Symmetry Measurement of Zygomaticomaxillary Complex of the Patients in Rajavithi Hospital

Abstract

Background: The zygomaticomaxillary complex is the main component of the mid-facial skeleton involving functional support of the peri-orbital area and aesthetics of the cheek. Current developments in computer-aid design, computer-assisted surgery, and intraoperative navigation system require knowledge of the three-dimensional landmark to assist preoperative planning and intra-operative performance. Objective: The aim of this study was to assess the symmetry of the cheek bone and study the zygomaticomaxillary complex anatomy in Rajavithi Hospital. Methods: Facial computed tomography data of sixty patients (thirty males and thirty females) were obtained and aligned in iPlan software. Five reference points (i.e., obitale, maxillozygoin, suprajugal curvature, jugale, and zygoin) were marked on the three-dimensional reconstruction. Distances between the nasion and the reference points were measured in the three planes. Differences in the distance between the landmarks and the asymmetrical index were calculated. Two plastic surgeons performed this process to assess interrator reliability. Results: The three-dimensional distance between nasion and four zygomaticomaxillary complex landmarks were not statistically different bilaterally except for the distance at obitale which was only 3.11±3.32 mm different. The asymmetrical index of the five landmarks ranged between 4.89±3.38 mm and 6.31±4.71 mm. Conclusions: The study showed the anatomical location of five landmarks in three dimensions. The anatomical landmarks of the zygomaticomaxillary complex were symmetrical. Thus, knowledge of the three-dimensional locations could aid in computer-aid design, computer-assisted surgery, and navigation-assisted surgery for both restorative, reconstructive, and aesthetic aims.