eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Trauma

Zygomaticomaxillary Complex Fractures: Follow-up

Author: Travis T Tollefson, MD, FACS, Assistant Professor, Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center
Coauthor(s): E Bradley Strong, MD, Associate Professor, Department of Otolaryngology-Head and Neck Surgery, University of California at Davis
Contributor Information and Disclosures

Updated: Sep 24, 2009

Outcome and Prognosis

Unacceptably poor surgical outcomes are uncommon. Significant facial asymmetry requiring surgical revision occurs in 3-4% of patients. Postoperative infection rates are extremely low, and these infections nearly always resolve with oral antibiotics. In general, the long-term prognosis after repair of zygomaticomaxillary complex (ZMC) fractures is very good.

Future and Controversies

Future advances in the treatment of facial trauma most likely will involve more extensive use of endoscopy for minimally invasive repair of traumatic injuries. The authors are using computer imaging software that can compare the more nonfractured side and create a computer model for reconstruction planning.38 Image-guidance surgery systems may also play a role in optimizing fracture reduction. 

 


More on Zygomaticomaxillary Complex Fractures

Overview: Zygomaticomaxillary Complex Fractures
Workup: Zygomaticomaxillary Complex Fractures
Treatment: Zygomaticomaxillary Complex Fractures
Follow-up: Zygomaticomaxillary Complex Fractures
Multimedia: Zygomaticomaxillary Complex Fractures
References
[ CLOSE WINDOW ]

References

  1. Donald PJ. Zygomatic fractures. In: English GM, ed. Otolaryngology: A Text Book. ed. Hagerstown, Md: Medical Dept, Harper & Row; 1976.

  2. Arosarena OA, Fritsch TA, Hsueh Y, Aynehchi B, Haug R. Maxillofacial injuries and violence against women. Arch Facial Plast Surg. Jan-Feb 2009;11(1):48-52. [Medline].

  3. Ellis E 3rd, el-Attar A, Moos KF. An analysis of 2,067 cases of zygomatico-orbital fracture. J Oral Maxillofac Surg. Jun 1985;43(6):417-28. [Medline].

  4. Yanagisawa E. Symposium on maxillo-facial trauma. 3. Pitfalls in the management of zygomatic fractures. Laryngoscope. Apr 1973;83(4):527-46. [Medline].

  5. Knight JS, North JF. The classification of malar fractures: An analysis of displacement as a guide to treatment. Br J Plast Surg. 1961;13:325-339.

  6. Zingg M, Laedrach K, Chen J, et al. Classification and treatment of zygomatic fractures: a review of 1,025 cases. J Oral Maxillofac Surg. Aug 1992;50(8):778-90. [Medline].

  7. Jackson IT. Classification and treatment of orbitozygomatic and orbitoethmoid fractures. The place of bone grafting and plate fixation. Clin Plast Surg. Jan 1989;16(1):77-91. [Medline].

  8. Jelks GW, La Trentra G. Orbital fractures. In: Foster CA, Sherman JE, eds. Surgery of Facial Bone Fractures. New York, NY: Churchill Livingston; 1987:67-91.

  9. Strong EB, Sykes JM. Zygoma complex fractures. Facial Plast Surg. 1998;14(1):105-15. [Medline].

  10. Fujii N, Yamashiro M. Classification of malar complex fractures using computed tomography. J Oral Maxillofac Surg. Sep 1983;41(9):562-7. [Medline].

  11. Stanley RB Jr. The zygomatic arch as a guide to reconstruction of comminuted malar fractures. Arch Otolaryngol Head Neck Surg. Dec 1989;115(12):1459-62. [Medline].

  12. Zingg M, Chowdhury K, Ladrach K, Vuillemin T, Sutter F, Raveh J. Treatment of 813 zygoma-lateral orbital complex fractures. New aspects. Arch Otolaryngol Head Neck Surg. Jun 1991;117(6):611-20; discussion 621-2. [Medline].

  13. Lynch DJ, Lamp JC, Royster HP. The conjunctival approach for exploration of the orbital floor. Plast Reconstr Surg. Aug 1974;54(2):153-6. [Medline].

  14. Tessier P. The conjunctival approach to the orbital floor and maxilla in congenital malformation and trauma. J Maxillofac Surg. Mar 1973;1(1):3-8. [Medline].

  15. Converse JM, Firmin F, Wood-Smith D, Friedland JA. The conjunctival approach in orbital fractures. Plast Reconstr Surg. Dec 1973;52(6):656-7. [Medline].

  16. Tenzel RR, Miller GR. Orbital blow-out fracture repair, conjunctival approach. Am J Ophthalmol. May 1971;71(5):1141-2. [Medline].

  17. Mueller R. Endoscopic treatment of facial fractures. Facial Plast Surg. Jan 2008;24(1):78-91. [Medline].

  18. Walter WL. Early surgical repair of blowout fracture of the orbital floor by using the transantral approach. South Med J. Oct 1972;65(10):1229-43. [Medline].

  19. Gillies HD, Kilner JP, Stone D. Fractures of the malar-zygomatic compound with a description of a new x-ray position. Br J Surg. 1927;14:651.

  20. Matsunaga RS, Simpson W, Toffel PH. Simplified protocol for treatment of malar fractures. Based on a 1,220-case, eight-year experience. Arch Otolaryngol. Sep 1977;103(9):535-8. [Medline].

  21. Eisele DW, Duckert LG. Single-point stabilization of zygomatic fractures with the minicompression plate. Arch Otolaryngol Head Neck Surg. Mar 1987;113(3):267-70. [Medline].

  22. Karlan MS, Cassisi NJ. Fractures of the zygoma. A geometric, biomechanical, and surgical analysis. Arch Otolaryngol. Jun 1979;105(6):320-7. [Medline].

  23. Chuong R, Kaban LB. Fractures of the zygomatic complex. J Oral Maxillofac Surg. Apr 1986;44(4):283-8. [Medline].

  24. Ballenger JJ. Diseases of the Nose, Throat, Ear, Head, and Neck. 14th ed. Philadelphia, Pa: Lea & Febinger; 1991.

  25. Lund K. Fractures of the zygoma: a follow-up study on 62 patients. J Oral Surg. Aug 1971;29(8):557-60. [Medline].

  26. Lundin K, Ridell A, Sandberg N, Ohman A. One thousand maxillo-facial and related fractures at the ENT-clinic in Gothenburg. A two-year prospective study. Acta Otolaryngol. Apr 1973;75(4):359-61. [Medline].

  27. Larsen OD, Thomsen M. Zygomatic fractures. II. A follow-up study of 137 patients. Scand J Plast Reconstr Surg. 1978;12(1):59-63. [Medline].

  28. Dingman RO, Natvig P. Surgery of Facial Fractures. Philadelphia, Pa: WB Saunders Co; 1976.

  29. Wavak P, Zook EG. Immobilization of fractures of the zygomatic bone with an antral pack. Surg Gynecol Obstet. Oct 1979;149(4):587-9. [Medline].

  30. Davidson J, Nickerson D, Nickerson B. Zygomatic fractures: comparison of methods of internal fixation. Plast Reconstr Surg. Jul 1990;86(1):25-32. [Medline].

  31. Lederman IR. Loss of vision associated with surgical treatment of zygomatic-orbital floor fracture. Plast Reconstr Surg. Jul 1981;68(1):94-9. [Medline].

  32. Crumley RL, Leibsohn J, Krause CJ, Burton TC. Fractures of the orbital floor. Laryngoscope. Jun 1977;87(6):934-47. [Medline].

  33. Dingman RO, Natvig P. Surgery of Facial Fractures. Philadelphia, Pa: WB Saunders Co; 1964:212-213.

  34. Appling WD, Patrinely JR, Salzer TA. Transconjunctival approach vs subciliary skin-muscle flap approach for orbital fracture repair. Arch Otolaryngol Head Neck Surg. Sep 1993;119(9):1000-7. [Medline].

  35. Wray RC, Holtmann B, Ribaudo JM, Keiter J, Weeks PM. A comparison of conjunctival and subciliary incisions for orbital fractures. Br J Plast Surg. Apr 1977;30(2):142-5. [Medline].

  36. Patel BC, Patipa M, Anderson RL, McLeish W. Management of postblepharoplasty lower eyelid retraction with hard palate grafts and lateral tarsal strip. Plast Reconstr Surg. Apr 1997;99(5):1251-60. [Medline].

  37. Perino KE, Zide MF, Kinnebrew MC. Late treatment of malunited malar fractures. J Oral Maxillofac Surg. Jan 1984;42(1):20-34. [Medline].

  38. Pham AM, Rafii AA, Metzger MC, Jamali A, Strong EB. Computer modeling and intraoperative navigation in maxillofacial surgery. Otolaryngol Head Neck Surg. Oct 2007;137(4):624-31. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

maxillary zygomatic fractures, zygomaticomaxillary complex, zygomaticomaxillary fractures, zygomaticomaxillary complex fracture, facial fractures, facial fracture, jaw fracture, cheek fracture, ZMC, ZMC fracture, upper jaw bone, upper jaw, jaw, broken jaw, os zygomaticum, zygomatic bone, cheek bone, cheekbone, broken cheek bone, broken cheekbone

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Travis T Tollefson, MD, FACS, Assistant Professor, Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center
Travis T Tollefson, MD, FACS is a member of the following medical societies: American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, and American Rhinologic Society
Disclosure: Nothing to disclose.

Coauthor(s)

E Bradley Strong, MD, Associate Professor, Department of Otolaryngology-Head and Neck Surgery, University of California at Davis
E Bradley Strong, MD is a member of the following medical societies: Alpha Omega Alpha and American Rhinologic Society
Disclosure: Nothing to disclose.

Medical Editor

Michael Mercandetti, MD, MBA, FACS, Consulting Staff, Department of Surgery, Doctors Hospital of Sarasota
Michael Mercandetti, MD, MBA, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Ophthalmology, American College of Surgeons, American Society for Laser Medicine and Surgery, American Society of Ophthalmic Plastic and Reconstructive Surgery, Association of Military Surgeons of the US, and Sarasota County Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Erik Kass, MD, Chief, Department of Clinical Otolaryngology, Associates in Otolaryngology of Northern Virginia
Erik Kass, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Association for Cancer Research, American Medical Association, and American Rhinologic Society
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.