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Review
. 2020 Nov;34(4):254-259.
doi: 10.1055/s-0040-1721761. Epub 2020 Dec 24.

Secondary Reconstruction of the Zygomaticomaxillary Complex

Hessah M Aman  1 , Abdulrahman Alenezi  2 , Yadranko Ducic  3 , Likith V Reddy  1
Affiliations
Review

Secondary Reconstruction of the Zygomaticomaxillary Complex

Hessah M Aman et al. Semin Plast Surg. 2020 Nov.

Abstract

Zygomaticomaxillary (ZMC) fractures are the second most common facial fractures after nasal bone fractures. The zygoma, with its location and multiple points of articulations, lends itself to both facial structure and esthetics. Secondary ZMC deformities are complications of inadequate primary correction, delayed repair, or lack of repair. Secondary revisions of ZMC aim to correct ZMC displacement and projection and to address orbital discrepancies. Extensive correction involving significant orbital and malar defects requires zygomatic repositioning osteotomies and would greatly benefit from the utilization of virtual surgical planning, intraoperative navigation, and imaging. Minor corrections in malar projection can be corrected by onlay grafting and soft tissue augmentation and resuspension. Isolated or minor orbital corrections can be managed by autogenous or alloplastic material to restore lost orbital volume and anatomy.

Keywords: ZMC; enophthalmos; onlay graft; secondary reconstruction; surgical navigation.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Secondary deformity due to poor zygoma reduction (loss of projection and enophthalmos).
Fig. 2
Fig. 2
Algorithm of ZMC secondary corrections. ZMC, zygomaticomaxillary.
Fig. 3
Fig. 3
Virtual surgical planning: demonstration of the proposed midface reposition (top middle and top right) and excision guide (lower left, middle left).
Fig. 4
Fig. 4
Zygoma and orbit reconstruction with mirroring and navigation.
Fig. 5
Fig. 5
Posttraumatic alteration of the posterior orbital floor and the corresponding change in the globe position.
Fig. 6
Fig. 6
Correction of zygoma projection and severe enophthalmos with cranial bone.
See this image and copyright information in PMC

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