Intraoperative imaging of zygomaticomaxillary complex fractures using a 3D C-arm system

TY - JOUR

T1 - Intraoperative imaging of zygomaticomaxillary complex fractures using a 3D C-arm system

AU - Heiland, M

AU - Schulze, D

AU - Blake, F

AU - Schmelzle, R

PY - 2005/6/1

Y1 - 2005/6/1

N2 - After preclinical studies and evaluation of radiation exposures, intraoperative three-dimensional (3D) C-arm based imaging is now available for the facial skeleton. Fourteen patients admitted for surgical treatment of zygomaticomaxillary complex (ZMC) fractures were included in the study. Preoperative diagnostics and surgical treatment were performed as usual. Intraoperatively, after open reduction, a cone-beam computed tomography (CBCT) dataset was generated using the SIREMOBIL Iso-C3D (Siemens Medical Solutions, Erlangen, Germany). After DICOM-import in eFilm Workstation axial, coronal and sagittal reconstructions were evaluated by five examiners with the help of six defined criteria. In our study, secondary reconstructions were available after 6 min, excluding the time needed for the evaluation of the images. Especially the positioning of the isocentre of the SIREMOBIL Iso-C3D proved to be uncomplicated. Because of the size of the datasets, assessment of the symmetry of the malar projection proved difficult. Best scoring results were found regarding the visualization of the fragment position, bony anchorage of the screws and the fitting of the plates. Remarkable was the low level of metal artefacts in primary and secondary reconstructions. In conclusion, our results demonstrate intraoperative CBCT using the SIREMOBIL Iso-C3D suitable for assessment of postoperative results following ZMC reduction.

AB - After preclinical studies and evaluation of radiation exposures, intraoperative three-dimensional (3D) C-arm based imaging is now available for the facial skeleton. Fourteen patients admitted for surgical treatment of zygomaticomaxillary complex (ZMC) fractures were included in the study. Preoperative diagnostics and surgical treatment were performed as usual. Intraoperatively, after open reduction, a cone-beam computed tomography (CBCT) dataset was generated using the SIREMOBIL Iso-C3D (Siemens Medical Solutions, Erlangen, Germany). After DICOM-import in eFilm Workstation axial, coronal and sagittal reconstructions were evaluated by five examiners with the help of six defined criteria. In our study, secondary reconstructions were available after 6 min, excluding the time needed for the evaluation of the images. Especially the positioning of the isocentre of the SIREMOBIL Iso-C3D proved to be uncomplicated. Because of the size of the datasets, assessment of the symmetry of the malar projection proved difficult. Best scoring results were found regarding the visualization of the fragment position, bony anchorage of the screws and the fitting of the plates. Remarkable was the low level of metal artefacts in primary and secondary reconstructions. In conclusion, our results demonstrate intraoperative CBCT using the SIREMOBIL Iso-C3D suitable for assessment of postoperative results following ZMC reduction.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Bone Plates

KW - Bone Screws

KW - Female

KW - Fracture Fixation, Internal

KW - Humans

KW - Imaging, Three-Dimensional

KW - Male

KW - Maxillary Fractures

KW - Middle Aged

KW - Monitoring, Intraoperative

KW - Oral Surgical Procedures

KW - Reconstructive Surgical Procedures

KW - Tomography, Spiral Computed

KW - Zygomatic Fractures

U2 - 10.1016/j.ijom.2004.09.010

DO - 10.1016/j.ijom.2004.09.010

M3 - SCORING: Journal article

C2 - 16053844

VL - 34

SP - 369

EP - 375

JO - INT J ORAL MAX SURG

JF - INT J ORAL MAX SURG

SN - 0901-5027

IS - 4

ER -