Outcomes of zygomatic fractures: a cross-sectional study

Facial trauma represents a significant event in a patient*s life, often
resulting in physical deformities and potential psychological consequences. In
facial trauma cases, fractures occurring in the zygomatic bone area are
prevalent due to the distinctive shape and positioning within the face. These
fractures can disrupt the facial symmetry, which plays a role in the perceived
aesthetics and functionality of the human face, impacting not only physical
appearance but also psychological well-being and social interactions.
The zygomatic bone, a critical component of the midfacial skeleton, contributes
to the contour and width of the face, supports the orbit and has a functional
role as the origin of one of the masticatory muscles, the masseter muscle.
Therefore, fractures in this region can lead to a variety of complications
including diplopia, enophthalmos, sensory disturbances and mastication
problems. Treatment aims not only to restore function and aesthetics but also
to prevent long-term deformities.
Despite advancements in surgical techniques and imaging modalities,
postoperative complications such as residual deformity, asymmetry of hard and
soft tissue, and dissatisfaction with facial appearance remain remain concerns
that warrant further investigation. Even when bone symmetry is achieved,
patients may still report perceived asymmetry. Current literature, primarily
focused on hard tissue symmetry, indicates the necessity of including both
soft and hard tissues in future symmetry analyses.

This study aims to create a detailed database of patients treated for zygomatic
fractures at Erasmus MC from 2008 to June 2023. By leveraging data from
electronic patient records, we intend to gather extensive demographic,
clinical, and treatment-related information. Following this, patients will be
invited to undergo additional evaluations including Cone Beam Computed
Tomography (CBCT) scans, which offer precise imaging to assess for any residual
displacement and asymmetry. For soft tissue, 3D facial photography will be used
to objectively measure facial asymmetry, offering a comprehensive view of both
functional and aesthetic results post-recovery. Patient satisfaction and
quality of life post-treatment will be assessed through validated
questionnaires (FACE-Q), providing insights into the psychological and social
impacts of these injuries. Functional tests will be conducted to evaluate
ocular motility and cutaneous sensory function.

Through this multifaceted approach, the study aims to identify factors
contributing to optimal outcomes and those that may predispose patients to
poorer prognoses. The findings will not only enhance understanding of zygomatic
fractures but also inform future clinical practices, ensuring improved patient
care and satisfaction through better expectation management.

This study aims to create a detailed database of patients treated for zygomatic
fractures at Erasmus MC from 2008 to June 2023. By leveraging data from
electronic patient records, we intend to gather extensive demographic,
clinical, and treatment-related information. Following this, patients will be
invited to undergo additional evaluations including Cone Beam Computed
Tomography (CBCT) scans, which offer precise imaging to assess for any residual
displacement and asymmetry. For soft tissue, 3D facial photography will be used
to objectively measure facial asymmetry, offering a comprehensive view of both
functional and aesthetic results post-recovery. Patient satisfaction and
quality of life post-treatment will be assessed through validated
questionnaires (FACE-Q), providing insights into the psychological and social
impacts of these injuries. Functional tests will be conducted to evaluate
ocular motility and cutaneous sensory function.

Cone Beam Computed Tomography (CBCT) is an advanced imaging modality utilized
for high-resolution three-dimensional (3D) visualization of the maxillofacial
region. It employs a rotating C-arm apparatus to project a cone-shaped X-ray
beam through the patient's head, yielding detailed images with minimal
distortion. CBCT is pivotal in the diagnosis and assessment of maxillofacial
conditions, including zygomatic fractures, while ensuring low radiation
exposure. Over the past two decades, CBCT has been extensively integrated into
dental and maxillofacial imaging, with numerous studies substantiating its
efficacy and safety in clinical contexts. It serves as a cornerstone in
orthodontic, implantological, and trauma evaluation, supported by a substantial
body of evidence validating its ability to delineate bone structures and
identify fractures. Human exposure to CBCT has demonstrated a robust safety
profile, characterized by radiation doses lower than those of conventional CT
scans, thus imparting negligible additional risk.