Does additional intraoperative imaging improves outcomes in isolated zygomatic arch fractures: Systematic review

Purpose: To review the state-of-art and advances in the use of intraoperative imaging and its benefits on overall adequacy of reduction of depressed zygomatic arch fractures compared to the conventional blind reduction technique. Materials and methods: PubMed, Embase, Cochrane Central Register of Co...

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Main Authors: AshutoshKumar Singh, Safal Dhungel, PujanKranti Kayastha, Ajoy Roychoudhury, Anson Jose
Format: Article
Language:English
Published: Elsevier 2021-01-01
Series:Advances in Oral and Maxillofacial Surgery
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2667147621000017
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author AshutoshKumar Singh
Safal Dhungel
PujanKranti Kayastha
Ajoy Roychoudhury
Anson Jose
author_facet AshutoshKumar Singh
Safal Dhungel
PujanKranti Kayastha
Ajoy Roychoudhury
Anson Jose
author_sort AshutoshKumar Singh
collection DOAJ
description Purpose: To review the state-of-art and advances in the use of intraoperative imaging and its benefits on overall adequacy of reduction of depressed zygomatic arch fractures compared to the conventional blind reduction technique. Materials and methods: PubMed, Embase, Cochrane Central Register of Controlled Trials, Clinical Trials Registry, and a manual search of selected journals and the reference list of included articles was performed up until June 2020. Two randomized controlled trials and three retrospective cohort studies fulfilled the inclusion criteria. Qualitative synthesis of all the outcomes and studies was done. Metanalysis was performed for the completely reported outcomes. Results: There was a statistically significant difference in the overall adequacy of reduction based on clinical and radiographic assessments, Z = 2.30 (P = .02) in favour of imaging guided reduction. There was less residual cortical step and dislocation angle in the imaging group, Z = 2.62 (P = .009). There was no reoperation in imaging guided group compared to two cases of reoperations in the blind group. The mean time required for imaging guided reduction was more compared to the blind reduction. Conclusions: Imaging guided reduction of zygomatic arch results in lesser number of reoperations and better overall reduction. There is a relative reduction in risk of postoperative complications, and the evidence is moderately certain. Conclusions drawn from the results of this systematic review are promising, and it can be used to form the basis of randomized clinical trials to evaluate intraoperative imaging modalities in reduction of isolated zygomatic arch fractures.
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spelling doaj.art-9cae88e5df5443858f0e30ca9a76ec722022-12-21T22:54:46ZengElsevierAdvances in Oral and Maxillofacial Surgery2667-14762021-01-011100014Does additional intraoperative imaging improves outcomes in isolated zygomatic arch fractures: Systematic reviewAshutoshKumar Singh0Safal Dhungel1PujanKranti Kayastha2Ajoy Roychoudhury3Anson Jose4Department of Oral & Maxillofacial Surgery, College of Medical Sciences Teaching Hospital, Bharatpur, Nepal; Corresponding author. Department of Oral and Maxillofacial Surgery, College of Medical Sciences Teaching Hospital, Bharatpur-10, Chitwan, 44200, Nepal.Department of Oral & Maxillofacial Surgery, College of Medical Sciences Teaching Hospital, Bharatpur, NepalDepartment of Conservative and Restorative Dentistry, College of Medical Sciences Teaching Hospital, Bharatpur, NepalDepartment of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, IndiaPurpose: To review the state-of-art and advances in the use of intraoperative imaging and its benefits on overall adequacy of reduction of depressed zygomatic arch fractures compared to the conventional blind reduction technique. Materials and methods: PubMed, Embase, Cochrane Central Register of Controlled Trials, Clinical Trials Registry, and a manual search of selected journals and the reference list of included articles was performed up until June 2020. Two randomized controlled trials and three retrospective cohort studies fulfilled the inclusion criteria. Qualitative synthesis of all the outcomes and studies was done. Metanalysis was performed for the completely reported outcomes. Results: There was a statistically significant difference in the overall adequacy of reduction based on clinical and radiographic assessments, Z = 2.30 (P = .02) in favour of imaging guided reduction. There was less residual cortical step and dislocation angle in the imaging group, Z = 2.62 (P = .009). There was no reoperation in imaging guided group compared to two cases of reoperations in the blind group. The mean time required for imaging guided reduction was more compared to the blind reduction. Conclusions: Imaging guided reduction of zygomatic arch results in lesser number of reoperations and better overall reduction. There is a relative reduction in risk of postoperative complications, and the evidence is moderately certain. Conclusions drawn from the results of this systematic review are promising, and it can be used to form the basis of randomized clinical trials to evaluate intraoperative imaging modalities in reduction of isolated zygomatic arch fractures.http://www.sciencedirect.com/science/article/pii/S2667147621000017Zygomatic archIntraoperative imagingImaging guidedMaxillofacial traumaSystematic review
spellingShingle AshutoshKumar Singh
Safal Dhungel
PujanKranti Kayastha
Ajoy Roychoudhury
Anson Jose
Does additional intraoperative imaging improves outcomes in isolated zygomatic arch fractures: Systematic review
Advances in Oral and Maxillofacial Surgery
Zygomatic arch
Intraoperative imaging
Imaging guided
Maxillofacial trauma
Systematic review
title Does additional intraoperative imaging improves outcomes in isolated zygomatic arch fractures: Systematic review
title_full Does additional intraoperative imaging improves outcomes in isolated zygomatic arch fractures: Systematic review
title_fullStr Does additional intraoperative imaging improves outcomes in isolated zygomatic arch fractures: Systematic review
title_full_unstemmed Does additional intraoperative imaging improves outcomes in isolated zygomatic arch fractures: Systematic review
title_short Does additional intraoperative imaging improves outcomes in isolated zygomatic arch fractures: Systematic review
title_sort does additional intraoperative imaging improves outcomes in isolated zygomatic arch fractures systematic review
topic Zygomatic arch
Intraoperative imaging
Imaging guided
Maxillofacial trauma
Systematic review
url http://www.sciencedirect.com/science/article/pii/S2667147621000017
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