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Luotamo I, Snäll J, Toivari M. Complications and complaints in craniofacial fractures - Finnish national data for 20 years. Acta Odontol Scand 2024; 83:334-339. [PMID: 38804122 DOI: 10.2340/aos.v83.40570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/29/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Research on reasons for malpractice claims in oral and maxillofacial surgery is scarce. The aim of this study was to investigate the causes and prevalence of permanent harm among craniofacial fracture related malpractice claims. MATERIALS AND METHODS A retrospective register study was designed and implemented. All patients with a complaint and a diagnosis of facial or cranial fracture were included. The main outcome was the presence of permanent harm, and the predictor variable was the cause of complaint. Chi-square test was used for estimation of statistical significance. RESULTS Delay in correct diagnosis was the leading cause of malpractice claims (63.2%), and permanent harm was found in 23.1% of the population. 82.4% of injuries were facial fractures in total population. 65.3% (n = 98) of facial trauma were related with delayed diagnostics (p < 0.001). Permanent harm was more frequent in patients with delayed diagnosis (71.4%) than those without (60.7%, p = 0.299). CONCLUSIONS Claims of craniofacial trauma are related with under-diagnostics, and un-diagnosed facial fracture can lead to a high rate of permanent harm. Systematic clinical evaluation and facial trauma specialist consultation is recommended to set early correct diagnosis for and improve treatment of craniofacial trauma patients.
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Affiliation(s)
- Inka Luotamo
- Department of Oral and Maxillofacial Diseases, Kymenlaakso Central Hospital, Kotka, Finland; University of Helsinki, Helsinki, Finland.
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland; Helsinki University Hospital, Helsinki, Finland
| | - Miika Toivari
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland; Helsinki University Hospital, Helsinki, Finland
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2
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McGeough G, Davidson C, Aslam-Pervez B, Laraway D. Patient reported outcome measures (PROMs) in zygomatic fracture surgery. Br J Oral Maxillofac Surg 2024; 62:378-382. [PMID: 38599931 DOI: 10.1016/j.bjoms.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 04/12/2024]
Abstract
Attitudes towards healthcare in the NHS and in other Western healthcare systems have been changing dramatically in recent years. There is a significant movement calling for a shift from the traditional paternalistic model, with patients as passive recipients of treatments that are supported by objective and observable evidence, towards a more holistic approach, in which patients have agency, and treatments are tailored to the individual needs of a particular patient. Whilst patient safety and clinical effectiveness remain intrinsic to the traditional measurement of successful healthcare, Patient Reported Outcome Measures (PROMs) are increasingly being advocated as an important tool to uphold patient-centric care in the NHS.The aim of this study is to complete the first evaluation of PROMs that we know of in patients receiving surgical management of zygomatic fractures, by comparing two interventions commonly used in this condition: the zygomaticomaxillary complex open reduction and internal fixation (ZMC ORIF), and the Gillies approach to zygomatic elevation. We demonstrate high levels of patient satisfaction across all domains, irrespective of surgical approach, but that mood and anxiety remain an issue after surgery.
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Kozlowski KM, Rosston PA, Park AC, Hakimi AA, Socolovsky L, Wong BJF. A Thirteen-Year Analysis of Facial Fractures among Professional Soccer Players. Facial Plast Surg 2024; 40:120-126. [PMID: 36509105 DOI: 10.1055/a-1996-7595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This study aims to identify the epidemiology and effects of facial fractures on return to play (RTP) in Major League Soccer (MLS) and the English Premier League (EPL). A total of 39 MLS players and 40 EPL players who sustained facial fractures from 2007 to 2019 were identified. Data on player demographics, the injury, and the impact of their injury on RTP were collected. Elbow-to-head was the most common mechanism of injury (20.3%). The most common fracture involved the nasal bone (48.3%). Most players (90%) RTP the same season. Players who sustained nasal fractures missed significantly fewer games (p < 0.001) than those who suffered other craniofacial fractures. Players treated surgically missed significantly more games (3.21 vs. 0.71, p = 0.006) and days (30.1 vs. 8.70, p = 0.002) than those managed nonoperatively. Significantly more EPL players who sustained facial fractures wore headgear upon RTP compared to MLS players (82% vs. 56%, p <0 .01). Most professional soccer players who sustain a facial fracture RTP the same season, but their recovery time can vary depending on the type of fracture, injury management, or injury severity. Our findings can help inform future craniofacial injury management as well as guidelines on player safety and fracture prevention.
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Affiliation(s)
- Konrad M Kozlowski
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
| | | | - Asher C Park
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
| | - Amir A Hakimi
- Department of Otolaryngology - Head and Neck Surgery, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Leandro Socolovsky
- Department of Otolaryngology - Head and Neck Surgery, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Brian J-F Wong
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California
- Department of Otolaryngology - Head & Neck Surgery, University of California - Irvine, Orange, California
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4
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Ganesan A, Rustagi N, Kaur A, Chaudhry K, Kumar P, Chopane S, Chugh A. Minimal clinically important difference in maxillofacial trauma patients: a prospective cohort study. Br J Oral Maxillofac Surg 2024; 62:177-183. [PMID: 38336576 DOI: 10.1016/j.bjoms.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/17/2023] [Accepted: 11/28/2023] [Indexed: 02/12/2024]
Abstract
The present study estimated the minimal clinically important difference (MCID) for pain on a visual analogue scale - numerical rating scale (VAS-NRS) and mean bite force (MBF) in patients treated for maxillofacial trauma (MFT). This cohort study included 120 MFT patients treated according to AO principles. Preoperative and four-week postoperative pain on the VAS-NRS, and MBF were measured to calculate MCIDs as indicators of functional rehabilitation. The patient's perspective of the treatment was assessed using a four-item anchor question. The MCID was determined by two anchor-based approaches, namely, the change difference (CD) method and receiver operating characteristic (ROC) curve method. According to the CD method, the MCID for pain was 2.4 and the MBF was 147.9 N. Based on the ROC curve, the MCID for pain was 2.5 (sensitivity 91.7%, specificity 47.2%) and MBF was 159.1 N (sensitivity 71.4%, specificity 61.1%). This study demonstrated a high sensitivity (>70%) for MCID, which implies that pain reduction of 2.4-2.5 points on the VAS-NRS and a gain in MBF of 147.9-159.1N are clinically relevant for patients treated for MFT.
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Affiliation(s)
- Aparna Ganesan
- Ex-Junior Resident, Oral & Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Neeti Rustagi
- Additional Professor, Department of Community & Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Amanjot Kaur
- Assistant Professor, Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, Vijaypur, Jammu, India
| | - Kirti Chaudhry
- Additional Professor, Oral & Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India.
| | - Pravin Kumar
- Professor & Head of the Department, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Shivakumar Chopane
- Ex-Junior Resident, Oral & Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Ankita Chugh
- Professor, Oral & Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
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5
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Liu Y, Enin K, Sciegienka S, Hardi A, Spataro E. Intraoperative Computed Tomography Use in Orbital Fracture Repair: A Systematic Review and Meta-Analysis. Facial Plast Surg Aesthet Med 2023; 25:548-555. [PMID: 37782903 DOI: 10.1089/fpsam.2023.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Abstract
Background: Intraoperative computed tomography (CT) allows surgeons to make adjustments during orbital fracture repair that may impact postoperative outcomes. Learning/Study Objectives: To determine the impact of intraoperative CT use on intraoperative revision and surgical outcomes for orbital fracture repair. Methods: A systematic review was performed in concordance with the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines: the population was patients undergoing orbital fracture repair; intervention was use of intraoperative CT; comparison was patients not undergoing intraoperative CT; and outcomes were intraoperative revision rate, postoperative complications, and secondary revision surgeries. Meta-analysis was performed on the rate of intraoperative revision. Results: The search criteria yielded 790 articles, 377 were eligible for review, and 20 articles met criteria for analysis. In 19, intraoperative imaging led to immediate surgical corrections, with a random pooled effect size of 0.27 (0.20-0.35). Six studies reported secondary revision surgery rates (range 0-10.5%), and six studies reported postoperative complication rates (range 10-30%). Conclusions: Intraoperative imaging helps surgeons make precise, real-time adjustments in 27% of orbital fracture repair cases, which may improve surgical outcomes; however, more research is needed to investigate its impact on health care costs, operating time, and radiation exposure.
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Affiliation(s)
- Yupeng Liu
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kwasi Enin
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sebastian Sciegienka
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Angela Hardi
- Bernard Becker Medical Library, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Emily Spataro
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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Lubamba GP, Dai X, Song Z, Al-Shujaa EA, Guan J, Wang X, Isouradi-Bourley JPS, Zhang Y, Milolo AM, Bushabu FN, Xu P, Che D. Assessment of quality of life in patients treated for orbital fractures. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101486. [PMID: 37105493 DOI: 10.1016/j.jormas.2023.101486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE This study aimed to assess the quality of life (QOL), before and after surgery, of patients who underwent open reduction and internal fixation for orbital fractures. STUDY DESIGN A prospective study. PARTICIPANTS AND SETTING The self-report outcome measures of 50 patients treated at the Department of Oral and Maxillofacial Surgery of the Second Affiliated Hospital of Jiamusi University from January 2016 to June 2019 were prospectively collected. MAIN MEASURES The quality of life was assessed using four patient-reported outcome measures (PROMs): the 15D questionnaire, Oral Health Impact Profile-14 (OHIP-14), Hospital Anxiety and Depression Scale (HADS), and 36-item Short Form Survey (SF-36). Both descriptive and comparative data analyses were calculated. RESULTS Zygomaticomaxillary complex fractures were the most encountered (40.3%). The total OHIP-14 scores before and after treatment were 1.72 and 1.68, respectively. Vision, breathing, sleeping, eating, usual activities, discomfort and symptoms, and vitality showed minimal changes in the 15D questionnaire. The HADS scores were ranged from 0 to 7, indicating no anxiety or depression. The comparison of SF-36 scores after 3 months and after ≥6 months of treatment revealed no significant difference. CONCLUSIONS Patients' QOL was minimally impacted by orbital fractures and their treatments. The severity of the negative impact can be minimized if appropriate management strategies are taken.
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Affiliation(s)
- Grace Paka Lubamba
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China; Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo; Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xinpeng Dai
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Zhenyu Song
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Eissa A Al-Shujaa
- Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jian Guan
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China.
| | - Xinyu Wang
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | | | - Yanqi Zhang
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Augustin Mantshumba Milolo
- Department of Prosthodontics, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo
| | - Fidele Nyimi Bushabu
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo
| | - Pengkun Xu
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Di Che
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
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Verma SK, Jha AK, Prakash O, Ekram S, Tigga C, Noorani MK, Mehta V, Meto A, Meto A, Fiorillo L, Cicciù M. Impact of dental and orofacial trauma on oral health-related quality of life in adults: A systematic review. Chin J Traumatol 2023:S1008-1275(23)00045-7. [PMID: 37344288 DOI: 10.1016/j.cjtee.2023.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
PURPOSE Dental and orofacial trauma among the adult population constitutes a major public health problem. The impact is not just physical but also psychological. To analyse the impacts of dental and orofacial trauma on oral health-related quality of life (OHRQoL) in adults and determine whether the 2 variables are closely interlinked. METHODS This is a systematic review. The terms "dental trauma", "orofacial trauma", "oral health", "oral health related impact life", "OHRQoL", "positive and negative affect scale", "quality of life", "facial injuries", "adults", and "young adults" were researched in the databases of PubMed, ScienceDirect, Scopus and Google Scholar for associated studies up to December 30, 2022. A comprehensive search was designed and the articles were independently screened for eligibility by 2 reviewers. The included studies' author, year of publication, the country where the study was conducted, population demographics (number and age), an instrument used for assessing OHRQoL and the relevant result were recorded and compared. The quality of the evidence was assessed using Joanna Briggs Institute checklist for observational studies. RESULTS Out of 482 unique records, 3 articles were included for data extraction. Observational studies were included. Two studies did not mention confounding factors. Different scales were used for dental and orofacial trauma and OHRQoL. OHRQoL has a directly proportional relationship with orofacial trauma. Adolescents with orofacial trauma have a significant impact on this value with a prevalence of 88.4%. CONCLUSION The highest impact on OHRQoL was seen immediately after the diagnosis of an orofacial trauma. The impact increases with the severity of the trauma. Therefore, to promote overall dental and general health, health education initiatives should include information on the causes, prevention, and requirement for prompt responses by the populace in seeking dental intervention.
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Affiliation(s)
- Santosh Kumar Verma
- Department of Periodontology & Oral Implantology, Dental College, Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - Awanindra Kumar Jha
- Department of Orthodontic and Dentofacial Orthopedic, Dental College, Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - Om Prakash
- Department of Oral and Maxillofacial Surgery, Dental College Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - Subia Ekram
- Department of Oral and Maxillofacial Surgery, Dental College Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - Chandmani Tigga
- Department of Oral and Maxillofacial Surgery, Dental College Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | | | - Vini Mehta
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, 411018, Maharashtra, India
| | - Aida Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007, Tirana, Albania
| | - Agron Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007, Tirana, Albania
| | - Luca Fiorillo
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, 411018, Maharashtra, India; Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007, Tirana, Albania; Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100, Messina, Italy; Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, 80100, Naples, Italy
| | - Marco Cicciù
- Department of Surgery and Surgical Specialties, University of Catania, 95100, Catania, Italy.
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Jiménez-López YI, Hernandez-Herrera AM, Gómez Díaz HJ, Torres González R, Jáuregui Renaud K. Quality of life related to both general and oral health two years after treatment for subcondylar fracture. Br J Oral Maxillofac Surg 2023; 61:209-214. [PMID: 36805787 DOI: 10.1016/j.bjoms.2023.01.005] [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: 09/13/2022] [Revised: 01/05/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
The success of treatment for condylar fractures is usually assessed by functional outcomes, while studies on patient perceptions are scarce. A cross-sectional study was performed to assess the middle-term quality of life, related to both general health and oral health, of patients treated for subcondylar fracture, either by open reduction or by closed fixation, compared to healthy volunteers. In a single trauma centre, among 226 consecutive patients with subcondylar fractures that were treated in years 2018-2019 (two to three years prior to the survey), 148 fulfilled the selection criteria. They were classified as those with other facial fractures that were treated by open reduction (n = 79), and those without other fractures that were treated either by open reduction (n = 34) or by closed fixation (n = 35). An age matched group of healthy volunteers (n = 65) also participated in the study. All participants replied to the Short-Form-Health-Survey (SF-36) and the Oral-Health-Impact-Profile (OHIP-49), using the social messenger platform WhatsApp. The SF-36 showed that patients with closed-fixation reported better mental health than patients with open reduction, but worse than healthy volunteers. Contrariwise, on the OHIP-49, compared to patients with open reduction (with/without other facial fractures) and to healthy volunteers, patients with closed-fixation reported worse quality of life on physical pain, psychological discomfort, and physical disability. The influence of age was evident just on the OHIP-49, on the report of physical limitation and physical pain. Two to three years after the subcondylar fracture, patients treated either by open reduction or closed fixation might report decreased quality of life compared to healthy volunteers; patients treated by open reduction might report lesser mental health related quality of life (SF-36), but superior oral health related quality of life (OHIP-49) than patients treated by closed fixation.
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Affiliation(s)
- Yadira Ivonne Jiménez-López
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Cuauhtemoc 330, Colonia Doctores, CP 06720 Ciudad de México, Mexico.
| | - Ana María Hernandez-Herrera
- Unidad Médica de Alta Especialidad Hospital de Traumatología, Ortopedia y Rehabilitación "Victorio de la Fuente Narvaez", Instituto Mexicano del Seguro Social, Av Fortuna 101, Magdalena de las Salinas, CP 07760 Ciudad de México, Mexico.
| | - Humberto Jessé Gómez Díaz
- Unidad Médica de Alta Especialidad Hospital de Traumatología, Ortopedia y Rehabilitación "Victorio de la Fuente Narvaez", Instituto Mexicano del Seguro Social, Av Fortuna 101, Magdalena de las Salinas, CP 07760 Ciudad de México, Mexico.
| | - Rubén Torres González
- Unidad Médica de Alta Especialidad Hospital de Traumatología, Ortopedia y Rehabilitación "Victorio de la Fuente Narvaez", Instituto Mexicano del Seguro Social, Av Fortuna 101, Magdalena de las Salinas, CP 07760 Ciudad de México, Mexico.
| | - Kathrine Jáuregui Renaud
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Cuauhtemoc 330, Colonia Doctores, CP 06720 Ciudad de México, Mexico.
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Barreto SBL, Castro GG, Carvalho CN, Ferreira MC. Cases of Maxillofacial Trauma Treated at Hospitals in a Large City in Northeastern Brazil: Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16999. [PMID: 36554879 PMCID: PMC9778779 DOI: 10.3390/ijerph192416999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Maxillofacial trauma is associated with facial deformation, loss of function, emotional and social impacts, and high financial costs. This study investigated cases of maxillofacial trauma in a large Brazilian city through a cross-sectional study conducted at two public and two private hospitals. Primary data of 400 patients were collected through a questionnaire, clinical examination, and tomography. Statistical analysis at the 5% significance level was performed. Motorcycle accident was the major cause of trauma (41%); the most frequent trauma and treatment were mandibular fracture (24.3%) and surgery (71%), respectively. The female sex was more affected only regarding domestic accidents (p = 0.041) and falls (p < 0.001). Motorcycle accidents were more prevalent among 20 to 29 year-olds (p < 0.001), followed by physical aggression (p < 0.001) and sports accidents (p = 0.004). Falls were more frequent among 40 to 59 year-olds (p < 0.001). Mandibular fracture affected males and 20 to 29 year-olds more and was mainly associated with motorcycle accidents (48.2%) and physical aggression (22.7%) (p = 0.008). Nose fracture was more frequent in falls (29.6%), physical aggression (22.5%), and sports accidents (21.1%) (p < 0.001). Compound fracture was associated with motorcycle accidents (84.2%; p = 0.028). Maxillofacial trauma (mandibular, nasal, and zygomatic fractures) was associated with motorcycle accidents, physical aggression, and falls. Surgical treatment, hospital care, and public services were the most frequent.
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10
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Saxena S, Giri KY, Sharma P, Niranjanaprasad IB, Dandriyal R, Abhishek K, Vishal G. Comparative Assessment of Clinical and Quality of Life Outcomes in Mandibular Angle Fractures Treated with Standard and Three-Dimensional Mini-Plates. J Maxillofac Oral Surg 2022; 21:1386-1392. [PMID: 36896055 PMCID: PMC9989096 DOI: 10.1007/s12663-022-01699-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/29/2022] [Indexed: 11/29/2022] Open
Abstract
Aims and Objectives To undertake a multidimensional comparative assessment of the standard and three dimensional (3D) mini-plates in managing isolated mandibular angle fractures (MAFs). Patients and Methods Thirty-six subjects were divided equally into two groups. Group A underwent fixation with a standard 2 mm miniplate, while group B with 2 mm 3D mini-plates. Evaluations were done preoperatively (T0), postoperatively at one week (T1), one month (T2) and three months (T3). Maximal inter-incisal mouth opening (MIO) and mean bite force (MBF) at the central incisors, right and left molars were calculated. Postoperative complications and Quality of life (QoL) outcomes were evaluated using the short form Oral Health Impact Profile (OHIP-14). Results Mean operative time was almost similar for both groups. Although mean MIO improved significantly from T1 to T3 in both groups, intergroup comparison of MIO was not significant. The MBF values were significantly higher in group B on the right and left molars at T2 and T3. Although significant improvement in OHIP-14 scores was seen from T2 to T3 in both the groups, intergroup comparison of OHIP was not significant. Conclusion 3D plates demonstrated similar clinical and QoL outcomes compared to the standard mini-plates.
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Affiliation(s)
| | - K. Y. Giri
- Department of Oral and Maxillofacial Surgery, Drs. S. & N. R. Siddhartha Institute of Dental Sciences, Gannavaram Mandal, Krishna District, A. P. 521286 India
| | - Preeti Sharma
- Department of Oral and Maxillofacial Surgery, Government Medical College and Hospital, Chandigarh, 160030 India
| | - Indra B. Niranjanaprasad
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, Uttar Pradesh 243006 India
| | - Ramakant Dandriyal
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, Uttar Pradesh 243006 India
| | | | - Gaurav Vishal
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, Uttar Pradesh 243006 India
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11
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Plath M, Cavaliere C, Seide S, Hohenberger R, Plinkert PK, Baumann I, Zaoui K. Does a closed reduction improve aesthetical and functional outcome after nasal fracture? Eur Arch Otorhinolaryngol 2022; 280:2299-2308. [PMID: 36434436 DOI: 10.1007/s00405-022-07754-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/14/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSES How closed reduction (CR) to repair a nasal fracture affects the patient's quality of life (QoL) has not been investigated. Here, we assessed QoL before and after CR using disease-specific questionnaires and compared the QoL scores of patients with nasal fractures with normative scores from a reference cohort. METHODS This was a prospective study of 96 patients with nasal fractures undergoing CR. Patients were interviewed about aesthetic, functional, and QoL issues before and after surgery using the Functional Rhinoplasty Outcome Inventory (FROI-17) and the Rhinoplasty Outcome Evaluation (ROE). Photographs of the nasal area were taken before and after surgery and reviewed. Data were compared with those from a reference cohort (n = 1000). RESULTS Most fractures were type I (80.6%) and most were caused by sport-related accidents (36.5%). The ROE scores increased from 67.3 preoperatively to 73.4 postoperatively (p = 0.001). The FROI-17 also improved, indicating the overall effect of the nose on QoL (p = 0.002). Compared with the reference cohort, patients felt more affected by nasal symptoms before surgery (- 9.37, p = 0.02) than by more general aspects. ROE scores returned to normative values after surgery (p < 0.001). The postoperative cohort had lower scores for the FROI-17 item overall effects of the nose on QoL than the reference cohort did, although the nasal symptom score remained higher in patients than in reference controls. CONCLUSIONS This study showed that CR can improve the aesthetical but not the functional outcome of the nose.
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Gierthmuehlen M, Jarc N, Plachta DTT, Schmoor C, Scheiwe C, Gierthmuehlen PC. Mastication after craniotomy: pilot assessment of postoperative oral health-related quality of life. Acta Neurochir (Wien) 2022; 164:1347-1355. [PMID: 34668078 PMCID: PMC9061666 DOI: 10.1007/s00701-021-05020-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 10/04/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Neurosurgical approaches to the brain often require the mobilization of the temporal muscle. Many patients complain of postoperative pain, atrophy, reduced mouth opening, and masticatory problems. Although the pterional, frontolateral-extended-pterional, and temporal craniotomies are the most frequently used approaches in neurosurgery, a systematic assessment of the postoperative oral health-related quality of life has never been performed so far. This study evaluates the oral health-related quality of life of patients after pterional, frontolateral-extended-pterional, or temporal craniotomy using a validated and standardized dental questionnaire, compares the results with the normal values of the general population, and investigates whether this questionnaire is sensitive to changes caused by surgical manipulation of the temporal muscle. METHODS The "Oral Health Impact Profile" (OHIP14) is a validated questionnaire to assess the oral health-related quality of life. It asks the patients to assess their oral health situation within the past 7 days in 14 questions. Possible answers range from 0 (never) to 4 (very often). Sixty patients with benign intracranial processes operated through a lateral cranial approach were included. The questionnaire was answered before surgery (baseline) and 3 months and 15 months after surgery. RESULTS Overall, postoperative OHIP scores increase significantly after 3 months and decrease after 15 months, but not to preoperative values. No factors can be identified which show a considerable relationship with the postoperative OHIP score. CONCLUSIONS Postoperative impairment of mouth opening and pain during mastication can be observed 3 to 15 months after surgery and sometimes cause feedback from patients and their dentists. However, in line with existing literature, these complaints decrease with time. The study shows that the OHIP questionnaire is sensitive to changes caused by surgical manipulation of the temporal muscle and can therefore be used to investigate the influence of surgical techniques on postoperative complaints. Postoperatively, patients show worse OHIP scores than the general population, demonstrating that neurosurgical cranial approaches negatively influence the patient's oral health-related wellbeing. Larger studies using the OHIP questionnaire should evaluate if postoperative physical therapy, speech therapy, or specialized rehabilitation devices can improve the masticatory impairment after craniotomy. TRIAL REGISTRATION Clinical trial register: DRKS00011096.
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Só BB, Jardim LC, Schuch LF, Kovalski LNS, Zan R, Calcagnotto T, Martins MD, Martins MAT. Analysis of factors that influence quality of life of individuals undergoing treatment for mandibular fractures: A systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:289-301. [PMID: 35440426 DOI: 10.1016/j.oooo.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/22/2021] [Accepted: 01/12/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To address the factors that affect the quality of life (QoL) of individuals undergoing treatment for mandibular fractures. STUDY DESIGN This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the search strategy was constructed according to the Populations, Interventions, Comparison, Outcomes, and Study Design principle in the following databases: PubMed, Web of Science, Scopus, and EMBASE. Risk of bias assessment was performed with Risk Of Bias In Non-randomized Studies of Interventions and Cochrane Risk of Bias tool for randomized trials 2. RESULTS Nineteen studies were included: 15 observational and 4 clinical trials. Mean age ranged from 28 to 39 years, with a higher proportion of males. The condyle was the main fracture location and traffic accident was the fracture cause. Treatment approaches were mostly open reduction (89.4%) and maxillomandibular fixation (63%). QoL measurements varied considerably with the General Oral Health Assessment Index (31.5%) and Oral Health Impact Profile-14 (21%) as the main instruments. Meta-analysis showed that open reduction and maxillomandibular fixation did not present significant differences to QoL (P = .39), but significant differences were observed with time (P < .00001). Other factors affected QoL, such as mental health, pain, socializing, appearance, and eating difficulties. CONCLUSIONS Several factors, apart from the treatment approach, mentioned in this review seemed to affect the QoL of patients with mandibular trauma. Treatment choice should be based on well-stablished clinical criteria and on all other factors mentioned here.
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Affiliation(s)
- Bruna Barcelos Só
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luisa Comerlato Jardim
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Luan Nathiel Santana Kovalski
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rafael Zan
- Oral and Maxillofacial Surgery Department, FATEC Dental CEEO, Igrejinha, RS, Brazil
| | - Thiago Calcagnotto
- Oral and Maxillofacial Surgery Department, FATEC Dental CEEO, Igrejinha, RS, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
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Pauli N, Grinups M, Folkestad L, Gudnadottir G. Patient-Reported Symptoms after Midfacial Trauma. Surg J (N Y) 2022; 8:e22-e27. [PMID: 35059499 PMCID: PMC8763470 DOI: 10.1055/s-0041-1742174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background
The aim of this study was to assess patient-reported symptoms and health-related quality of life, 12 to 24 months after injury in patients with midfacial fractures.
Methods
Patients diagnosed with midfacial fractures were assessed regarding symptoms related to the fracture as well as assessment of the patients overall health-related quality of life using the Gothenburg Trismus Questionnaire (GTQ), the Folkestad facial trauma questionnaire, and EuroQol five-dimensional (EQ-5D). Questionnaires were distributed to the study patients 12 to 24 months after the trauma. Medical records were retrospectively surveyed for age, gender, trauma etiology, date of injury, fracture classification, treatment regimen, and time of surgery.
Results
Sixty-seven percent of the study group reports sensibility disturbance in the face 12 to 24 months after trauma and 52% reported cosmetic consequences related to the trauma. Numbness in the face was the symptom reported to be most disturbing for the patients. Few of the patients reported severe jaw-related problems, problems with muscular tension, or eating limitation according to the validated questionnaire GTQ.
Conclusion
Sensibility disturbance remains a significant and common symptom 12 to 24 months after midfacial trauma. There is a need for a validated patient-reported outcome instrument for facial trauma that covers multiple aspects of facial trauma such as vision disturbance and diplopia, jaw-related problems, and facial pain as well as sensibility disturbance and cosmetic consequences.
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Affiliation(s)
- Nina Pauli
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martina Grinups
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lena Folkestad
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunnhildur Gudnadottir
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
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Michalak P, Wyszyńska-Pawelec G, Szuta M, Hajto-Bryk J, Zapała J, Zarzecka JK. Fractures of the Craniofacial Skeleton in the Elderly: Retrospective Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111219. [PMID: 34769738 PMCID: PMC8583471 DOI: 10.3390/ijerph182111219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/20/2021] [Accepted: 10/23/2021] [Indexed: 11/30/2022]
Abstract
The aim of the retrospective analysis of the medical documentation of 101 patients was to assess the incidence, etiology, and type of craniofacial fractures in the elderly population of southern Poland, who required specialist treatment at the Department of Cranio-Maxillo-Facial Surgery Jagiellonian University, Krakow, Poland, in the period 2010–2019. Patients were divided into 3 age groups: 65–74, 75–84, and 85 and older. The following was noted: age, sex, place of residence, education, cause and location of fracture, treatment, injuries and comorbidities, complications, alcohol and other drugs at the time of injury, and the period of hospitalization. The dominant group were patients aged 65–74 (72.28%), mainly males (56.44%). The main cause was fall (47.52%). The fractures involved mainly the mandible and the zygomaticomaxillary complex. Over half of patients (50.50%) lived in the countryside or small towns. Work tool-related accidents prevailed among geriatric patients living in small towns and rural areas. Craniofacial fractures were additionally accompanied by common complications regarding the organ of vision. Further studies analyzing factors leading to increased risk of craniofacial injuries in the elderly of the rural population will enable proper support programs, prophylaxis, and principles concerning agricultural activities.
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Affiliation(s)
- Piotr Michalak
- Department of Conservative Dentistry with Endodontics, Jagiellonian University Medical College, 31-008 Krakow, Poland; (J.H.-B.); (J.K.Z.)
- Correspondence: ; Tel.: +48-607-505-906
| | - Grażyna Wyszyńska-Pawelec
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 31-008 Krakow, Poland; (G.W.-P.); (J.Z.)
| | - Mariusz Szuta
- Department of Oral Surgery, Jagiellonian University Medical College, 31-008 Kraków, Poland;
| | - Justyna Hajto-Bryk
- Department of Conservative Dentistry with Endodontics, Jagiellonian University Medical College, 31-008 Krakow, Poland; (J.H.-B.); (J.K.Z.)
| | - Jan Zapała
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 31-008 Krakow, Poland; (G.W.-P.); (J.Z.)
| | - Joanna Katarzyna Zarzecka
- Department of Conservative Dentistry with Endodontics, Jagiellonian University Medical College, 31-008 Krakow, Poland; (J.H.-B.); (J.K.Z.)
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Quality of life following maxillofacial trauma in the elderly: a multicenter, prospective study. Oral Maxillofac Surg 2021; 26:383-392. [PMID: 34499265 DOI: 10.1007/s10006-021-01003-4] [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: 02/10/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND/AIMS When facial trauma involves elderly patients, the possible presence of frailty and comorbidities in victims of trauma may worsen the posttraumatic symptoms and decrease quality of life. The aim of this multicenter study was to assess the quality of life following surgical or non-operative management of maxillofacial trauma in elderly patients. MATERIALS AND METHODS This cohort study was based on the administration of validated self-administered questionnaires to all the geriatric patients (70 years or more) with facial fractures from the involved maxillofacial surgical units across Europe, since 1st January 2019 to 31st June 2019. The following questionnaires were administered: SF36 questionnaire; the VFQ-25 questionnaire; the Oral Health Impact Profile - 14 (OHIP14). Outcome variables were VFQ-25 and OHIP-14 results. RESULTS A total of 37 patients (14 male and 23 female patients) met the inclusion criteria and were included in the study. Elderly patients had an improvement in almost all the categories examined by the SF-36 questionnaire 6 months after trauma, with the only exception of a worsening as for role limitations due to physical health. An improvement was observed in almost all the categories at SF-36 test. A worsening of scores of OHIP-14 for all the considered dimensions in the whole study population was observed too. CONCLUSIONS Elderly patients following facial trauma experience significant emotional, social, and functional disturbances. We observed that emotional problems, energy/fatigue, social functioning, and generally social limitations played a great role in the decrease of QoL in elderly patients following maxillofacial trauma.
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Salehi PP, Torabi SJ, Lee YH, Azizzadeh B. Effects of COVID-19 on Facial Plastic and Reconstructive Surgery Fellowship Training and Director Practices. OTO Open 2021; 5:2473974X211014130. [PMID: 34031647 PMCID: PMC8127772 DOI: 10.1177/2473974x211014130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 04/01/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES The objectives of this study include characterizing the practice patterns and testing strategies of facial plastic and reconstructive surgery (FPRS) fellowship directors (FDs) secondary to COVID-19 and to quantify the impact of COVID-19 on FPRS fellowship training. STUDY DESIGN Cross-sectional survey. SETTING Online. METHODS A survey was sent to all American Academy of Facial Plastic and Reconstructive Surgery FDs and co-FDs in September 2020. Descriptive analyses were performed. RESULTS Of 77 eligible FDs, 45 responded (58.4%) representing a diverse group across the United States. All but 1 FD routinely screened patients for COVID-19 in the preoperative setting. FDs largely believed that universal preoperative testing was cost-effective (66.7%), improved patient safety (80.0%) and health care worker safety (95.6%), and was not burdensome for patients (53.3%). With regard to volume of cosmetic/aesthetic, reconstructive, facial nerve, and trauma surgery, FDs indicated largely no change in volume (34.9%, 71.0%, 68.4%, and 80.0%, respectively) or fellow experience (67.4%, 80.6%, 84.2%, and 80.0%). Half (50.0%) of the FDs reported decreased volume of congenital/craniofacial surgery, but 75.0% did not believe that there was a change in fellow experience. Overall, of the 15 responses indicating "worsened training" across all domains of FPRS, 14 were located in the Northeast (93.33%). CONCLUSIONS The COVID-19 pandemic has had the least impact on the volume of reconstructive procedures, facial nerve operations, and trauma surgery and a negative impact on congenital/craniofacial surgery volume, and it has accelerated the demand for cosmetic/aesthetic operations. Overall, the majority of FDs did not feel as though their fellows' trainings would be adversely affected by the ongoing pandemic.
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Affiliation(s)
- Parsa P. Salehi
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Sina J. Torabi
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Yan Ho Lee
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Babak Azizzadeh
- Center for Advanced Facial Plastic Surgery, Beverly Hills, California, USA
- Division of Head and Neck Surgery, Department of Otolaryngology–Head and Neck Surgery, David Geffen School of Medicine, University of California–Los Angeles, Los Angeles, California, USA
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Howson K, Yeung E, Rayner L, Fan K. Real-time screening tool for identifying post-traumatic stress disorder in facial trauma patients in a UK maxillofacial trauma clinic. Int J Oral Maxillofac Surg 2021; 50:1464-1470. [PMID: 33712316 DOI: 10.1016/j.ijom.2021.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/26/2020] [Accepted: 01/28/2021] [Indexed: 11/18/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a distressing consequence of a traumatic event associated with an increased suicide risk and reduced quality of life. Surgeons often have low confidence in identifying psychological problems. The prevalence of PTSD following facial trauma ranges from 23% to 41%. This highlights the importance of identifying and managing at-risk patients to optimize both mental and physical recovery. IMPARTS (Integrating Mental and Physical healthcare: Research, Training and Services) provides electronic screening tools to guide the non-mental health clinician in the 'real-time' identification, documentation, and management of potential mental health problems. The bespoke IMPARTS facial trauma screening tool was piloted in a UK oral and maxillofacial surgery trauma clinic from July 2015 to November 2017. A total of 199 patients completed screening, with 48 (24%) screening positive for possible PTSD. Further analysis of these 48 patients revealed that four (8%) had PTSD symptoms alone; three (6%) also screened positive for depression, 17 (35%) for co-existing symptoms of anxiety, and 24 (50%) for PTSD, anxiety, and depression. IMPARTS was found to be a highly effective tool aiding the non-mental health clinician to screen for PTSD and initiate prompt management. The data captured informs planning of the psychological support service.
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Affiliation(s)
- K Howson
- Oral and Maxillofacial Surgery Department, King's College Hospital, Denmark Hill, London, UK
| | - E Yeung
- Oral and Maxillofacial Surgery Department, King's College Hospital, Denmark Hill, London, UK
| | - L Rayner
- IMPARTS Mind and Body Programme, Psychological Medicine and Integrated Care Clinical Academic Group, King's College London, London, UK
| | - K Fan
- Oral and Maxillofacial Surgery Department, King's College Hospital, Denmark Hill, London, UK; Faculty of Dentistry, Oral & Craniofacial Sciences.
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Manzie T, David MC, Bobinskas A. Return to normal diet following mandibular fractures - how long is long enough? Br J Oral Maxillofac Surg 2021; 59:1050-1055. [PMID: 34311999 DOI: 10.1016/j.bjoms.2021.02.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/16/2021] [Indexed: 11/17/2022]
Abstract
Mandibular fractures are a common injury managed by oral and maxillofacial surgeons. Current open reduction and internal fixation (ORIF) treatment strategies are based on Champy's ideal line of osteosynthesis with the use of miniplate and load-sharing fixation techniques. Postoperative instructions for the duration of a soft diet have varied. This prospective, randomised study reviewed the outcomes of a patient led return to diet at 2 weeks and 4 weeks compared with 6 weeks (control group) following an ORIF of mandibular fractures. There was no significant difference in the incidence of complications between a graduated return to diet at 2, 4, or 6 weeks following an ORIF of the mandible, nor was there a difference in the quality of life during the postoperative period. Smoking has a notable risk factor for complications. The findings of this study suggest that strict adherence to a softened diet may not be necessary, and that patients identified at being of low risk of complications may be able to return to a normal diet from as early as two weeks.
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Affiliation(s)
- T Manzie
- Royal Perth Hospital, Perth, Western Australia, Australia; Fiona Stanley Hospital, Perth, Western Australia, Australia.
| | - M C David
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - A Bobinskas
- Fiona Stanley Hospital, Perth, Western Australia, Australia; The Canberra Hospital, Canberra, Australian Capital Territory, Australia
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Rajantie H, Kaukola L, Snäll J, Roine R, Sintonen H, Thorén H. Health-related quality of life in patients surgically treated for orbital blow-out fracture: a prospective study. Oral Maxillofac Surg 2020; 25:373-382. [PMID: 33280065 PMCID: PMC8352817 DOI: 10.1007/s10006-020-00923-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022]
Abstract
Purpose The purpose of this study was to evaluate patients’ health-related quality of life (HRQoL) before and after surgical treatment of orbital blow-out fracture. Methods This prospective study comprises of all adult patients undergoing a surgical reconstruction of an orbital blow-out fracture in 2006–2010. Their HRQoL was evaluated for 6 months postoperatively with the aid of the standardized 15D instrument and was compared with that of an age- and gender-standardized sample of the general Finnish population. A complementary questionnaire for more detailed information was also administered. Results Twenty-six patients completed the study. Mean 15D score among the patients preoperatively (0.898) was statistically significantly and clinically importantly worse than the score of the control population (0.936). Six months postoperatively, the mean 15D score was 0.920, with no significant difference compared with the control population and the significant differences on the different dimensions had disappeared. The most common complaint at 6 months postoperatively was diplopia in daily life (19%). Disturbances in facial sensation (27%) and defects in facial appearance (15%) were the most unpleasant subjective outcomes. Conclusion The HRQoL is significantly decreased after orbital blow-out fracture compared with the general population but will recover completely in 6 months. Thus, the negative impact of orbital blow-out fracture on HRQoL is only transient. Disturbances in facial sensation, defects in facial appearance, and diplopia are the most common subjective complaints after the injury and its surgical treatment. However, these do not appear to affect the overall quality of life in the long term. Supplementary Information The online version contains supplementary material available at 10.1007/s10006-020-00923-x.
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Affiliation(s)
- Hanna Rajantie
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Leena Kaukola
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Risto Roine
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
- Helsinki and Uusimaa Hospital District, Administration, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Hanna Thorén
- Department of Oral and Maxillofacial Surgery, University of Turku, Turku, Finland
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
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Does the Lockdown Influence the Oral and Maxillofacial Surgery Service in a Level 1 Trauma Hospital During the Novel Coronavirus 2019 (COVID 19) Pandemia? J Craniofac Surg 2020; 32:1002-1005. [PMID: 33165246 DOI: 10.1097/scs.0000000000007054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The pandemic status of the Novel Coronavirus 2019 has affected many countries around the world, due to the high virulence of the SARS-CoV-2, the recommended protocol to prevent infection is social isolation. The purpose of this study was to compare the number of patients admitted and their epidemiological data on a Level 1 Trauma Hospital after the declaration of the pandemic status and the first week of mandatory lockdown, with the same period of time in the last year. This was a retrospective study of medical records from the patients admitted in the Oral and Maxillofacial Surgery of the João XXIII Hospital, between the March 24 and March 31 of 2020 and the same period of the last year. There was a 52.27% decrease in the total number of patients and 76.34% decrease in the total consultations of the service of oral and maxillofacial surgery during the lockdown. All the groups presented a decrease in significance with motor vehicle accidents events, the group 11 to 20 years old presented an increase on the correlation with violence (P = 0.019) and falls (P = 0.002). When comparing both sex with the etiologies, the male one presented an increase in the correlation with violence and falls. The female sex presented correlations only with the minor causes. No valid significance was observed when comparing females with violence events. The lockdown is an effective way to reduce the transmission of the COVID-19, the hospital usage and occupation.
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22
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Petersen LØ, Ipsen EØ, Felding UA, von Buchwald C, Steinmetz J. Sequelae of Major Trauma Patients with Maxillofacial Fractures. Ann Otol Rhinol Laryngol 2020; 130:475-482. [PMID: 32935553 DOI: 10.1177/0003489420958732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Sequelae after maxillofacial fractures are frequent and may affect the patient's quality of life. This study examined sequelae associated with maxillofacial fractures of severely traumatized patients focusing mainly on nerve injuries. METHODS A retrospective study including trauma patients with relevant facial fractures admitted to our Trauma Center in the period 2011-2016. Presence of posttraumatic maxillofacial sequelae was identified by examining the medical records of the included patients. Focusing on facial sensory deficits and facial nerve paralysis, but also comprising data on diplopia, blindness, malocclusion, trismus, eye globe malposition, flattening of the malar, facial contour changes, and wound infections. RESULTS Two-hundred-seventy-five severely traumatized patients were included, comprising 201 men (73%), with a median age of 40 years and ISS of 20. 163 (59%) patients only had assessments within 3 months from trauma of which 79 patients (48.5%) had facial complications at initial examination, mostly malocclusion and trismus. Most patients in this group had no or only minor sequelae at their last clinical assessment, mainly being sensory deficits. 112 (41%) patients had assessments both within and beyond 3 months of which 73 patients (65.2%) had facial complications at initial examination, while 91 patients (81%) had reported sequelae within 3 months decreasing to 47 patients (42%) at their last clinical assessment beyond 3 months from trauma, mostly sensory deficits. An improvement of most sequelae was observed. CONCLUSION Objective sequelae were found to be quite common after maxillofacial fractures in severely traumatized patients, especially sensory deficits. However, most of the addressed sequelae seemed to improve over time.
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Affiliation(s)
- Lasse Østrup Petersen
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Emil Ørskov Ipsen
- Trauma Centre and Department of Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Ascanius Felding
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Steinmetz
- Trauma Centre and Department of Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Lupi-Ferandin S, Glumac S, Poljak N, Galic T, Ivkovic N, Brborovic O, Pecotic R, Dogas Z. Health-Related Quality of Life in Patients After Surgically Treated Midface Fracture: A Comparison with the Croatian Population Norm. Ther Clin Risk Manag 2020; 16:261-267. [PMID: 32308403 PMCID: PMC7153997 DOI: 10.2147/tcrm.s249116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/18/2020] [Indexed: 11/23/2022] Open
Abstract
Aim To evaluate the health-related life quality of patients after surgically treated midface fractures. Patients and Methods This retrospective cohort study compared the 36-Item Short Form Health Survey (SF-36) scores of 42 male patients following surgically treated maxillary or zygomatic fractures with the reported normative data of the SF-36 for the Croatian population. Results The current study showed that the health-related life quality of surgically treated patients was comparable to similar age, gender, and regional demographics in the Croatian population norm. However, we revealed a significant deterioration of the “Emotional wellbeing” domain in younger patients (P = 0.03) and a severely affected domain of “Physical functioning” in older patients (P = 0.049). Conclusion There was a significant negative psychological impact from facial trauma on younger patients. In contrast, older patients were more prone to physical impairment. Therefore, follow-up visits are an opportunity to screen and refer younger patients to mental health services in a timely manner to prevent severe psychological difficulties and an opportunity to identify older patients who require physical therapy.
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Affiliation(s)
- Slaven Lupi-Ferandin
- Department of Maxillofacial and Oral Surgery, University Hospital of Split, Split, Croatia
| | - Sandro Glumac
- Department of Anesthesiology and Intensive Care, University Hospital of Split, Split, Croatia
| | - Nancy Poljak
- Study of Dental Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tea Galic
- Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia.,Department of Neuroscience, School of Medicine, University of Split, Split, Croatia
| | - Natalija Ivkovic
- Sleep Medicine Center, School of Medicine, University of Split, Split, Croatia
| | - Ognjen Brborovic
- Department of Social Medicine and Organization of Health Care, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Renata Pecotic
- Department of Neuroscience, School of Medicine, University of Split, Split, Croatia.,Sleep Medicine Center, School of Medicine, University of Split, Split, Croatia
| | - Zoran Dogas
- Department of Neuroscience, School of Medicine, University of Split, Split, Croatia.,Sleep Medicine Center, School of Medicine, University of Split, Split, Croatia
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Salehi PP, Heiser A, Torabi SJ, Azizzadeh B, Lee J, Lee YH. Facial Fractures and the National Basketball Association: Epidemiology and Outcomes. Laryngoscope 2020; 130:E824-E832. [DOI: 10.1002/lary.28690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/09/2020] [Accepted: 03/25/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Parsa P. Salehi
- Department of Surgery, Otolaryngology–Head and Neck Surgery Yale University School of Medicine New Haven Connecticut U.S.A
| | - Alyssa Heiser
- Department of Otolaryngology–Head and Neck Surgery The University of Vermont Medical Center Burlington Vermont U.S.A
| | - Sina J. Torabi
- Department of Surgery, Otolaryngology–Head and Neck Surgery Yale University School of Medicine New Haven Connecticut U.S.A
| | - Babak Azizzadeh
- Center for Advanced Facial Plastic Surgery Beverly Hills California U.S.A
- Division of Head and Neck Surgery, Department of Otolaryngology–Head and Neck Surgery David Geffen School of Medicine at the University of California Los Angeles California Los Angeles U.S.A
| | - Jonathan Lee
- Department of Surgery, Division of Plastic Surgery Baystate Medical Center Springfield Massachusetts U.S.A
| | - Yan H. Lee
- Department of Surgery, Otolaryngology–Head and Neck Surgery Yale University School of Medicine New Haven Connecticut U.S.A
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Tan PG, Soh CL. Quality of life assessments in maxillofacial trauma patients – A systematic review. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2020. [DOI: 10.1016/j.ajoms.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zandi M, Dehghan A, Bigonah N, Doulati S, Mohammad Gholi Mezerji N. Histological assessment of the effects of teriparatide therapy on mandibular fracture healing: A preclinical study. J Craniomaxillofac Surg 2020; 48:211-216. [PMID: 32014386 DOI: 10.1016/j.jcms.2020.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/31/2019] [Accepted: 01/13/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE This study was performed to evaluate the effects of teriparatide therapy on mandibular fracture healing in a rat model. SUBJECTS AND METHODS A unilateral mandibular fracture, 5 mm posterior to the last molar tooth, was surgically created in 120 rats. Half of the animals received a daily subcutaneous injection of 2 μg/kg teriparatide while the control rats received normal saline, starting from the day of surgery until sacrifice. Twenty rats from each group were sacrificed on postoperative days 10, 20, and 30. The healing process was evaluated histologically and scored using a grading system (ranging from 1 to 10). RESULTS On day 10 the fracture gaps of the control and teriparatide groups were mainly filled with fibrous tissue and new trabecular bone, respectively. On day 20 a large amount of new trabecular bone and some areas of fibrocartilaginous tissue were seen in the fracture gaps of the control rats. In the teriparatide group the fracture area was entirely filled with trabecular bone, which in some areas had been replaced by mature bone. On day 30 the fracture gaps of the control group were entirely bridged by new trabecular bone, while in the teriparatide group they was predominantly filled with mature bone. At all three time-points the mean healing scores for the teriparatide group (6.20 ± 0.70, 8.50 ± 0.69, and 9.85 ± 0.37, respectively) were significantly higher (p < 0.001) than for the control group (4.90 ± 0.55, 7.15 ± 0.59, and 8.90 ± 0.64, respectively). CONCLUSION Based on the results of this study, teriparatide should be tested in humans in order to establish whether comparable results can be achieved.
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Affiliation(s)
- Mohammad Zandi
- Department of Oral and Maxillofacial Surgery, Hamadan University of Medical Sciences, Hamadan, Iran; Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Arash Dehghan
- Department of Pathology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nemat Bigonah
- Department of Oral and Maxillofacial Surgery, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Shideh Doulati
- Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Martins NDCES, Branco MPC, Pessoa LSDF, Alves GÂDS, Studart-Pereira LM. Facial trauma and background level: a study on the population’s perspective. REVISTA CEFAC 2020. [DOI: 10.1590/1982-0216/20202223319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
ABSTRACT Purpose: to verify the population’s understanding on facial trauma, according to their level of schooling. Methods: an observational, cross-sectional, quantitative, documentary study conducted, based on 852 interviews carried out in two Brazilian state capitals. The association between the levels of schooling and varied knowledge of facial trauma was investigated. The data were analyzed with Pearson’s chi-square test or Fisher’s exact test, with a margin of error of 5%. Results: there was a statistically significant association between the participants’ schooling and their understanding on the consequences of trauma in: functions (p = 0.001), mouth mobility (p = 0.005), and dental issues (p = 0.003). In the most affected population, schooling was also associated with youth (p = 0.001) and adults (p = 0.044). Regarding causes, there was association with falls (p = 0.034) and traffic accidents (p = 0.034). There was association with bikers (p = 0.016) and motorcyclists (p = 0.001) as the population with greater propensity. Schooling was associated with all the professionals. Concerning the consequences to the victim’s life, there was association also with general health (p = 0.049), household chores (p = 0.001), and social life (p = 0.001). Recklessness was the only cause with an association (p = 0.004). Schooling was associated with previous knowledge of trauma (p = 0.001). Conclusion: their understanding on the consequences of trauma, most affected population, main causes, professionals involved in the treatment, repercussion for people’s lives, and previous knowledge of the subject increased along with the levels of background.
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Analysis of Factors Affecting Quality of Life in Patients Treated for Maxillofacial Fractures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010004. [PMID: 31861285 PMCID: PMC6981460 DOI: 10.3390/ijerph17010004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 11/16/2022]
Abstract
Maxillofacial fractures (MFF) belong to the major modern medicine and public health concerns. The recovery from MFF is associated with a number of social problems. The patient’s mood may be affected by the change in self-image and lack of satisfaction with life, in many cases leading to a deepening of mental health disorders, resulting in alcoholism, loss of job or conflicts in the area of family life. The aim of this study was to evaluate the quality of life of patients with MFF, with respect to demographic and medical variables. The mean age of the 227 patients was 36 years. The mandible was the most frequent MFF location (52.9%), followed by the zygomatic bone (30.8%) then the maxilla (16.3%). Bone fracture displacement occurred in 79.3% of patients. A comminuted fracture was found in 71% of patients. The quality of life of patients with MFF was significantly better in all analyzed domains 3 months after the end of hospitalization compared to the initial survey carried out shortly after implementation of the treatment. Among the demographic variables, older age had a statistically significant but weak positive association with the improvement of the quality of life of respondents in General health perception domain.
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Youkhana B, Tavassol F, Johannsen H, Spalthoff S, Gellrich NC, Stier R. An in-depth technical and medical investigation of facial injuries caused by car accidents. Injury 2019; 50:1433-1439. [PMID: 31285054 DOI: 10.1016/j.injury.2019.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 06/24/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Many studies have investigated the issue of facial injuries caused by car accidents, but only a few have addressed the technical and clinical aspects of such accidents and injuries in depth. The aim of this study was to identify risk factors and protective elements for facial injuries in car accidents. METHODS We analysed the technical and clinical data of patients with facial injuries caused by car accidents over a 16-year period (2000-2016) and investigated the following factors: sitting position, sex, age, accident time, use of a seatbelt, deployment of the front airbag, direction of impact, speed at the time of collision, and occurrence and location of facial injuries. RESULTS Of the 1291 patients involved in car accidents who were included in our study, 291 (22.5%) had suffered facial injuries. We found a significant association between occurrence of facial injuries and sex, speed at the time of collision, impact from the back, seatbelt usage, and deployment of the front airbag. In accidents occurring at speeds over 40 km/h, automobile security measures had no significant influence on the occurrence of facial injuries in drivers and front-seat passengers. In accidents occurring at speeds between 0 and 20 km/h, seatbelt usage (without airbag deployment) solely showed a significant protective influence against the occurrence of facial injuries (odd ratio [OR], 0.130; confidence interval [CI], 0.038-0.451). In contrast, patients who were in accidents at speeds between 21 and 40 km/h suffered significantly fewer facial injuries when wearing a seatbelt with the front airbag being deployed (OR, 0.245; CI, 0.091-0.665) or undeployed (OR, 0.216; CI, 0.084-0.561). CONCLUSION Male sex and a high speed at the time of collision are significant risk factors for the occurrence of facial injuries. The security measurements evaluated in this study only exerted a protective influence at low speeds (below 40 km/h). This indicates a possible weakness of these security systems with regard to preventing facial injuries. Engineers could benefit from these findings and improve the efficiency of existing security measures and eventually help decrease the incidence of facial injuries.
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Affiliation(s)
- Bernard Youkhana
- Department for Cranio Maxillofacial Surgery, Medical School Hannover, Hannover, Germany
| | - Frank Tavassol
- Department for Cranio Maxillofacial Surgery, Medical School Hannover, Hannover, Germany
| | - Heiko Johannsen
- Accident Research Institute, Medical School Hannover, Hannover, Germany
| | - Simon Spalthoff
- Department for Cranio Maxillofacial Surgery, Medical School Hannover, Hannover, Germany
| | | | - Rebecca Stier
- Department for Cranio Maxillofacial Surgery, Medical School Hannover, Hannover, Germany.
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Povolotskiy R, Youssef P, Kaye R, Paskhover B. Facial Fractures in Young Adults: A National Retrospective Study. Ann Otol Rhinol Laryngol 2019; 128:516-523. [PMID: 30735056 DOI: 10.1177/0003489419830114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES "Young adulthood" is a term used to define individuals falling within the 18- to 22-year-old age range. Injuries account for more than a third of emergency department visits in this population. A particular area of concern is accidents that lead to injuries of the facial bones because they can have long-term functional, aesthetic, and psychosocial impacts. As many as 30 million young adults participate in some sort of sport in the United States per year, and facial injuries from these activities are not uncommon and thus require further exploration. METHODS The National Electronic Injury Surveillance System was used to conduct a retrospective review to explore patterns of maxillofacial fractures in young adult patients between the ages of 18 and 22 years from 2004 through 2017. The data analyzed yielded information about patient demographics, diagnoses, and associated products. RESULTS A total of 3486 emergency department visits were included in the study. The most common facial fractures were nasal fractures (64.4%), mandible fractures (12.3%), and orbital fractures (6.1%). The most common causes of fractures were sports (55.48%), fixed structures (6.39%), and stairs or steps (5.60%). The top 3 sports associated with facial fractures were basketball (25.4%), baseball (11.6%), and football (10.4%). CONCLUSIONS For young adult individuals, some sort of sporting activity is common outside of the National Collegiate Athletic Association. The overwhelming majority of facial fractures in this population were caused by sports, and the authors believe this issue warrants further exploration and discussion. According to the Centers for Disease Control and Prevention, an estimated 8.6 million sports- and recreation-related injuries occurred per year between 2011 and 2014. Despite ever growing research and guidelines into sports injury incidence and prevention, it is clear that sports are the cause of a large portion of maxillofacial fractures in the United States.
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Affiliation(s)
- Roman Povolotskiy
- 1 Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Pavly Youssef
- 1 Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Rachel Kaye
- 1 Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Boris Paskhover
- 1 Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
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31
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Clinical Outcomes Between Atrophic and Nonatrophic Mandibular Fracture in Elderly Patients. J Craniofac Surg 2018; 29:e815-e818. [DOI: 10.1097/scs.0000000000004863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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de Macedo Bernardino Í, da Nóbrega LM, da Silva JRC, de Medeiros CLSG, de Olinda RA, d'Ávila S. Spatial distribution of maxillofacial injuries caused by urban violence: An ecological analysis to identify high-risk areas. Community Dent Oral Epidemiol 2018; 47:85-91. [PMID: 30318849 DOI: 10.1111/cdoe.12428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/07/2018] [Accepted: 09/23/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the spatial and spatial-temporal distribution of oral and maxillofacial injuries caused by urban violence, as well as to identify underlying disparities at regional level through a geostatistical approach. METHODS This was a historical ecological cohort study of trauma cases caused by urban violence using aggregate data from victims assisted in a Brazilian medical-forensic service between January 2012 and December 2015. The longitudinal patterns of change observed in each geographic area (neighbourhoods) were evaluated using the finite mixture model (FMM). The spatial autocorrelation of events was investigated using the Getis-Ord Indicator (Gi*) to identify significant hot and cold spatial clusters. With a spatial regression model, it was also found when socioeconomic variables, residential infrastructure and neighbourhood infrastructure were associated with high incidence rates. The significance level was set at P ≤ 0.05. RESULTS The finite mixture model revealed three different patterns of longitudinal trajectory of the incidence of oral and maxillofacial trauma caused by urban violence (TP1 to TP3, P < 0.05). TP1 was characterized by an incidence that remained stable and high over time, comprising 17.4% of the city's neighbourhoods. In TP2, it was observed that the incidence was moderate, with a slightly increasing trend in the last year evaluated, representing around 41.8% of the sample. In contrast, in TP3, it was found that the incidence was relatively low and remained stable over time, accounting for about 40.8% of the sample. The Getis-Ord (Gi*) statistic identified significant high-risk clusters in the western (P < 0.05), southern (P < 0.05), and eastern regions (P < 0.05) and low risk in the northern region (P < 0.05). The spatial regression model indicated significant association between areas with unfavourable socioeconomic conditions and higher incidence of events (β = 0.178, SE = 0.046, P < 0.001). CONCLUSIONS Clusters demarcating areas with high socio-spatial vulnerability for urban violence and oral and maxillofacial injuries were identified. The findings highlight the need to improve living conditions in segregated urban areas and develop intersectoral actions to improve living conditions, employment, public safety, social support, health care and prevention.
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Affiliation(s)
| | | | | | | | | | - Sérgio d'Ávila
- Department of Dentistry, Universidade Estadual da Paraíba, Campina Grande, PB, Brazil
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Guys NP, Mir A, Svider PF, Sheyn A. Wet and wounded: Pediatric facial trauma from swimming and diving. Int J Pediatr Otorhinolaryngol 2018; 111:153-157. [PMID: 29958600 DOI: 10.1016/j.ijporl.2018.06.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 06/05/2018] [Accepted: 06/06/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Swimming has been reported as the most common recreational activity among American youths, while diving remains a popular youth activity as well. We characterize the most common facial injuries occurring during these activities and evaluate facial fracture mechanisms and demographic trends, as this information may be helpful in preventative counseling as well as diagnosis. METHODS The National Electronic Injury Surveillance System was assessed for swimming- and diving-related facial injuries in children from 2007 to 2016. Estimates of national injury incidence were recorded, and patient diagnoses, demographics, and injury mechanisms were evaluated. RESULTS In the 10-year period assessed, 789 NEISS entries extrapolated to an estimated 27,709 patients nationwide were analyzed. The yearly incidence fluctuated but steadily rose from 2013 to 2016. Males comprised a majority of injuries (58%), and laceration was the most common diagnosis (65%), followed by abrasion/contusion (22%) and fracture (9%). Facial fractures were most likely to involve the nasal bones (87%). Swimming injuries were more numerous overall (74%), but a greater proportion of diving injuries resulted in fracture (12% vs. 7%). Teenagers were also more likely to suffer fractures than were younger children involved in the same activities. CONCLUSION Most analyses of swimming and diving injuries have focused on spinal and orthopedic trauma. Nevertheless, the nature of headfirst diving and swim strokes suggest facial trauma is an underappreciated concern for clinicians. These findings reinforce the need for safer swimming and diving practices and serve as a useful resource for physicians managing pediatric facial injuries.
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Affiliation(s)
- Nicholas P Guys
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
| | - Ahsan Mir
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Peter F Svider
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Anthony Sheyn
- Department of Otolaryngology, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Pediatric Otolaryngology, LeBonheur Children's Hospital, Memphis, TN, USA
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Ologunde R, McLeod NMH. Use of patient-reported outcome measures in oral and maxillofacial trauma surgery: a review. Br J Oral Maxillofac Surg 2018; 56:371-379. [PMID: 29650475 DOI: 10.1016/j.bjoms.2018.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/21/2018] [Indexed: 11/15/2022]
Abstract
In the UK, about one person/100/year sustains a facial injury, so trauma surgery accounts for a considerable part of the caseload in oral and maxillofacial surgery (OMFS). Patient-reported outcome measures (PROM) allow for patient-centred assessment of postoperative outcomes, but to our knowledge, most research in OMFS trauma does not currently include them. To investigate their use, we searched Medline to find relevant studies that reported outcomes from inception in January 1879 to August 2016. Those not in the English language and those that did not report operations were excluded. We retrieved 416 articles, of which 21 met the inclusion criteria (five randomised controlled trials and 16 cohort studies) yielding 16 outcome measures. Most of these had been devised by authors (eight studies), four studies reported use of the Geriatric Oral Health Assessment Index, and three the Nasal Obstruction Symptom Evaluation. Most were used in studies on mandibular surgery (n=13), followed by those on nasal and facial surgery (n=3 each). There is a great heterogeneity in the use of these assessments in OMF trauma. In view of their increasing importance compared with simpler objective measures that may not be relevant to the patients' own perception, more research is needed to establish which of them can be used to measure the QoL of patients treated for OMF trauma.
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Affiliation(s)
- R Ologunde
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - N M H McLeod
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
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Glória JCR, Fernandes IA, Silveira EMD, Souza GMD, Rocha RL, Galvão EL, Falci SGM. Comparison of Bite Force with Locking Plates versus Non-Locking Plates in the Treatment of Mandibular Fractures: A Meta-Analysis. Int Arch Otorhinolaryngol 2018; 22:181-189. [PMID: 29619110 PMCID: PMC5882372 DOI: 10.1055/s-0037-1604056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 05/09/2017] [Indexed: 11/25/2022] Open
Abstract
Introduction Mandibular fractures represent a high percentage of all facial fractures, and the bite force is a fundamental parameter to measure the actual mandibular function and, subsequently, the masticatory efficiency and quality of life. Objectives The purpose of the present systematic review was to verify if there is any difference in the bite forces of patients with mandibular fractures fixed by locking or non-locking plates, testing the null hypothesis of no difference in this parameter. Data Synthesis A systematic review of the literature was conducted using four databases (PubMed, Virtual Health Library, Web of Science and Science Direct) without restrictions as to publication date or language. We found 3,039 abstracts, and selected 4 articles for this review. Conclusion The overall results show better performance in bite force for the locking plates when compared with the non-locking plates in the incisor region (mean deviation [MD]: 1.18; 95% confidence interval [95%CI]: 0.13-2.23), right molar region (MD: 4.71; 95%CI: 0.63-8.79) and left molar region (MD: 10.34; 95%CI: 4.55-16.13). Although the results of this study indicated a better bite force result with the locking plates, there is still no sufficient evidence to support this information safely.
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Affiliation(s)
- José Cristiano Ramos Glória
- Department of Oral and Maxillofacial Surgery, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Ighor Andrade Fernandes
- Department of Oral and Maxillofacial Surgery, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | | | - Glaciele Maria de Souza
- Department of Oral and Maxillofacial Surgery, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Ricardo Lopes Rocha
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Endi Lanza Galvão
- Research Department, Centro de Pesquisas Rene Rachou, Belo Horizonte, MG, Brazil
| | - Saulo Gabriel Moreira Falci
- Department of Oral and Maxillofacial Surgery, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
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de Macedo Bernardino Í, Santos L, Ferreira A, de Almeida Lima T, da Nóbrega L, d’Avila S. Multiple correspondence analysis as a strategy to explore the association between categories of qualitative variables related to oral–maxillofacial trauma and violent crimes at the community level. Int J Oral Maxillofac Surg 2018; 47:339-344. [DOI: 10.1016/j.ijom.2017.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 07/04/2017] [Accepted: 08/09/2017] [Indexed: 10/19/2022]
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Fama F, Cicciu M, Sindoni A, Nastro-Siniscalchi E, Falzea R, Cervino G, Polito F, De Ponte F, Gioffre-Florio M. Maxillofacial and concomitant serious injuries: An eight-year single center experience. Chin J Traumatol 2017; 20:4-8. [PMID: 28209449 PMCID: PMC5343103 DOI: 10.1016/j.cjtee.2016.11.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 12/31/2016] [Accepted: 01/03/2017] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Maxillofacial injuries are frequently associated with multiple trauma and can determine functional and aesthetic bad outcomes. The severity of maxillofacial injuries may be considerable and can divert clinicians' attention from other concomitant injuries which is less evident but potentially life-threatening. The aim of this study was to find out the concomitant injuries in patients referred to the Emergency Department (ED) of the University Hospital of Messina (North-East Sicily, Italy) for maxillofacial traumas. METHODS We retrospectively evaluated data of 240,833 patients admitted at the ED of the University Hospital of Messina from January 2008 to December 2015 because of maxillofacial injuries leading to hospitalization and surgical treatment. Patients who primarily received treatment care at different institutions, pediatric trauma patients and adult patients who were transferred in accordance with pre-existing agreements in case of paucity of beds were excluded. Finally we included 447 (0.2%) patients over the 8 years. Data were evaluated with emphasis on epidemiology (age, gender, mechanism of trauma), primary survey and abnormalities and pattern of trauma. RESULTS The most frequent cause of maxillofacial trauma was road accidents (319 patients, 71.4%), among which motorcycle ones were prevalent. The maxillofacial injured who presented major lesions were 98 patients and minor lesions occurred in 349 patients; 443 (99.1%) patients underwent maxillofacial surgery, immediate or delayed depending on the severity of concomitant injuries (χ2 = 557.2, p < 0.0001). Five concomitant neglected lesions were found to be associated with severe maxillofacial traumas (χ2 = 17.13, p < 0.0001 vs minor lesions). All of the neglected lesions occurred in paucisymptomatic patients who showed painless abdomen, no hemodynamic instability, no signs of hematoma of anterior and posterior abdominal wall or other suspicious clinical signs and symptoms. CONCLUSION Among the patients admitted firstly in other surgical wards different from the Maxillofacial Surgery Unit, diagnosis was more difficult, especially for blunt abdominal traumas, in which patients showed only vague and nonspecific symptoms concealing serious and life-threatening injuries. We recommend the routine use of whole body CT scan, when the maxillofacial injuries appear prevalent, mainly in patients affected by maxillofacial major lesions.
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Affiliation(s)
- Fausto Fama
- Department of Human Pathology, University Hospital of Messina, 98125 Messina, Italy,Corresponding author. Fax: +39 0902212801.
| | - Marco Cicciu
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Alessandro Sindoni
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Enrico Nastro-Siniscalchi
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Roberto Falzea
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Francesca Polito
- Department of Clinical and Experimental Medicine, University Hospital of Messina, 98125 Messina, Italy
| | - Francesco De Ponte
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Maria Gioffre-Florio
- Department of Human Pathology, University Hospital of Messina, 98125 Messina, Italy
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