Quantitative analysis of soft tissue sagging after lateral midface fractures: A 10-year retrospective study.
Esthetics
Facial asymmetry
Fracture fixation
Orbital fractures
Zygoma
Journal
Journal of stomatology, oral and maxillofacial surgery
ISSN: 2468-7855
Titre abrégé: J Stomatol Oral Maxillofac Surg
Pays: France
ID NLM: 101701089
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
received:
17
11
2021
revised:
22
12
2021
accepted:
16
02
2022
pubmed:
25
2
2022
medline:
5
10
2022
entrez:
24
2
2022
Statut:
ppublish
Résumé
Lateral midface fractures occasionally require open reduction and internal fixation to restore function and facial symmetry. However, some patients retain facial asymmetry despite undergoing surgery due to hard tissue displacement or soft tissue sagging. This study aimed to determine the influence of soft tissue sagging on the postoperative facial symmetry. We examined the medical records of 590 patients who underwent planned plate removal after lateral midface or zygomatic bone fractures. After applying the inclusion and exclusion criteria, we analyzed 106 cases of lateral midface fractures for hard tissue displacement and soft tissue sagging using pre- and postoperative radiological imaging and postoperative face scanning. We observed significantly larger soft tissue sagging (p < 0.001) and hard tissue displacement (p = 0.006) on the fractured side than on the non-fractured side. There was no correlation between differences in the soft tissue sagging and those in the hard tissue displacement (|rho|=0). Linear regression analysis showed no statistical influence of sex or age group on the soft tissue sagging and hard tissue displacement. Therefore, we recommend treating soft tissue sagging as a discrete aspect of midfacial fracture treatment to achieve optimal postoperative facial symmetry. From a clinical perspective, we recommend better soft tissue management during open fracture treatment than focusing mainly on the reduction of bony hard tissues.
Sections du résumé
BACKGROUND
Lateral midface fractures occasionally require open reduction and internal fixation to restore function and facial symmetry. However, some patients retain facial asymmetry despite undergoing surgery due to hard tissue displacement or soft tissue sagging. This study aimed to determine the influence of soft tissue sagging on the postoperative facial symmetry.
METHODS
We examined the medical records of 590 patients who underwent planned plate removal after lateral midface or zygomatic bone fractures. After applying the inclusion and exclusion criteria, we analyzed 106 cases of lateral midface fractures for hard tissue displacement and soft tissue sagging using pre- and postoperative radiological imaging and postoperative face scanning.
RESULTS
We observed significantly larger soft tissue sagging (p < 0.001) and hard tissue displacement (p = 0.006) on the fractured side than on the non-fractured side. There was no correlation between differences in the soft tissue sagging and those in the hard tissue displacement (|rho|=0). Linear regression analysis showed no statistical influence of sex or age group on the soft tissue sagging and hard tissue displacement.
CONCLUSION
Therefore, we recommend treating soft tissue sagging as a discrete aspect of midfacial fracture treatment to achieve optimal postoperative facial symmetry. From a clinical perspective, we recommend better soft tissue management during open fracture treatment than focusing mainly on the reduction of bony hard tissues.
Identifiants
pubmed: 35202862
pii: S2468-7855(22)00040-4
doi: 10.1016/j.jormas.2022.02.009
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e619-e625Informations de copyright
Copyright © 2022 Elsevier Masson SAS. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.