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Mao J, Xue J, Li Y, Zhou Q, Zhou S, Zhou Z. Factors influencing traumatic brain injuries in maxillofacial fractures: A 12-year retrospective analysis of 2841 patients. Dent Traumatol 2024; 40:435-443. [PMID: 38459650 DOI: 10.1111/edt.12942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND/AIM Results of studies investigating the association between traumatic brain injury (TBI) and maxillofacial fractures (MFs) have varied considerably. The present study aimed to evaluate the correlation between TBIs and MFs, as well as the impact of age, sex, trauma mechanism, and season on TBIs. MATERIALS AND METHODS This 12-year retrospective study of 2841 patients used univariate and multivariate logistic regression to assess the association between MFs and other factors impacting TBIs. RESULTS Among 2841 patients, 1978 TBIs occurred in 829 (29.2%), with intracranial injuries (n = 828) is the most common. Of 829 patients with TBIs, 688 were male and 141 were female, corresponding to a male-to-female ratio of 4.9:1.0. The most common age group was 40-49 years (24.6%). Vehicles (including motor vehicles and electric vehicles) accidents were the primary causes of injuries. Multivariate regression analyses revealed an increased risk for TBIs among males (odds ratio [OR] 0.632, p < 0.001). Patients >40 years of age were at higher risk for TBIs, especially those ≥70 years (OR 3.966, p = 0.001). Vehicle accidents were a high-risk factor for TBIs (OR 6.894, p < 0.001), and winter was the most prevalent season for such injuries (OR 1.559, p = 0.002). Risk for TBI increased by 136.4% in combined midfacial and mandibular fractures (p = 0.016) and by 101.6% in multiple midfacial fractures (p = 0.045). TBIs were less common in single mandibular fractures, notably in single-angle fractures, with a risk of only 0.204-fold. CONCLUSION TBIs in MFs were significantly correlated with sex, age, aetiology, season and fracture location. Maxillofacial surgeons and emergency physicians must be aware of the possible association between TBIs and MFs to assess and manage this complicated relationship in a timely manner.
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Affiliation(s)
- Jingjing Mao
- Ningxia Medical University, Yinchuan, Ningxia, P.R. China
- Ningxia Key Laboratory of Oral Diseases Research, Yinchuan, Ningxia, P.R. China
| | - Jiawen Xue
- Ningxia Medical University, Yinchuan, Ningxia, P.R. China
| | - Yunlong Li
- Ningxia Medical University, Yinchuan, Ningxia, P.R. China
| | - Qi Zhou
- Ningxia Medical University, Yinchuan, Ningxia, P.R. China
| | - Shuo Zhou
- Ningxia Medical University, Yinchuan, Ningxia, P.R. China
| | - Zhongwei Zhou
- Department of Oral and Maxillofacial Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, P.R. China
- Clinical Research Center for Oral Diseases of Ningxia, Yinchuan, Ningxia, P.R. China
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Dasukil S, Verma S, Jena AK, Mohapatra M. Frequency of concomitant injuries in maxillofacial trauma in a tertiary health care centre in India: A 5-year retrospective study. Chin J Traumatol 2024:S1008-1275(24)00035-X. [PMID: 38616471 DOI: 10.1016/j.cjtee.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 12/09/2023] [Accepted: 01/23/2024] [Indexed: 04/16/2024] Open
Abstract
PURPOSE Road traffic accidents (RTA), assaults, falls, and sports-related injuries are the leading causes of maxillofacial trauma. Due to quite different geographical environment and fast urbanization, the use of various protective equipment is restricted in India. Thus, compared to other countries, there might be a significant difference in the pattern and frequency of associated injuries among subjects with maxillofacial trauma. The present study was conducted to identify the causes and pattern of various maxillofacial fractures and the frequency of other related injuries among subjects with maxillofacial trauma. METHODS This is a cross-sectional retrospective study recording 2617 subjects with maxillofacial trauma. The patient demographics, causes of trauma, types of maxillofacial injury, and associated soft and hard tissue injuries were recorded. The types of maxillofacial and associated injuries were diagnosed from details of clinical examinations and the interpretation of various radiographs available in the file. The associated injuries were divided into head injury, other bony injuries, and soft tissue and vital structure injuries. Descriptive statistics and the test of proportion were used. A p value < 0.05 was considered as a level of significance. RESULTS The maxillofacial injuries were significantly common in patients aged 16 - 45 years (66.7%) than in patients aged ≤ 15 and > 46 years (33.3%) (p < 0.001). The RTA was the most common cause of maxillofacial injury (n = 2139, 81.7%), followed by fall (n = 206, 7.9%), other causes of injury (n = 178, 6.8%), and assaults (n = 94, 3.6%). The maxillofacial injury by 2-wheel vehicle accidents was significantly higher than that by 4-wheel vehicle and other vehicle accidents (p < 0.001). There was a significant correlation between alcohol and RTA (p < 0.001). The head injury (n = 931, 61.1%) was the most common associated injury, followed by soft tissue and vital structures injuries (n = 328, 21.5%) and other bone injuries (n = 264, 17.3%). DISCUSSION Head injury was the most common associated injury followed by soft tissue and vital structures and bone injuries among subjects with maxillofacial trauma. Clavicle fracture and injury to the lower extremities were the most common hard and soft tissue-associated injuries.
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Affiliation(s)
- Saubhik Dasukil
- Department of Dentistry, All India Institute of Medical Sciences, Sijua, Bhubaneswar, Odisha, India.
| | - Shiwangi Verma
- Department of Dentistry, All India Institute of Medical Sciences, Sijua, Bhubaneswar, Odisha, India
| | - Ashok Kumar Jena
- Department of Dentistry, All India Institute of Medical Sciences, Sijua, Bhubaneswar, Odisha, India
| | - Mounabati Mohapatra
- Department of Dentistry, All India Institute of Medical Sciences, Sijua, Bhubaneswar, Odisha, India
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Adeleke AI, Hlongwa M, Makhunga S, Ginindza TG. Epidemiology of maxillofacial injury among adults in sub-Saharan Africa: a scoping review. Inj Epidemiol 2023; 10:58. [PMID: 37968736 PMCID: PMC10652446 DOI: 10.1186/s40621-023-00470-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/05/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Injuries remain one of the leading causes of death globally. These disproportionately affect young adults and are particularly prevalent in sub-Saharan Africa (SSA). Maxillofacial injuries (MI) pose significant challenges to public health systems. However, much remains unknown regarding the epidemiology and extent of the financial burden in resource-limited areas, such as SSA, further necessitating more research and support. This scoping review aims to investigate the mechanism, distribution, and financial impact of MI in adults aged ≥ 18 years in SSA. MAIN BODY The scoping review was guided by the methodological frameworks of Arksey and O'Malley and Levac. An electronic literature search for English-published articles on maxillofacial injuries in adults ≥ 18 years was conducted in Scopus, Medline, PubMed, Science Direct, CINAHL, Health Source: Nursing/Academic Edition, and grey literature. The PRISMA chart was used to document database searches and screening outcomes while reporting was guided by PRISMA-ScR. The data extraction process revolved around the predefined study outcomes, which encompassed the study characteristics and epidemiological parameters. The review used a narrative approach to report findings and evaluate publication quality using the STROBE checklist. The database search yielded 8246 studies, of which 30 met the inclusion criteria. A total of 7317 participants were included, 79.3% of whom were males. The peak age range for incidence was between 18 and 40 years. Road traffic collision (RTC) was the leading cause of MI, 59% of which resulted from motorcycle collisions. Assault/interpersonal violence ranked as the second leading cause of MI. The mandible was MI's most frequently affected hard tissue, followed by the midface. Factors such as alcohol/illicit drug use, poor knowledge of traffic regulations, and non-observance of these regulations were associated with MI. In our study, the cost range for mandibular fractures was $200-$468.6, borne by victims and their families. CONCLUSIONS Maxillofacial injuries are predominantly caused by road traffic collisions and assaults in SSA. The findings can provide valuable insights into policy decisions and prevention strategies aimed at reducing injury burden. Further research is warranted to explore the psychological impact of MI, including PTSD, for tailored support and intervention. Scoping Review Registration The protocol has been registered on the Open Science Framework. Registration DOI: https://doi.org/10.17605/OSF.IO/BWVDK .
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Affiliation(s)
- Adekunle I Adeleke
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Durban, 4041, South Africa.
| | - Mbuzeleni Hlongwa
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Durban, 4041, South Africa
- Public Health, Societies, and Belonging, Human Sciences Research Council, Pretoria, South Africa
| | - Sizwe Makhunga
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Durban, 4041, South Africa
| | - Themba G Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Durban, 4041, South Africa
- Cancer and Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Tsur N, Talmy T, Radomislensky I, Almog O, Gendler S. Traumatic maxillofacial injuries: Patterns, outcomes, and long-term follow-up of a military cohort. Dent Traumatol 2023; 39:147-156. [PMID: 36345164 DOI: 10.1111/edt.12801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIMS Maxillofacial trauma poses a distinct challenge on the modern battlefield, and data on its long-term implications are scarce. The aim of this study was to investigate maxillofacial injury characteristics, outcomes, and complications along the continuum of care among hospitalized military personnel from the pre-hospital setting through long-term rehabilitation. MATERIALS AND METHODS A registry-based study was undertaken of three national trauma and rehabilitation registries: The Israel Defense Forces Trauma Registry (IDF-TR), which records pre-hospital data. The Israeli National Trauma Registry for in-hospital data and the Israel Ministry of Defense Rehabilitation Department (MOD-RD) registry contain long-term disability data. The cohort comprised IDF soldiers who suffered maxillofacial injuries between 1997 and 2020. RESULTS A total of 672 patients with maxillofacial injuries were included in the study, and 6.4% of all trauma admissions were related to maxillofacial injuries. Of these, 366 (54%) were injured in non-military (NMC) circumstances, and 306 (46%) were wounded in military circumstances (MC). The mechanisms of injury were mainly traffic-related among the NMC group compared with an explosion in the MC group. Maxillofacial fractures were frequently associated with traumatic brain injuries with higher rates in the NMC group than in the MC group (55% vs. 30%, p < .001). In a multivariate analysis, zygomatic and orbital fractures were associated with higher odds of concomitant head injury. The most common categories of long-term disability included central nervous system disorders, skull injuries, epilepsy, hearing impairment, ophthalmologic conditions, and post-traumatic stress disorder. CONCLUSIONS Maxillofacial injuries are often associated with concomitant traumatic brain injury. Long-term disabilities associated with these injuries included the central nervous system, hearing, ophthalmologic impairments, and post-traumatic stress disorder.
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Affiliation(s)
- Nir Tsur
- The Trauma and Combat Medicine Branch, Surgeon General's, Headquarters, Israel Defense Forces, Ramat Gan, Israel.,Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Tomer Talmy
- The Trauma and Combat Medicine Branch, Surgeon General's, Headquarters, Israel Defense Forces, Ramat Gan, Israel
| | - Irina Radomislensky
- The National Center for Trauma & Emergency Medicine Research, Gertner Institute, Tel HaShomer, Israel
| | - Ofer Almog
- The Trauma and Combat Medicine Branch, Surgeon General's, Headquarters, Israel Defense Forces, Ramat Gan, Israel.,The Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
| | - Sami Gendler
- The Trauma and Combat Medicine Branch, Surgeon General's, Headquarters, Israel Defense Forces, Ramat Gan, Israel
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Adeleke AI, Hlongwa M, Makhunga S, Ginindza TG. Mapping Evidence on the Epidemiology and Cost Associated with Maxillofacial Injury among Adults in Sub-Saharan Africa: A Scoping Review Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1531. [PMID: 36674286 PMCID: PMC9865531 DOI: 10.3390/ijerph20021531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: Maxillofacial injury (MI) occurs universally, for it disregards preference for age, gender, and geographical region. The global incidence and prevalence of facial fractures rose by 39.45% and 54.39%, respectively, between the years 1990 to 2017. Projections indicate that the burden of injuries will persist in sub-Saharan Africa (SSA) in the next twenty years. This scoping review aims to map the literature on MI epidemiology and the economic burden on society in SSA. (2) Methods: The methodology presented by Arksey and O'Malley and extended by Levac and colleagues will be employed in the scoping review. The researcher will report the proposed review through the Preferred Reporting Items for Systematic Review, and Meta-Analysis extension for scoping reviews (PRISMA-ScR). The review will include studies encompassing MI in sub-Saharan African adults 18 years and above. (3) Results: This will be presented as a thematic analysis of the data extracted from the included studies, and the Nvivo version 12 will be employed. (4) Discussion: We anticipate searching for related literature on the prevalence, incidence, risk factors, mortality, and cost associated with MI in the adult population of SSA. The conclusion from the review will assist in ascertaining research gaps, informing policy, planning, authorizing upcoming research, and prioritizing funding for injury prevention and management.
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Affiliation(s)
- Adekunle I. Adeleke
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Mbuzeleni Hlongwa
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7925, South Africa
| | - Sizwe Makhunga
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Themba G. Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
- Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
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Kuck JY, Azhar AMN, Wee N, Manikam R. Diagnostic accuracy of the tongue blade test combined with clinical signs to detect maxillary and mandibular fractures in the emergency department. World J Emerg Med 2023; 14:122-127. [PMID: 36911056 PMCID: PMC9999133 DOI: 10.5847/wjem.j.1920-8642.2023.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/10/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND To evaluate the diagnostic accuracy of clinical signs combined with the tongue blade test (TBT) to detect maxillary and mandibular fractures. METHODS A cross-sectional study enrolled patients with maxillary and mandibular injuries in the emergency department. Physical examination and the TBT were performed, followed by radiological imaging (facial X-ray or computed tomography [CT]). The diagnostic accuracy was calculated for individuals and a combination of clinical findings at predicting maxillary and mandibular fractures. RESULTS A total of 98 patients were identified, of whom 31.6% had maxillary fractures and 9.2% had mandibular fractures. The combination of malocclusion, tenderness on palpation and swelling with positive TBT had 100% specificity to detect maxillary and mandibular fractures. In the absence of malocclusion, the combination of tenderness on palpation and swelling with positive TBT produced a specificity of 97.8% for maxillary fracture and a specificity of 96.2% for mandibular fracture. A clinical decision tool consisting of malocclusion, tenderness on palpation, swelling and TBT revealed a specificity of 100% and a positive predictive value of 100%. CONCLUSION The clinical decision tool is potentially useful to rule out mandibular fractures, thus preventing unnecessary radiation exposure.
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Affiliation(s)
- Jee Yen Kuck
- Emergency Department, University of Malaya, Kuala Lumpur 50603, Malaysia
| | | | - Neena Wee
- Emergency Department, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Rishya Manikam
- Emergency Department, University of Malaya, Kuala Lumpur 50603, Malaysia
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Singh AK, Dhungel S, Ahmad Z, Holmes S. Can an App-Based Maxillofacial Trauma Score Predict the Operative Time, ICU Need and Length of Stay? Craniomaxillofac Trauma Reconstr 2022; 15:332-339. [PMID: 36387314 PMCID: PMC9647374 DOI: 10.1177/19433875211055598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
Study Design Retrospective chart review. Objective Injury and trauma scores are the mainstay of predicting outcomes of trauma patients. ZS (Zeeshan and Simon) maxillofacial trauma score is based on 4 previous facial trauma scores and is user friendly, app-based visually coded facial trauma scoring system. Our study was designed to seek the application of an app-based ZS maxillofacial trauma score to predict the operative time, intensive care unit (ICU) need and length of stay. Methods We performed a retrospective chart review of patients who presented to a university medical college teaching hospital with maxillofacial fractures from October 2018 until October 2019. ZS maxillofacial trauma scoring app was used to calculate the ZS maxillofacial trauma severity score, which was our primary predictor variable. Our primary outcome of interest was operative time. Our secondary outcome of interest was ICU need and length of stay. Correlation analysis, linear regression and logistic regression were performed for statistical analysis. A statistical P-value of .05 was considered significant at a 95% confidence interval. Results There were 95 male and 5 female patients included in the study. The age ranged from 3 to 84 years with a mean of 30.76 (SD = 14.04). A statistically significant correlation between the ZS score and operative time (r = 0.67, P < .001) was observed. ZS score predicted operative time (b 1 = 7.67, P < .001) in our study sample. Increasing ZS trauma score was also significantly associated with ICU requirement (X 2 (3) = 13.682, P = .003), but the length of stay could not be predicted based on ZS score.Conclusions: ZS maxillofacial trauma score can predict the operative time, and an association was seen with the need for ICU with increasing ZS score, but could not predict the length of stay or the ICU need. It has potential for future integration with electronic health record systems.
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Affiliation(s)
- Ashutosh Kumar Singh
- Department of Oral and
Maxillofacial Surgery, TU Dental Teaching
Hospital, MMC, IOM, Kathmandu, Nepal
| | - Safal Dhungel
- Department of Oral and
Maxillofacial Surgery, College of Medical Sciences Teaching
Hospital, Bharatpur, Nepal
| | | | - Simon Holmes
- Department of OMFS, The Royal London
Hospital, London, UK
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8
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Al-Ali MA, Alao DO, Abu-Zidan FM. Factors affecting mortality of hospitalized facial trauma patients in Al-Ain City, United Arab Emirates. PLoS One 2022; 17:e0278381. [PMID: 36445878 PMCID: PMC9707776 DOI: 10.1371/journal.pone.0278381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/15/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Facial injuries affect one-third of severely injured patients. These injuries have devastating long-term negative impacts on quality of life. We aimed to study the epidemiology of facial injuries and factors affecting the mortality of hospitalized facial trauma patients in Al-Ain City, United Arab Emirates. METHODOLOGY This is a retrospective analysis of prospectively collected data from Al-Ain Hospital Trauma Registry. All patients with facial injury who were hospitalized for more than 24 hours or who died after arrival at the hospital during the period from January 2014 to December 2017 were studied. Two sample data analysis was used to compare patients who died and those who survived. Significant factors were then entered into a backward logistic regression model to define factors affecting mortality. RESULTS 408 patients having a mean age of 31.9 years were studied, 87.3% were males. The main mechanisms of injury were road traffic collisions (52.2%) and fall from height (11.3%). 289 (70.8%) patients had associated injuries which were mainly in the head and chest. The backward logistic regression model showed that the Glasgow Coma Scale (GCS) was the only factor that predicted mortality, p<0.0001 with the best cut-off point of 7.5, having a sensitivity of 0.972 and a specificity of 0.8. The ROC had an area under the curve of 0.924. CONCLUSION The majority of facial injury patients in our setting are young males who were involved in road traffic collisions or falls from height. The most important factor predicting the mortality of these patients was the low GCS. Those having a GCS of 8 and more had a better chance of survival. This information is very important when counseling patients or their relatives for facial surgery.
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Affiliation(s)
- Mohamed A. Al-Ali
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- Department of Otolaryngology, Al-Ain Hospital, Al-Ain, United Arab Emirates
- * E-mail:
| | - David O. Alao
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Fikri M. Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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9
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Ghanaati S. Focus on craniomaxillofacial injuries in trauma patients. Eur J Trauma Emerg Surg 2022; 48:2511-2512. [PMID: 35939124 PMCID: PMC9360090 DOI: 10.1007/s00068-022-02036-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Shahram Ghanaati
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Theodor Stern-Kai 7, 60590, Frankfurt, Hessen, Germany.
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10
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Kubat GO, Sahin C, Ozen O. Association of frontal and maxillary bone fractures and concomitant craniocerebral injuries in patients presenting with head trauma. Niger J Clin Pract 2022; 25:342-348. [PMID: 35295058 DOI: 10.4103/njcp.njcp_1582_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Maxillofacial fractures and craniocerebral injuries are common in patients with head trauma. These are injuries with high mortality and morbidity. Therefore, patients with head trauma should be evaluated early with a multidisciplinary approach. Aim The association between frontal and maxillary bone fractures and concurrent craniocerebral injuries were investigated in patients presenting with head trauma in this study. The data of the patients were analyzed retrospectively. Methods and Material Age and gender distributions were evaluated in frontal and maxillary fractures. Concomitant craniocerebral injuries were investigated. Craniocerebral injuries were grouped as pneumocephalus, extra-axial, intra-axial injuries and brain edema. Craniocerebral injuries in frontal and maxillary fractures were compared statistically. Results Frontal bone and maxillary bone fractures were detected in 24% and 95% of the patients. Coexistence of pneumocephalus and intra-axial injuries in frontal bone fracture was statistically significant. The association of frontal posterior wall fractures with pneumocephalus and parenchymal contusion was found to be statistically significant. In addition, the association of craniocerebral injuries were evaluated and statistically significant ones were determined. Conclusion The presence of maxillofacial fractures in patients presenting with head trauma increases mortality and morbidity. Craniocerebral injuries can be life-threatening and delay the treatment of facial fractures. Upper facial bone fractures are significantly more common in craniocerebral injuries.
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Affiliation(s)
- G Orhan Kubat
- Department of Otolaryngology, Alaaddin Keykubat University, School of Medicine, Alanya, Antalya, Turkey
| | - C Sahin
- Department of Otolaryngology, Alaaddin Keykubat University, School of Medicine, Alanya, Antalya, Turkey
| | - O Ozen
- Department of Radiology, Alaaddin Keykubat University, School of Medicine, Alanya, Antalya, Turkey
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AlMofreh AlQahtani F, Bishawi K, Jaber M, Thomas S. Maxillofacial trauma in the gulf countries: a systematic review. Eur J Trauma Emerg Surg 2021; 47:397-406. [PMID: 32572511 DOI: 10.1007/s00068-020-01417-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/15/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The objective of this review was to determine the prevalence, major causative factors and the most common sites of Maxillofacial Trauma in the Gulf Cooperation Council (GCC) Countries. METHODS All articles that were published in the English language in the databases such as Google Scholar, EBSCO, PubMed, NCBI, Medline, COCHRANE, ELSEVIER and SCOPUS were reviewed for MFT from GCC during the last 23 years. RESULTS A total of 19,151 patients (16,567 males and 2584 females) (86-14%) with an age range between 0 and 97 years were included in the study. In all of the Gulf countries males outnumber females in terms of maxillofacial injuries with a ratio of 6.4:1. The mandible was the most common site of trauma followed by the maxilla. Road Traffic Accidents (RTA) was the most common cause of injury in the GCC followed by falls. CONCLUSION Maxillofacial injuries are highly prevalent, distributed among the Gulf countries, and is mainly caused by RTAs especially among males who are highly prone to MFT in the gulf. The reasons are due to lack of road safety culture and weak enactment of traffic legislation, other possible factors include intrinsic car safety features, high speed driving and the amount/use of highways in these societies.
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Affiliation(s)
| | - Khaled Bishawi
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Mohamed Jaber
- College of Dentistry, Ajman University, Ajman, United Arab Emirates. .,Department of Oral Surgery, College of Dentistry, Ajman University, P.O. Box 346, Ajman, United Arab Emirates.
| | - Sam Thomas
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
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12
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Tan FY, Selvaraju K, Audimulam H, Yong ZC, Adnan TH, Balasundram S. Length of hospital stay among oral and maxillofacial patients: a retrospective study. J Korean Assoc Oral Maxillofac Surg 2021; 47:25-33. [PMID: 33632974 PMCID: PMC7925160 DOI: 10.5125/jkaoms.2021.47.1.25] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/19/2020] [Accepted: 12/24/2020] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES : Many conditions of the oral and maxillofacial region require hospitalization and in-patient care. The average length of stay (LOS) of these patients varies and is usually affected by multiple confounding variables. However, even with an increasing number of hospital admissions, published evidence on the factors that affect the LOS of oral and maxillofacial patients is lacking. Therefore, this study assessed the LOS of in-patients at the oral and maxillofacial surgery department of a government-funded, multi-specialty hospital in Malaysia, based on their reasons for admission and other factors. MATERIALS AND METHODS Our samples were collected retrospectively over a 5-year period and included patients with maxillofacial infections, post-trauma stabilization, facial bone fracture surgery, benign and malignant lesion surgery, dentoalveolar surgery, and other maxillofacial surgeries as reasons for admission. Factors potentially affecting LOS were also recorded, and their significance was determined using multiple logistic regression analyses. A P-value of less than 0.05 was considered to be statistically significant. RESULTS A total of 1,380 patients were included in this study. Most (84.5%) of our in-patients were of Malay ethnicity, and males outnumbered females in our sample by 502 subjects. The median LOS of our in-patients was 3 days. Sex, ethnicity, age, reason for admission, and American Society of Anesthesiology (ASA) classification were factors that significantly affected LOS. CONCLUSION The median LOS reported in this study was 3 days. LOS was significantly affected by sex, ethnicity, age, reason of admission and ASA classification.
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Affiliation(s)
- Fo Yew Tan
- Department of Oral and Maxillofacial Surgery, Hospital Sultanah Nora Ismail, Batu Pahat, Malaysia
| | - Kalpana Selvaraju
- Department of Oral and Maxillofacial Surgery, Hospital Sultanah Nora Ismail, Batu Pahat, Malaysia
| | - Harshinie Audimulam
- Department of Oral and Maxillofacial Surgery, Hospital Sultanah Nora Ismail, Batu Pahat, Malaysia
| | - Zhi Chuan Yong
- Department of Oral and Maxillofacial Surgery, Hospital Sultanah Nora Ismail, Batu Pahat, Malaysia
| | - Tassha Hilda Adnan
- Sector for Biostatistics & Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | - Sathesh Balasundram
- Department of Oral and Maxillofacial Surgery, Hospital Sultanah Nora Ismail, Batu Pahat, Malaysia
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AlAli AM, Ibrahim HHH, Algharib A, Alsaad F, Rajab B. Characteristics of pediatric maxillofacial fractures in Kuwait: A single-center retrospective study. Dent Traumatol 2021; 37:557-561. [PMID: 33571399 DOI: 10.1111/edt.12662] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/14/2021] [Accepted: 01/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pediatric maxillofacial fractures always present a challenge due to the unique nature of the facial skeleton anatomy and development. The aim of this study was to investigate the incidence, etiology, site of fracture, and management modalities of pediatric maxillofacial fractures in Kuwait. METHODS A retrospective cross-sectional study was conducted. The records of all pediatric patients who were diagnosed with maxillofacial fractures and admitted to one of the major hospitals in Kuwait between January 2007 and March 2020 were reviewed. RESULTS A total of 186 patients aged between 0 and 13 years old were included. An average of 13 patients was seen each year between 2007 and 2020. The leading cause of the pediatric maxillofacial trauma was road traffic accidents (RTA) that accounted for 38.2% of the patients followed by 22% falls from height (FFH). Male patients were more affected than females, with a ratio of 2.3:1. More than half of the children had mid-face fractures, of which 57% were in multiple sites. Conservative management was the main approach for 52.2% of the patients. CONCLUSIONS Pediatric maxillofacial fractures were mainly attributed to road traffic accidents in Kuwait. Mid-face bone fractures were reported more than mandibular fractures and were mostly managed conservatively.
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Affiliation(s)
- Ahmad M AlAli
- Oral and Maxillofacial Surgery Department, Al-Adan Specialized Dental Centre, Ministry of Health, Kuwait, Kuwait
| | - Hussein H H Ibrahim
- Oral and Maxillofacial Surgery Department, Al-Adan Specialized Dental Centre, Ministry of Health, Kuwait, Kuwait
| | - Abdullah Algharib
- Oral and Maxillofacial Surgery Department, Al-Adan Specialized Dental Centre, Ministry of Health, Kuwait, Kuwait
| | - Fahad Alsaad
- Oral and Maxillofacial Surgery Department, Al-Adan Specialized Dental Centre, Ministry of Health, Kuwait, Kuwait
| | - Bashar Rajab
- Oral and Maxillofacial Surgery Department, Al-Adan Specialized Dental Centre, Ministry of Health, Kuwait, Kuwait
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14
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Novelli G, Moretti M, De Ponti E, Bozzetti A, Sozzi D, Canzi G. Analysis of different safety devices in the prevention of motorcycle-related craniofacial trauma - A retrospective study. Ann Maxillofac Surg 2021; 11:293-297. [PMID: 35265501 PMCID: PMC8848692 DOI: 10.4103/ams.ams_203_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction: Motorcycle accidents are one of the most frequent causes of trauma. Safety devices and helmets can influence the severity of injuries. Our retrospective study wants to evaluate the different effectiveness of Open-face and Full-face helmets in the prevention of craniofacial trauma. Materials and Methods: The sample consists of 440 patients admitted to two Level I Trauma Centres in Northern Italy, between January 2002 and February 2019, because of motorcycle-related craniofacial trauma. For each patient personal data were collected, as well as type and site of fractures, type of helmet, if worn, Comprehensive Facial Injury (CFI) score and Abbreviated Injury Score (AIS-Head) for head injuries. Inferential statistical analysis was then conducted. Results: Two hundred and eighty-eight patients wore Open-face helmets (69.7%) and 125 patients wore Full-face ones (30.3%). Mean CFI score (Standard deviation - SD) observed in patients with Open-face helmets was 7.0 (SD: 6.8) and surgery was required in 149 cases (51.7%); while it was 4.9 (SD: 6.0) in patients with Full-face helmets for whom surgery was required in 43 cases (34.4%) (P < 0.0001 and P = 0.002, respectively). Multivariate analysis shows that severity of facial trauma is a significant risk factor for head injury severity with OR 1.90 (95% confidence interval: 1.43 - 2.51) and P < 0.0001. Discussion: Full-face helmets are definitely considered to be more protective for facial trauma, which is also a significant risk factor for the severity of head injuries. The type of helmet chosen influences the need of surgical treatment in case of craniofacial trauma.
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