RESUMO
INTRODUCTION: The zygomatic complex is integral to the facial contour, protection of the eye and other facial structures, and dental occlusion. Its importance in facial function and aesthetics requires high quality outcomes of the treatment. CASE PRESENTATION: This paper reports the case of a 46-year-old man who had an occupational accident resulting in extensive facial trauma and zygomatic fractures. The patient presented with hyposphagma, palpable step in the area of the infraorbital rim, paresthesia of the right infraorbital nerve, flattening of zygomatic prominence, abrasion of the chin and nose, a 7-cm laceration in the midface region, ecchymosis in the palate, and alteration in the dental occlusion without limitation of mouth opening. Computed tomography (CT) confirmed the zygomatic complex fractures. The treatment was reduction and fixation with plates and screws. CT was used throughout the treatment period as an essential diagnostic tool for accurate fracture assessment and classification, formulation of the surgical plan, and postoperative evaluation. CONCLUSION: This case study illustrated the correct use of CT for improved and efficient treatment of traumatic injury of the zygoma, an anatomical area where restoration of function and aesthetics is challenging. The patient signed a written informed consent statement for publication.
RESUMO
Dentre as fraturas maxilofaciais, o complexo zigomático é o mais acometido, seguido das fraturas nasais e das fraturas Mandibulares O objetivo deste trabalho é apresentar um relato de caso de fratura de complexo zigomático tratada pelo serviço de Cirurgia e Traumatologia Bucomaxilofacial, como também descrever as formas de diagnóstico e tratamento clínico e cirúrgico.
Among the maxillofacial fractures, the zygomatic complex is most affected followed by nasal fractures and mandibular fractures. The objective of this work is to present a case report of a zygomatic complex fracture treated by the bucomaxillofacial Surgery and Traumatology service, as well as to describe the forms of diagnosis, clinical and surgical treatment.
Assuntos
Humanos , Masculino , Feminino , Fraturas Zigomáticas , Fixação de FraturaRESUMO
Se realizó un estudio descriptivo, transversal y aleatorizado de 102 pacientes con fracturas del complejo cigomático, tratados con osteosíntesis semirrígida en el Servicio de Cirugía Maxilofacial del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba, desde enero de 2005 hasta diciembre de 2011, con vistas a caracterizarles según variables demográficas y terapéuticas en las fases preoperatoria, intraoperatoria y posoperatoria. En la casuística predominaron los accidentes del tránsito como mecanismos causales de las lesiones (55,8 por ciento), la depresión de la eminencia cigomática y la presencia de escalones óseos palpables en el marco orbitario inferior y/o lateral como síntomas principales (92,1 por ciento, respectivamente), y la exposición escleral como complicación posoperatoria (55,2 por ciento), entre otros; asimismo, el valor del tiempo preoperatorio incrementó el riesgo de secuelas y la vía de acceso subciliar se asoció con un mayor riesgo de exposición escleral para el acceso al marco inferior y/o suelo orbitario. Por otra parte, tanto el enoftalmos como el hipoftalmos son de difícil solución y tienen una tendencia significativa de convertirse en secuelas posoperatorias
A descriptive, cross-sectional and randomized study of 102 patients with fractures of the zygomatic complex, treated with semirigid osteosynthesis in the Maxillofacial Surgery Service of Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital was carried out in Santiago de Cuba, from January, 2005 to December, 2011, aimed at characterizing them according to demographic and therapeutic variables in the presurgical, intrasurgical and postsurgical phases. In the case material there was a prevalence of traffic accidents as causal mechanisms of the lesions (55.8 percent), depression of the zygomatic eminence and presence of palpable bony steps in the lower and/or lateral orbitary edge as main symptoms (92.1 percent, respectively), and the scleral exhibition as postsurgical complication (55.2 percent), among others; also, the value of the presurgical time increased the risk of sequelae and the subciliary approach was associated with a higher risk of scleral exhibition for approaching to the lower edge and/or orbitary floor. On the other hand, either enophthalmos or hypophthalmos are of difficult solution and have a significant tendency of becoming postsurgical sequelae