2024). Inclusion criteria included ZMC fractures classified as Zingg B or C, treated via open reduction and internal fixation (ORIF). Pre- and post-operative CT scans were processed for two- and three-dimensional analyses. Discrepancies between CAS-optimized reduction and achieved surgical outcomes were quantified using cephalometric landmarks and volumetric assessments. Results: Out of the 16 patients (69% male, mean age 48.1 years), fractures were predominantly on the right side (81%). CAS comparison between the post-operative and the contralateral side revealed significant asymmetries along the X and Y axes, particularly in the fronto-zygomatic suture (FZS), zygo-maxillary point (MP), and zygo-temporal point (ZT). Computer-assisted comparison between the post-operative and the CAS-simulated reductions showed statistical differences along all three orthonormal axes, highlighting the challenges in achieving ideal symmetry despite advanced surgical techniques. CAS-optimized reductions demonstrated measurable improvements compared to traditional methods, underscoring their utility in outcome evaluation. Conclusions: CAS technology enhances the precision of ZMC fracture outcome evaluation, allowing for detailed comparison between surgical outcomes and virtual simulations. Its application underscores the potential for improved surgical planning and execution, especially in complex cases. Future studies should focus on expanding sample size, refining workflows, and integrating artificial intelligence to automate processes for broader clinical applicability.https://www.mdpi.com/2379-139X/11/2/19traumazygomatic fracturesurgical outcomecomputer-assisted surgery (CAS)mirroring |
| spellingShingle | Simone Benedetti Andrea Frosolini Flavia Cascino Laura Viola Pignataro Leonardo Franz Gino Marioni Guido Gabriele Paolo Gennaro Computer-Assisted Evaluation of Zygomatic Fracture Outcomes: Case Series and Proposal of a Reproducible Workflow Tomography trauma zygomatic fracture surgical outcome computer-assisted surgery (CAS) mirroring |
| title | Computer-Assisted Evaluation of Zygomatic Fracture Outcomes: Case Series and Proposal of a Reproducible Workflow |
| title_full | Computer-Assisted Evaluation of Zygomatic Fracture Outcomes: Case Series and Proposal of a Reproducible Workflow |
| title_fullStr | Computer-Assisted Evaluation of Zygomatic Fracture Outcomes: Case Series and Proposal of a Reproducible Workflow |
| title_full_unstemmed | Computer-Assisted Evaluation of Zygomatic Fracture Outcomes: Case Series and Proposal of a Reproducible Workflow |
| title_short | Computer-Assisted Evaluation of Zygomatic Fracture Outcomes: Case Series and Proposal of a Reproducible Workflow |
| title_sort | computer assisted evaluation of zygomatic fracture outcomes case series and proposal of a reproducible workflow |
| topic | trauma zygomatic fracture surgical outcome computer-assisted surgery (CAS) mirroring |
| url | https://www.mdpi.com/2379-139X/11/2/19 |
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