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Gaikwad R, Almutairi M, Al-Moshiqah A, Almutairi F, Alharbi A, Alhudaithi A, Alayouni AA, Alharbi AM, Algefari S. Maxillofacial Bone Fractures in Children and Adolescents in Saudi Arabia: A Systematic Review. Cureus 2024; 16:e60765. [PMID: 38903286 PMCID: PMC11188698 DOI: 10.7759/cureus.60765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2024] [Indexed: 06/22/2024] Open
Abstract
Facial injuries, including maxillofacial trauma (MFT), are common in children and adolescents due to their age and bone maturation stage. Children's injuries are less common than adults' due to parental supervision and the flexibility of the facial bone. Causes of maxillofacial bone fractures (MFBF) vary based on socioeconomic, cultural, and environmental factors. Management of MFBF in children and adolescents should consider their growth and development stage. A systematic review is needed to understand the prevalence, pattern, and distribution of MFBF in Saudi Arabia. This systematic review aimed to identify papers on MFBF in children and adolescents in Saudi Arabia using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. The search strategy involved searching electronic databases like PubMed/Medline, Web of Science, and Ebsco. The review included full-text original research papers, with inclusion criteria including English publications, human studies, and no restrictions on sample size, gender, date, or language. The selection process involved screening titles and abstracts, evaluating full texts, and identifying relevant studies. Data extraction involved two authors individually assessing selected studies. The PRISMA flow diagram of the literature search revealed that 26 papers were identified, of which 15 remained after excluding duplicates. After screening titles and abstracts, 10 articles were removed, and five papers were assessed for eligibility. Four papers met the inclusion criteria for the systematic review. The studies examined 1447 patients for the presence of MFBF in different regions. The majority of MFBF were caused by falls and road traffic accidents (RTAs) in children and adolescents. Mandibular fractures were the most common, followed by maxillary fractures. The majority of patients had tooth/teeth avulsions, followed by tooth luxation and crown fractures. Only one study described investigation methods for MFBF diagnosis. The systematic review reveals a high prevalence of MFBF among children and adolescents in Saudi Arabia, primarily due to falls and RTAs. The mandible is the most frequently fractured bone, and many children have concomitant teeth involvement. To reduce MFBF, effective initiatives and parental awareness strategies are recommended.
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Affiliation(s)
- Rahul Gaikwad
- Community Dentistry and Oral Epidemiology, College of Dentistry, Qassim University, Buraydah, SAU
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Walshaw EG, Taylor R, Anderson J, Sexton P, Parmar JD, Carter LM. The psychological sequelae of maxillofacial trauma: a scoping review of the literature. Br J Oral Maxillofac Surg 2022; 60:1303-1320. [PMID: 36446645 DOI: 10.1016/j.bjoms.2022.09.013] [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: 06/21/2022] [Accepted: 09/05/2022] [Indexed: 11/27/2022]
Abstract
Managing the physical sequelae of facial trauma is routine for the maxillofacial surgeon. However, managing the psychological consequences is more challenging. The often violent mechanism of injury, changes in appearance, altered self-perception, and self-confidence can significantly impact daily life. This review summarises the literature regarding post-traumatic stress disorder (PTSD) and facial trauma, highlighting evidence to guide clinical practice. PubMed and MEDLINE were searched for relevant keywords and MeSH headings. Articles between 2000-2022 were independently reviewed by two authors. Articles were excluded if the full text was not available in English, did not relate to facial trauma, or was not related to PTSD/psychological sequelae. A total of 211 articles were retrieved. The most common reasons for exclusion were papers not reporting psychological outcomes (n = 68) or not relating to facial trauma (n = 35). Articles were sub-categorised to enable evaluation of key themes. Categories included children and adolescents, cross sectional, longitudinal studies, and interventional studies. Whilst there were potential confounders such as socioeconomic factors, overall, patients who had experienced facial trauma (regardless of the mechanism of injury) had an increased risk of PTSD and anxiety/depression. PTSD following facial injury is increasingly recognised as an important issue. A robust evidence base is desirable to inform clinical practice and provide holistic care to often vulnerable patients. Identifying those at increased risk of negative psychological sequelae is essential. We have appraised the literature relevant to OMFS trauma clinicians.
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Affiliation(s)
- Emma G Walshaw
- University of Leeds, Worsley Building, University of Leeds, Woodhouse, Leeds LS2 9JT, United Kingdom.
| | - Richard Taylor
- University of Leeds, Worsley Building, University of Leeds, Woodhouse, Leeds LS2 9JT, United Kingdom.
| | - Jane Anderson
- University of Huddersfield, Queensgate, Huddersfield HD1 3DH, United Kingdom.
| | - Paul Sexton
- Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom.
| | - Jiten D Parmar
- Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom.
| | - Lachlan M Carter
- Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom.
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Sliding Flap for the Wide Upper Eyelid Margin Defect After Cancer Removal. J Craniofac Surg 2022; 33:2063-2066. [PMID: 35148531 DOI: 10.1097/scs.0000000000008551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Reconstruction of eyelid margin defects following resection of upper-eyelid skin malignancies is typically performed using a lower eyelid switch flap, including eyelash reconstruction. However, a subsequent procedure for flap separation, and prolonged swelling of the flap may occur as a complication. OBJECTIVE The authors performed anterior lamellar reconstruction using a sliding flap with excess upper eyelid skin, a procedure that is a less invasive and simpler. MATERIALS AND METHODS The authors performed anterior lamellar reconstruction using a sliding flap in 7 patients with full-thickness upper eyelid margin defect after skin cancer resection. The mean age of the patients was 76.0 years. The horizontal width of the defect in our cohort ranged from 11 to 25 mm and the vertical width ranged from 5 to 10 mm. RESULTS All the flaps and mucosal grafts were well taken, and none of the patients complained of lack of eyelash reconstruction. However, eyelid margin irregularity, possibly due to flap or mucosal graft contraction, was observed in 2 patients, and 1 patient developed keratoconjunctivitis. CONCLUSIONS The sliding flap technique is a minimally invasive and simple procedure for wide eyelid margin reconstruction. However, 2 patients developed eyelid margin irregularities and 1 patient developed keratoconjunctivitis. Those complications might have occurred owing to the condition of posterior lamellar reconstruction. Therefore, for the successful use of a sliding flap for anterior lamellar reconstruction, the form of the eyelid edge and the choice of posterior lamellar reconstruction are key considerations. In future, we plan to establish a better reconstructive technique by accumulating more evidence.
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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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Alqahtani F, Bishawi K, Jaber M. Analysis of the pattern of maxillofacial injuries in Saudi Arabia: A systematic review. Saudi Dent J 2019; 32:61-67. [PMID: 32071533 PMCID: PMC7016231 DOI: 10.1016/j.sdentj.2019.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/22/2019] [Accepted: 08/25/2019] [Indexed: 10/27/2022] Open
Abstract
Objectives Maxillofacial trauma (MFT) is a serious health problem and in Saudi Arabia is mainly caused by road traffic accidents (RTAs). MFT commonly associated with injuries to the face, head, and jaws and may cause soft tissue lacerations and bruises. MFT can also cause fatal blood loss and airway obstruction. The objective of this review was to determine the prevalence of MFT, identify the major causative factors in males and females in the main cities of Saudi Arabia. Materials and methods We performed literature searches of all published studies describing MFT from KSA during the last 20 years. Results In Saudi Arabia, males are more prone to MFT than females, although the male: female ratio of MFT varies between different cities. Specifically, Aseer has the highest male: female ratio (10:1), followed by AlHofuf (8.3:1) while AlQurayyat had the least gender ratios of MFT (2:1). Most cases of MFT are associated with RTAs, which accounted for (63%-90.3%) in Medina, (89.1%) in Aseer, (86.1% -87.1%) in Riyadh, (67%-73.1%) in Jeddah, (71%) in Khamis Mushait, (64.2%) in Makkah and (63.3%) in Al-Hofuf. The least percentage of RTA resulting into MFT was recorded in AlQurayyat (24%). Conclusion Maxillofacial trauma is a serious health problem in Saudi Arabia. RTAs remain the major cause of maxillofacial injuries especially among males, thus strict implementation of traffic rules is a must to minimize maxillofacial injuries and its physical and psychological impact.
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Affiliation(s)
- Feras Alqahtani
- College of Dentistry, Ajman University, United Arab Emirates
| | - Khaled Bishawi
- College of Dentistry, Ajman University, United Arab Emirates
| | - Mohamed Jaber
- College of Dentistry, Ajman University, United Arab Emirates
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Bertossi D, Dell’Acqua I, Albanese M, Marchetti P, Nocini P. Face Treatment Using Nonsurgical Mini-Invasive Techniques as Postsurgical Procedure for Traumatic Injury. Aesthet Surg J 2019; 39:NP266-NP278. [PMID: 30649172 DOI: 10.1093/asj/sjz017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/25/2018] [Accepted: 01/10/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Facial trauma can cause major psychological damage and compromise a patient's quality of life. Unfortunately, surgery cannot always solve this problem or provide an acceptable result. OBJECTIVES Treatment with injectables may provide a solution that is minimally invasive and better accepted by patients as a means to improve poor outcomes after facial trauma. METHODS This retrospective study involved 50 patients (29 men, 21 women) who underwent primary surgery to treat facial trauma between January 2015 and January 2017. Based on the facial area affected by poor outcomes (upper face, midface, and lower face), patients underwent ≥1 aesthetic medicine treatments with hyaluronic acid dermal fillers and botulinum toxin injections. To evaluate patient satisfaction and the effect of the treatment on quality of life, patients were asked to complete 2 questionnaires, POSAS and FACE-Q, prior to treatment and 90 days after the last treatment session. RESULTS Questionnaire scores indicated improvements in aesthetic and psychological metrics, perceived both by the patient and the observer. CONCLUSIONS Minimally invasive aesthetic treatments represent a valuable adjunct to surgical procedures for improving facial aesthetics after injury and consequently the quality of life of patients affected by facial trauma. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Dario Bertossi
- Department of Maxillofacial Plastic Surgery, Division of Dental and Maxillofacial Surgery, G.B. Rossi Hospital and Medical University of Verona, Verona, Italy
- Department of Public Health and Community Medicine, Unit of Epidemiology and Medical Statistics, G.B. Rossi Hospital and Medical University of Verona, Verona, Italy
| | - Irene Dell’Acqua
- Department of Maxillofacial Plastic Surgery, Division of Dental and Maxillofacial Surgery, G.B. Rossi Hospital and Medical University of Verona, Verona, Italy
- Department of Public Health and Community Medicine, Unit of Epidemiology and Medical Statistics, G.B. Rossi Hospital and Medical University of Verona, Verona, Italy
| | - Massimo Albanese
- Department of Maxillofacial Plastic Surgery, Division of Dental and Maxillofacial Surgery, G.B. Rossi Hospital and Medical University of Verona, Verona, Italy
- Department of Public Health and Community Medicine, Unit of Epidemiology and Medical Statistics, G.B. Rossi Hospital and Medical University of Verona, Verona, Italy
| | - Pierpaolo Marchetti
- Department of Maxillofacial Plastic Surgery, Division of Dental and Maxillofacial Surgery, G.B. Rossi Hospital and Medical University of Verona, Verona, Italy
- Department of Public Health and Community Medicine, Unit of Epidemiology and Medical Statistics, G.B. Rossi Hospital and Medical University of Verona, Verona, Italy
| | - Pierfrancesco Nocini
- Department of Maxillofacial Plastic Surgery, Division of Dental and Maxillofacial Surgery, G.B. Rossi Hospital and Medical University of Verona, Verona, Italy
- Department of Public Health and Community Medicine, Unit of Epidemiology and Medical Statistics, G.B. Rossi Hospital and Medical University of Verona, Verona, Italy
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da Nóbrega LM, de Macedo Bernardino Í, Leal PM, de Castro Martins C, Granville-Garcia AF, d'Avila S. Traffic accidents, maxillofacial injuries and risk factors: A systematic review of observational studies. J Evid Based Med 2019; 12:3-8. [PMID: 30506994 DOI: 10.1111/jebm.12332] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 10/16/2018] [Indexed: 01/11/2023]
Abstract
AIM This study aimed to evaluate the scientific evidence regarding the risk factors for maxillofacial injuries among victims of traffic accidents. METHOD A systematic review of articles published until February 2017 was carried out in the following databases: PubMed, Web of Science, Scopus, and Cochrane Library. Studies were selected by two independent reviewers (ϰ = 0.841). The risk of bias in the selected studies was assessed using an adapted version of the Newcastle-Ottawa Scale for observational studies. RESULTS A total of 2703 records were found, of which only three articles fulfilled the inclusion criteria and were analyzed, including 422 244 patients. The male/female ratio ranged from 3.4: 1 to 6: 1. All eligible studies performed the multivariate statistical analysis. Eleven risk factors for maxillofacial traumas were identified: victim's gender (P < 0.05), age group (P < 0.05), residence region (P < 0.05), impact characteristics (P < 0.05), increased net change in velocity due to collision (P < 0.05), increase in occupant's height (P < 0.05), nonuse of protective equipment (P < 0.05), type of accident (P < 0.05), time of occurrence (P < 0.05), lesion severity (P < 0.05), and occurrence of concomitant lesions (P < 0.05). CONCLUSION The results suggest that sociodemographic characteristics, as well as those related to the collision patterns and circumstances of traffic accidents, may influence the occurrence of maxillofacial injuries. However, the results should be interpreted with caution due to the high heterogeneity among studies.
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Affiliation(s)
| | | | - Paula Miliana Leal
- Department of Dentistry, Universidade Estadual da Paraíba, Campina Grande, PB, Brazil
| | | | | | - Sérgio d'Avila
- Department of Dentistry, Universidade Estadual da Paraíba, Campina Grande, PB, Brazil
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Woodruff SI, Galarneau MR, McCabe CT, Luu BN, Sack DI, Han PP. Body-Region-Specific Injuries as Predictors of Psychosocial Outcomes Among Those Injured in Combat: Results From the Wounded Warrior Recovery Project. MILITARY PSYCHOLOGY 2018. [DOI: 10.1037/mil0000181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Michael R. Galarneau
- Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, San Diego, California
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Rahtz E, Bhui K, Hutchison I, Korszun A. Are facial injuries really different? An observational cohort study comparing appearance concern and psychological distress in facial trauma and non-facial trauma patients. J Plast Reconstr Aesthet Surg 2018; 71:62-71. [DOI: 10.1016/j.bjps.2017.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 07/27/2017] [Accepted: 08/06/2017] [Indexed: 11/25/2022]
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Krishnan B, Rajkumar RP. Psychological Consequences of Maxillofacial Trauma in the Indian Population: A Preliminary Study. Craniomaxillofac Trauma Reconstr 2017; 11:199-204. [PMID: 30087749 DOI: 10.1055/s-0037-1604426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 04/02/2017] [Indexed: 02/06/2023] Open
Abstract
The aim of this article is to identify the prevalence of posttraumatic psychological symptoms following maxillofacial trauma among an Indian population sample and assess changes in these symptoms over a period of time. Forty-eight adult patients were assessed within 2 weeks of injury with two follow-up visits (4-6 weeks and 12-14 weeks). Patients were administered three self-reporting questionnaires in local language (GHQ-12; HADS; TSQ) on all occasions. Relevant sociodemographic and clinical data were obtained. Forty patients were included in the final analysis. Emotional distress was present in nine participants and five participants satisfied the TSQ criteria for a diagnosis of stress disorder. Anxiety and depression were observed in 10 and 4 patients, respectively. Characteristics associated with abnormal high scores included substance abuse, low education and income levels, facial scars, and complications needing additional intervention. These findings reveal the abnormal psychological response to maxillofacial trauma in immediate and follow-up periods. The use of such screening tools can be considered by the maxillofacial surgeon for early identification of psychological symptoms and referral to the psychiatrist.
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Affiliation(s)
- Balasubramanian Krishnan
- Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Pondicherry, India
| | - Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Pondicherry, India
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Sahni V. Psychological Impact of Facial Trauma. Craniomaxillofac Trauma Reconstr 2017; 11:15-20. [PMID: 29387299 DOI: 10.1055/s-0037-1603464] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 02/25/2017] [Indexed: 10/19/2022] Open
Abstract
Examination of the mental state of patients suffering from facial trauma is rarely ever recorded, let alone screening them for posttraumatic stress disorders (PTSDs) or generalized anxiety disorder. Providing early support to the patient in light of such psychological conditions can improve the overall quality of life. The aim of this study was to perform a literature review to assess the relation of mental state disorders to facial trauma in terms of their prevalence, assess screening methodology, and also to evaluate the prognosis of individuals subjected to psychological intervention/screening at an early stage of clinical examination. Research databases such as ScienceDirect, Google Scholar, PubMed, and Medline were searched using the keywords "psychological trauma," "facial trauma," and "PTSD." Only meta-analyses, systematic reviews, and original research articles in the English language were included in the study. Correspondence to journal editors and clinician opinions were excluded from the study. Out of a total of 459 results, only 8 articles satisfied the inclusion criteria of the study. The literature review showed that patients suffering from orofacial trauma had significantly increased levels of mental state disorders such as PTSD and generalized anxiety disorder, more so in victims of assault. The results of this literature review clearly point toward an increased prevalence of mental state disorders in patients suffering from facial trauma, which warrants for early intervention in this regard to improve the quality of life of these patients.
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Affiliation(s)
- Vaibhav Sahni
- Department of Oral and Maxillofacial Surgery, Christian Medical College and Hospital, Ludhiana, Punjab, India.,Department of Oral and Maxillofacial Surgery, Maharishi Markandeswar College of Dental Sciences and Research, Ambala, Haryana, India
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Yadav SK, Shrestha S. A study on posttraumatic experience of road traffic accident afflicted maxillofacial trauma patient at tertiary hospital. J Nat Sci Biol Med 2017; 8:40-45. [PMID: 28250673 PMCID: PMC5320822 DOI: 10.4103/0976-9668.198358] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: Patients are usually left in a vulnerable state after an accident. Because of this, they long for a good encounter when they are brought to the hospital. Physical impairment and psychological morbidities are some of the complications that can occur to them. Traditionally, surgeons tend to pay little attention to a patient's emotional and psychological perspective. The aim of this study was to understand the experience of oral and maxillofacial trauma patients due to road traffic accident right from immediate after the accident till the end of definitive treatment. Materials and Methods: Phenomenological approach of qualitative study was used to explore these patients’ experience. Twenty subjects involved in road traffic accidents without any cognitive impairment aged 18 and above were recruited. Purposive sampling was used to include maximal variation sample regarding age, gender, types of injury, and types of treatment received. Semi-structured and open-ended interview approach was used to obtain in-depth information. Results: Seven themes were identified to describe the patients’ response to and experience after meeting with a road traffic accident; they are unreal experiences, emotional responses, need to inform and need for information, need for assistance, their perception toward the maxillofacial injury, their experience on treatment and staff-patient interaction. Conclusion: This qualitative study has provided an in-depth understanding of patients experience during maxillofacial trauma and treatment, which otherwise cannot be obtained by the use of surveys and test questions.
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Affiliation(s)
- Santosh Kumar Yadav
- Department of Oral and Maxillofacial Surgery, College of Medical Sciences, Bharatpur, Chitwan, Nepal
| | - Suraksha Shrestha
- Department of Prosthodontics, College of Medical Sciences, Bharatpur, Chitwan, Nepal
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Impact of trauma and surgical treatment on the quality of life of patients with facial fractures. Int J Oral Maxillofac Surg 2016; 45:575-81. [DOI: 10.1016/j.ijom.2015.11.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 11/12/2015] [Accepted: 11/26/2015] [Indexed: 11/19/2022]
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Shah A, Nautiyal V, Gupta A, Ramola V. Trends of maxillofacial fractures in the Garhwal Himalayas at Government Medical College, Srinagar, Uttarakhand. Natl J Maxillofac Surg 2016; 7:80-85. [PMID: 28163485 PMCID: PMC5242081 DOI: 10.4103/0975-5950.196139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Evaluation of Maxillofacial fractures in hilly region of Garhwal Himalyas and its relation with age, gender, anatomical location, seasonal variation and treatment provided. AIMS The aim of the present study is to analyze the pattern of maxillofacial fractures in the Garhwal Himalayan region of India and to compare the results with similar studies in India and the rest of the world. SETTINGS AND DESIGN This was a prospective study conducted on 102 patients with 128 facial fractures. MATERIALS AND METHODS This study was conducted on 102 patients who were admitted for the treatment of maxillofacial fractures in the Department of Dentistry at Government Medical College, Srinagar, Uttarakhand, India. STATISTICAL ANALYSIS USED All analyses were performed using Chi-square test and level of significance. RESULTS Peak incidence was noted in the second to fourth decades of life. Male: female ratio was 4:1. Road traffic accident was the main etiology (42.2%), followed by fall (37.2%) and assault (11.8%). Among other etiology of injury, distinguishing feature was bear bite, which was only seen in winters causing 5.9% of total injury. Fall was reported high in females whereas road traffic accident in males. Mandible was fractured in 73.5% of patients while mid-face in 26.5% of patients. Open reduction with internal fixation was the choice of treatment in 60.8% of cases. Nearly 79.4% of patients were treated under local anesthesia. The mean duration of hospitalization was (standard deviation 5.2 days) 5.3 days. CONCLUSIONS Road traffic accidents still remain the main cause of maxillofacial fractures in developing countries such as India. In hilly area, road traffic accident can be minimized by better wide roads with guide walls/parapet, strict law enforcement for overspeed, overload, and to use seat belts while driving, and use of helmet while riding two-wheeler. Open reduction internal fixation remains the first choice of treatment in facial fractures due to early return of function with minimal morbidity and better nutritional status in patients compared to closed reduction.
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Affiliation(s)
- Amit Shah
- Department of Dentistry, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Pauri, Garhwal, India
| | - Vijay Nautiyal
- Department of Oral and Maxillofacial Surgery, Seema Dental College, Dehradun, Uttarakhand, India
| | - Arti Gupta
- Department of Community Medicine, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Pauri, Garhwal, India
| | - Vikas Ramola
- Department of Maxillofacial Surgery, Uttranchal Dental Medical Research Institute, Dehradun, Uttarakhand, India
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Quality of life, psychological wellbeing and treatment needs of trauma and head and neck cancer patients. Br J Oral Maxillofac Surg 2014; 52:513-7. [DOI: 10.1016/j.bjoms.2014.03.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 03/26/2014] [Indexed: 11/21/2022]
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Abstract
The face is a vital component of one's personality and body image. There are a vast number of variables that influence recovery and rehabilitation from acquired facial trauma many of which are psychological in nature. The present paper presents the various psychological issues one comes across in facial trauma patients. These may range from body image issues to post-traumatic stress disorder symptoms accompanied by anxiety and depression. Issues related to facial and body image affecting social life and general quality of life are vital and the plastic surgeon should be aware of such issues and competent to deal with them in patients and families.
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Affiliation(s)
- Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
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The psychosocial characteristics and needs of patients presenting with orofacial injury. Oral Maxillofac Surg Clin North Am 2010; 22:209-15. [PMID: 20403551 DOI: 10.1016/j.coms.2010.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Individuals with orofacial injury presenting to urban trauma centers in the United States tend to be disproportionately socioeconomically disadvantaged, young, adult, ethnic minority men. Most injuries are assaultive in origin, suggesting poor impulse control and maladaptive social behaviors. Compared with matched control populations, patients with orofacial injuries are more likely to report higher levels of substance use behaviors and to manifest greater levels of hostility, anxiety, and depression. Although they have significantly greater current and lifetime need for mental health service and social service, actual use of social services is low. The underlying psychosocial characteristics of many patients with orofacial injury, along with unmet service needs, render them vulnerable for posttrauma psychological sequelae and may compromise functional outcomes and recovery.
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Evaluation on the psychosocial status of orthognathic surgery patients. ACTA ACUST UNITED AC 2009; 108:828-32. [DOI: 10.1016/j.tripleo.2009.07.044] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Revised: 07/18/2009] [Accepted: 07/23/2009] [Indexed: 11/23/2022]
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