The Impact of Using Intraoperative Computed Tomography on the Number of Surgical Approaches Used for Zygomaticomaxillary Complex Repair.

Zygomaticomaxillary complex (ZMC) fractures are repaired using a variety of surgical approaches. Utilization of intraoperative computed tomography (CT) may reduce the number of surgical approaches. To compare the use of intraoperative CT for the operative repair of ZMC fractures, as measured by the number of surgical approaches. A retrospective review was completed on patients who underwent surgical repair of ZMC fractures by facial plastic and reconstructive surgeons at a tertiary hospital. Eighty-four patients underwent open ZMC repair between 2009 and 2022. Patients had a median age of 42 years (range: 19-93, interquartile range 29-59), were 76.2% Male ( = 64) and 78.6% ( = 66) White. There were 38 and 46 patients in the pre- and post-intraoperative CT cohorts, respectively. The most common incision utilized was a gingivobuccal incision (98.8%), followed by a transconjunctival approach (47.6%). Cases in which CT was utilized had a significantly reduced number of incisions (mean incisions: 2.45 pre vs. 1.67 post, < 0.001), with large reductions in the rate of transconjunctival incisions (pre-intraoperative CT: 73.7%; post-intraoperative CT: 26.1%, < 0.001) and lateral canthotomy incisions (23.7% vs. 4.3%, < 0.001). Intraoperative CT reduces the number of surgical approaches in patients with ZMC trauma.