Damage to the zygomatic-orbital complex: Characteristics of treatment methods and complications

BACKGROUND: Modern methods of restorative and reconstructive surgery have made it possible to improve the results of treatment of patients with defects in the zygomatic-orbital complex; however, achieving good long-term treatment results continues remains difficult. The study presented a description of the methods of surgical treatment of defects and deformities of the zygomatic-orbital complex. The study made it possible to identify the advantages and disadvantages of the previously proposed methods and to assess the volume and characteristics of complications associated with specific methods. The surgical method of treatment was defined as the treatment of diseases by separating and connecting tissues during a surgical operation.

AIM: This study aimed to identify the main methods of surgical treatment of defects and deformities of the zygomatic-orbital complex, describe the most common of them, and determine the frequency and type of complications associated with each method.

MATERIAL AND METHODS: The study was based on the results of a retrospective analysis of 9605 case histories of patients treated at the Clinic of Maxillofacial Surgery and Surgical Dentistry of the Military Medical Academy named after S.M. Kirov from 2014 to 2020. Of these patients, 715 had facial injuries 335 had midface injuries, and 189 had injuries of the zygomatic-orbital complex.

RESULTS: The study interviewed 10 oral and maxillofacial surgeons who scored (1–5, most uncomfortable to see no improvement) the seven most popular materials in the clinic based on nine characteristics. Of the 189 patients who received treatment, late (not earlier than 6 months) complications were detected in 31 (16.4%) patients, which were divided into three groups: (A) fractures of the zygomatic-orbital complex with slight displacement of fragments, (B) subtotal fractures with the formation of defects and deformations, and (C) total defects and deformations.

CONCLUSION: There is no consensus as to how many fixation points are needed in the treatment of MJ fractures. Generally, the number of unstable fragments determines the number of fixation points in direct proportion. A recent meta-analysis showed that a 3-point fixation had greater fracture stability up to 3 months postoperatively compared with a 2-point fixation, but the level of evidence was low.