Intraoperative repositioning assessment using navigation system in zygomatic fracture

Intraoperative repositioning assessment in the zygomatic fracture operation is very important in achieving adequate facial symmetry. A navigation system that has been developed in neurosurgery has recently been applied in the otolaryngol, orthopedic, and maxillofacial surgeries. We used a navigation system (Stealth Station TREON; Medtronic) in zygomatic fracture operation, and found it useful in performing accurate reduction and confirming the symmetry.

We applied a navigation system in 6 patients with zygomatic bone fracture. Navigation aided reduction of the bone fracture was performed by evaluating intraoperative procedures: (1) an evaluation by measuring the distances from the midline of the face and (2) an evaluation by comparing the affected side to the mirror image of the nonaffected side. A method using the distance from the midline of the face was performed in 3 cases, and a method using the mirror image of the nonaffected side was used in 6 cases.

Accurate reduction and symmetry were confirmed during the operation in all patients. Good symmetry was confirmed in postoperative computed tomographic scan. It was useful in performing accurate reduction of the fractures and confirming the symmetry of the face.

We suggest that the system can also be applied for the treatment of untreated facial fractures requiring osteotomy and of comminuted facial fractures with third-bone fragments and for the evaluation of bone graft.