The Volume Difference Along the External Surface of the Zygomatic Bone: A Novel Method of Measuring Zygomatic Bone Asymmetry.

ABSTRACT: This study introduced the volume difference along the external surface (VDAES) of the zygomatic bone as a novel approach to assess zygomatic bone asymmetry and was the first to describe a distinctive, 4-step method of measuring it. VDAES has a potential to be used as an objective tool to evaluate dislocation and can assist surgeons in predicting risks of long-term cosmetic complications in patients with zygomaticomaxillary complex fractures. After having measured 100 healthy study participants, the observed median VDAES was 1.48 cm3 for all study participants, 2.02 cm3 for males, and 1.09 cm3 for females, with the gender difference being significant (P = 0.003). Additional studies are needed to test the hypothesis of whether VDAES is more relevant than conventional methods of clinically evaluating zygomatic bone asymmetry.

Loss of Malar Bags in Lower Eyelid in Orbital Blow Out Fracture Reconstruction Following Pre- or Retro-Septal Transconjunctival Incision.

An isolated orbital blow out fracture may require surgical correction by accessing the infraorbital rim through a transconjunctival incision and inserting an orbital plate. The risk for aesthetic complications due to the incision has previously been well described. Sixty patients surgically treated using pre- or retro-septal transconjunctival incisions for isolated orbital blow out fractures were recruited and examined with regards to lower eyelid asymmetry. Forty-seven controls with conservative treatment were recruited and underwent a similar examination. A grading system for malar bags in the lower eyelids was set up to compare the 2 groups. All patients with moderate or severe malar bags on the nonoperated eyelid lost the malar bags on the operated side and developed asymmetry in the lower eyelids. No difference was found between the pre- and retro-septal approach. In this study we describe a new complication related to the transconjunctival incision and highlight the importance of informing patients in need of reconstruction of the orbital walls about the risk of postoperative asymmetry in the lower eyelids.