Zygomatic Arch Fracture Treatment With Digital And 3D Printing Technology And Endoscopic Assistance

Objective:1.To investigate the clinical application value of combining digital and 3D printing with endoscopic-assisted technology in the treatment of zygomatic-zygomatic arch fractures.2.To evaluate the accuracy of surgical repositioning and postoperative results of zygomatic-zygomatic arch fractures through self-comparison using spectral fusion chromatic contrast analysis.3.To summarize the indications,advantages,and disadvantages of using endoscopic technology-assisted applications in the treatment of zygomatic-zygomatic arch fractures,and to provide new ideas for surgical repositioning of such fractures.Methods:This study enrolled twelve patients who underwent surgical treatment for unilateral zygomatic-zygomatic arch fractures at the First Affiliated Hospital of Bengbu Medical College between September 2020 and September 2021.Prior to surgery,all patients received thin-section CT examination of the head.The CT data was saved in DICOM format and imported into Mimics 6.0 software for analysis.The fracture site was cut,spliced,and reconstructed using the principle of mirror image inversion to simulate the reset fracture site.The model was printed after mirror image simulation reset in a 1:1 ratio,and the fracture reset was simulated on the model.Finally,the preoperative design and pre-bending of the titanium plate were completed.The fracture site was repositioned intraoperatively using a combined incision with the assistance of endoscopy.Seven days after surgery,the patient underwent cranial 3D CT review,and the CT data were imported into Mimics 6.0software for 3D model reconstruction after fracture reduction.The reconstructed 3D model data were then imported into Geomagic Studio 12.0 software,along with the preoperative simulated fracture reduction 3D model data for analysis and processing.The fracture reduction effect was evaluated using spectral fusion color difference comparison analysis.The patients were followed up for 6-12 months after surgery to observe the facial symmetry,opening degree and opening type,postoperative complications and patient satisfaction.The patients were followed up for 6-12 months after surgery to observe facial symmetry,degree and type of mouth opening,postoperative complications,and patient satisfaction.Results:1.Digitalization and 3D printing,combined with endoscopic assistance,were utilized to perform fracture dissection and internal fixation according to the preoperative design,in 12 patients with unilateral zygomatic arch fractures.The surgery was successfully completed in all patients.2.The use of endoscopy provided a more intuitive view of the fracture site and surrounding soft tissues during surgery.This reduced intraoperative trauma and effectively prevented damage to nerves and blood vessels.As a result,successful fracture repositioning and titanium plate fixation were achieved.3.Spectral color difference analysis revealed that the difference in distance between the postoperative patient’s zygomatic bone and the position of the preoperative patient’s zygomatic bone,after mirror simulated reset,was within the color range of light blue,light green,and light yellow.The overall average upper deviation of the fracture area was 0.2430-0.0250 mm,and the average lower deviation was-0.3100-0.1800 mm.The overall deviation was less than 1 mm.4.During the 6-12 months postoperative follow-up,the patient’s face demonstrated a basic level of symmetry,with no step or collapse deformities at the fracture end,normal mouth opening and shape,and no adverse complications such as diplopia or infraorbital numbness.Furthermore,the postoperative facial scars were effectively concealed,and the patients expressed a high level of satisfaction with the overall outcome.Conclusion:1.The utilization of digital and 3D printing technology,combined with endoscopic assistance,has demonstrated clinical value in the successful resetting and fixation of unilateral zygomatic arch fractures.2.The utilization of digital design and 3D printing technology has allowed for the completion of preoperative surgical planning and simulation of zygomatic-zygomatic arch fractures,thereby enhancing the accuracy of fracture repositioning.3.Intraoperative endoscopic assistance provides visualization of the fracture site and surrounding soft tissues,allowing for precise repositioning of the fracture site.This technique serves as a valuable adjunct to the treatment of zygomatic-zygomatic arch fractures.4.The spectral fusion chromatic contrast analysis method offers a comprehensive,systematic,and intuitive self-contrast analysis of the effectiveness of zygomatic-zygomatic arch fracture reduction.5.Compared to traditional surgical methods,this procedure is less invasive,with concealed postoperative incisions and inconspicuous facial scars,resulting in a favorable aesthetic outcome.