Intraoperative Surgical Navigation Is as Effective as Conventional Surgery for Zygomaticomaxillary Complex Fracture...

Background/Objectives: Zygomaticomaxillary complex (ZMC) fractures are the second most common of all facial bone fractures, and conventional treatment represents a challenge even for experienced surgeons. The aim of this systematic review and meta-analysis was to compare Intraoperative Surgical Navigation (ISN) with conventional surgery in the treatment of ZMC fractures. Methods: We reported our systematic review and meta-analysis based on the recommendation of the PRISMA 2020 guideline. The electronic search was conducted on 9 February 2025 in two search engines (PubMed and Web of Science) and two databases (Embase and the Cochrane Library). Randomized controlled trials and observational studies were included. The outcome variables were accuracy, operative time, maximum mouth opening, postoperative stay, amount of bleeding, and cheek numbness. The random-effects model was used for the analysis, and the results were given as mean differences and odds ratios with 95% confidence intervals (CI). After duplicate removal, 1961 articles were found. After the selection procedure, five studies were found to be eligible for qualitative and quantitative analysis. Results: There were no statistically significant differences between ISN and conventional surgery regarding the outcomes investigated, except in postoperative average deviation of the zygomatic bone. Our results showed an improvement of 0.64 mm [CI: 0.32, 0.92] zygomatic bone deviation when ISN was used. Conclusions: The results suggest that ISN is as effective as the conventional technique in the treatment of ZMC fractures. However, because of the low number of eligible studies, further randomized controlled trials are necessary to strengthen the level of evidence on this matter.