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 Table of Contents  
SHORT COMMUNICATION
Year : 2022  |  Volume : 9  |  Issue : 1  |  Page : 82-84

Three-dimensional miniplate as a viable alternative fixation device for isolated maxillary sinus fracture management: A technical note


Department Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India

Date of Submission12-Nov-2021
Date of Acceptance15-Feb-2022
Date of Web Publication06-Apr-2022

Correspondence Address:
Uday Kiran Uppada
Department Oral and Maxillofacial Surgery, Sri Sai College of dental surgery, Vikarabad, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdrr.jdrr_187_21

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  Abstract 


Isolated fractures of the anterior wall of the maxillary sinus are rare. Literature reveals that these fractures can be managed surgically through numerous ways but none have shown superior results over the other clinically. We put forth that three-dimensional miniplates can serve as a viable alternative fixation device for isolated maxillary sinus fracture management.

Keywords: Buttresses, maxillary sinus fracture, three-dimensional plates


How to cite this article:
Uppada UK. Three-dimensional miniplate as a viable alternative fixation device for isolated maxillary sinus fracture management: A technical note. J Dent Res Rev 2022;9:82-4

How to cite this URL:
Uppada UK. Three-dimensional miniplate as a viable alternative fixation device for isolated maxillary sinus fracture management: A technical note. J Dent Res Rev [serial online] 2022 [cited 2022 Oct 5];9:82-4. Available from: https://www.jdrr.org/text.asp?2022/9/1/82/342709




  Introduction Top


Literature reveals that isolated fractures of the anterior wall of the maxillary sinus fractures account for only 1.3% of maxillofacial fractures.[1] It is observed that nearly 5% of mandibular fractures induce isolated posterior and lateral maxillary sinus fractures.[2],[3] Few studies in the past have advocated that surgical intervention to manage isolated fractures of the anterior wall of the maxillary sinus have added risks than benefits.[4],[5],[6] However, it was noted later that the majority of the patients who did not undergo surgical intervention developed acute maxillary sinusitis.[7]

Isolated fractures of the anterior wall of the maxillary sinus can be surgically managed using urinary balloon catheters and/or fibrin glue to reposition bony fragments.[5],[6] Transnasal endoscopic-assisted ultrasound-guided intranasal reduction of maxillary sinus wall has also been tried.[5] Literature reveals that none of these approaches have provided superior results. We advocate the placement of a three-dimensional (3D) miniplate in the management of isolated fractures of the anterior wall of the maxillary sinus.


  Technique Top


This technique is advocated for simple isolated fractures of the anterior wall of the maxillary sinus [Figure 1]. Following a circumvestibular incision and a subperiosteal dissection, the anterior wall of the maxillary sinus is exposed up to the infraorbital foramina on the affected side to visualize the fracture line [Figure 2]. Two langenbeck retractors are used to protect the tissues of the upper lip on either side of the infraorbital foramina and a 10 mm steel malleable retractor is placed behind the zygomaticomaxilary buttres. The fracture segments are manipulated and reduced if required. A 1.5 mm stainless steel 3D miniplate is adapted to the anatomical contour and placed in such a way that the screws can be drilled along the nasomaxillary and zygomaticomaxillary buttresses using 1.5 mm × 8 mm screws [Figure 3]. Wound toilet done hemostasis achieved and wound closed. [Figure 4] shows the postoperative radiograph.
Figure 1: Preoperative radiograph showing an isolated anterior wall fracture of the maxillary sinus

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Figure 2: Intraoperative picture showing an isolated anterior wall fracture of the maxillary sinus

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Figure 3: Intraoperative picture showing the three-dimensional plates as a viable alternative fixation device for isolated anterior wall fracture of the maxillary sinus

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Figure 4: Postoperative radiograph showing the three-dimensional plates as a viable alternative fixation device for isolated anterior wall fracture of the maxillary sinus

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  Discussion Top


It is a well-known fact that the 3D miniplates are geometrically stable due to the struts connecting the two horizontal arms that eliminates the need for two separate plates to be adapted in addition to the broadband platform that is created to provide additional stability following fracture reduction.[8],[9],[10] Based on the AO principles of fracture fixation, it is advocated that there should be a minimum of 2 screws on either side of the fracture line. The use of a 3D miniplate for the management of isolated fractures of the anterior wall of the maxillary sinus fulfills this criterion. In addition to this, the 3D miniplate's geometrical structure facilitates its placement in such a way that the screws can be drilled along the nasomaxillary and zygomaticomaxillary buttresses which are the strong pillars in this anatomical area to fix the weak isolated maxillary sinus fracture. Hence, it can be advocated that 3D miniplates can serve as a viable alternative fixation devices for isolated maxillary sinus fracture management.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patients have given their consent for their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Hwang K, You SH. Analysis of facial bone fractures: An 11-year study of 2,094 patients. Indian J Plast Surg 2010;43:42-8.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Blatt S, Rahimi-Nedjat R, Sagheb K, Piechowiak L, Walter C, Brüllmann D. Coincidence of mandibular fractures with isolated posterior maxillary sinus fractures. Dent Traumatol 2017;33:345-9.  Back to cited text no. 2
    
3.
Uppada UK, Sinha R, Susmitha M, Praseedha B, Kiran BR. Mandibular fracture patterns in a rural setup: A 7-year retrospective study. J Maxilofac Oral Surg 2020. [In Press].  Back to cited text no. 3
    
4.
Ballon A, Landes CA, Zeilhofer HF, Herzog M, Klein C, Sader R. The importance of the primary reconstruction of the traumatized anterior maxillary sinus wall. J Craniofac Surg 2008;19:505-9.  Back to cited text no. 4
    
5.
Yang HC, Kim YY, Jin SM, You H, Han JH, Nam KI. Transnasal endoscopic ultrasound-guided reduction of maxillary sinus wall fracture. Eur Arch Otorhinolaryngol 2017;274:3383-90.  Back to cited text no. 5
    
6.
Kim J, Yang HJ, Kim JH, Kim SJ. Reduction of the isolated anterior wall of the maxillary sinus fracture with double urinary balloon catheters and fibrin glue. Arch Craniofac Surg 2017;18:238-42.  Back to cited text no. 6
    
7.
Schmidt RS, Dodson KM, Goldman RA. Prophylactic antibiotic therapy for fractures of the maxillary sinus. Ear Nose Throat J 2015;94:170-7.  Back to cited text no. 7
    
8.
Salvadi RK, Sinha R, Vadepally Y, Uppada UK. Comparative evaluation of conventional miniplates, three-dimensional miniplates and lag screws for internal fixation of parasymphysis fracture of mandible – A double-blind randomized clinical study. J Maxilofac Oral Surg 2021. [In Press].  Back to cited text no. 8
    
9.
Uppada UK, Sinha R, Tiwari P, Vennela S, Khan TA. Evaluation of efficacy of various fixation devices in management of anterior mandibular fractures: A prospective clinical study. J Dent Res Rev 2019;6:72-6.  Back to cited text no. 9
    
10.
Kumar ES, Sinha R, Uppada UK. Are three-dimensional plates as effective as superior border plating in mandibular angle fractures? A comparative evaluation of effectiveness. J Dent Res Rev 2018;5:88.  Back to cited text no. 10
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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