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Malar Relocation with Reverse-L Osteotomy and Autogenous Bone Graft.

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Zygomaticomaxillary complex (ZMC) fractures from trauma can cause facial asymmetry and temporomandibular joint (TMJ) issues. A novel surgical technique successfully restored facial aesthetics and improved chewing function in a patient with ZMC fracture.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Plastic and Reconstructive Surgery
  • Trauma Surgery

Background:

  • The zygomaticomaxillary complex (ZMC) is crucial for facial structure, midfacial width, and cheek prominence.
  • ZMC fractures, often from blunt trauma, can lead to malar deficiency, aesthetic deformities, and functional impairments like trismus.
  • Conservative management of ZMC fractures may not always resolve functional deficits, such as temporomandibular joint (TMJ) discomfort during mastication.

Purpose of the Study:

  • To describe a surgical technique for correcting zygomaticomaxillary complex (ZMC) fractures.
  • To restore the aesthetic position and symmetry of the malar complex.
  • To improve mastication function in patients with ZMC fractures and associated trismus.

Main Methods:

  • A case study of a 48-year-old male patient with a right ZMC fracture due to blunt trauma (baseball injury).
  • The patient initially received conservative management, which did not resolve his symptoms of trismus and masticatory discomfort.
  • A surgical technique involving combined oblique-vertical osteotomy was performed to reposition the malar body anteriorly and laterally.

Main Results:

  • The surgical intervention successfully restored the pre-injury aesthetic position and symmetry of the malar complex.
  • The patient experienced significant improvement in mastication function.
  • Post-operative recovery addressed the discomfort during mouth opening and mastication caused by trismus.

Conclusions:

  • Combined oblique-vertical osteotomy is an effective surgical technique for ZMC fractures.
  • This surgical approach can successfully correct malar deficiency, improve facial aesthetics, and restore masticatory function.
  • Surgical correction offers a viable solution for patients experiencing persistent functional deficits after ZMC fractures.