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Introducción: Correspondiendo a una patología frecuente en la especialidad de cabeza, cuello y máxilo-facial, consecuencia de traumatismos severos, es importante determinar las características de las fracturas del tercio medio facial, para su manejo. Objetivo: Determinar la presentación de las fracturas del tercio medio facial por edad, sexo, agente causal. Diseño: Estudio observacional descriptivo. Lugar: Servicio de Cirugía de Cabeza, Cuello y Máxilo-Facial del Hospital Nacional Dos de Mayo, Lima, Perú. Participantes: Pacientes con fractura del tercio medio facial. Intervenciones: Recolección de datos registrados en las historias clínicas, entre junio 1999 y mayo 2009. Principales medidas de resultados: Edad, sexo, agente causal y clasificación. Resultados: De 471 pacientes, 83% fue de sexo masculino, 72,5% tenía entre 21 y 40 años de edad, 48% fue por accidentes de tránsito y 25% por robos; 83% correspondió solamente a fracturas del tercio medio y 88% a trazo unilateral. Conclusiones: Las fracturas del tercio medio facial son las más frecuentes de la región facial; el diagnóstico clínico depende de la estructura afectada. Se debe actuar oportunamente para evitar secuelas y complicaciones.
Introduction: Facial middle third fractures resulting from severe trauma are frequent pathology attended by Surgery Head, Neck and Maxillofacial specialists; to determine its characteristics is important for treatment. Objectives: To determine the presentation of facial middle third fractures by age, sex, causal agent. Design: Observational descriptive study. Setting: Head, Neck and Maxillofacial Surgery Service, Dos de Mayo National Hospital, Lima, Peru. Participants: Patients with facial middle third fracture. Interventions: Collection of data from medical records June 1999 through May 2009. Main outcome measures: Age, sex, causing agent and classification. Results: From 471 patients, 83% were male, 72.5% between 21 and 40 years of age; 48% resulted from traffic accidents and 25% from robberies; 83% were middle third fractures only, and 88% unilateral stroke. Conclusions: Facial middle third fractures are the most common fractures of the facial region; clinical diagnosis depends on the affected structure. Prompt treatment is necessary to prevent sequelae and complications.
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Objective To observe the surgical results of prominent malar-complex and to explore the more effective methods by improving the shape of face through operation.Methods Total 80 patients of prominent malar-complex were treated by strengthening reduction plasty of mala and zygoma through intra-oral approach accompanied with minor pre-auricular incision and the midfacial SMAS lift in order to improve the shape of prominent malar-complex and to prevent malar-cheek parenchyma sag.Results The face skeleton and midfacial chalasis of all patients were significantly improved with satisfaction.All the patients obtained good results during the follow-up period of over six months.Of them there was one case of maxillary sinusitis that had been cured by further symptomatic treatment.Conclusions Strengthening reduction plasty of mala and zygoma accompanied with the midfacialSMAS lift can properly and safely improve the facial shape of patients with prominent malar-complex.
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Objective To evaluate the effect of double L-shape osteotomy combined bony Z-plasty for prominent malar complex.Methods Thirty-two patients with prominent malar complex were treated with double L shape osteotomy combined bony Z plasty for prominent malar complex.Width of lower face was observed during follow-up phase.Questionnaires were used to assess the patents' level of satisfaction at 6 months after operation.Results All wounds got primary intention healing and no severe complication in perioperative period.Postoperative appearance of all 32 cases showed that the width of middle face was efficiently reduced.All patients expressed high levels of satisfaction 6 months after operation.Conclusions Double L-shape osteotomy combined bony Z-plasty for prominent malar complex is an effective and safe method for the treatment of prominent malar complex.
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PURPOSE: It has always been an aspiration for Asians to look more balanced and feminine, considering their facial features regarding relatively flat midface with marked prominences of the zygoma. Many studies have been dealt in this subject. However, the authors would like to emphasize the concept and introduce the technique of repositioning of the malar complex to a cosmetically beneficial point and stationing it on proper position by fixation on zygoma body and arch. METHODS: From January 1998 to December 2007, this method was performed in 50 patients of mild to moderate prominence and malposition of the malar complex. A simplified technique of lateral orbital osteotomy and oblique osteotomy on zygomatic arch through intraoral and preauricular incision was developed. Then, liberal malar complex can be moved to a supero-posterior direction and repositioned to a more cosmetically beneficial point. To maintain the stationed position and to protect from vector affected by the attached masticating muscle to zygomatc bone, fixation was done on both zygoma body and arch. RESULTS: We have obtained satisfactory results using this procedure without any observable complications. The advantages of this procedure are proper exposure, inconspicuous scar, safe, more natural contour, improved stability, and shorter healing time. CONCLUSION: The authors suggest that reduction malarplasty should be approached with underlying concept of repositioning and fixation. In mild moderate malar prominent cases, our technique will provide with maintenance of aesthetic concept, equal to the malar reduction performed under coronal approach and provide with more natural facial contour with stability even with less invasive surgical approach.
Subject(s)
Humans , Asian People , Cicatrix , Muscles , Orbit , Osteotomy , ZygomaABSTRACT
Objective To present a new method of osteotomy for malar complex hypertrophy .Methods The operative procedures was transpositional osteoplasty of the malar complex by coronal approach. A lateral orbital osteotomy began at the level of the frontozygomatic suture line,preserving the lateral orbital rim. It continued far down inferoposteriorly across the zygomaticomaxillary suture line. The zygomatic arch was obliquely cut at 1 cm anterior from the articular tubercle. The bone was not separated from the soft tissue to preserve the blood supply to the zygoma and slid upward, inside and setback. The single microplate,screw and steelwire fixation was done on the repositioned zygomatic body.To zygomatic body prominence,it was obtained a satisfactory effect that only shaved the protruded zygomatic body with chisels by means of an intraoral approach.Operative procedures for reductive malar complex plasty were performed in 12 cases. The patients consisted of 3 males and 9 females whose ages ranged from 21 to 36 years.Results Postoperative follow up for 3～24 months showed satisfactory results using this procedure.Conclusion This modified method has an ideal effect without the possibility of bone resorption of the malar complex.