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Lal B, Ganesh K, Alagarsamy R, Gupta S, Kumar M, Barathi A. Post-traumatic stress disorder in maxillofacial trauma victims- A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101993. [PMID: 39084561 DOI: 10.1016/j.jormas.2024.101993] [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: 05/22/2024] [Revised: 07/21/2024] [Accepted: 07/28/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Maxillofacial trauma often results in visible facial disfigurements and can lead to psychological complications such as post-traumatic stress disorder (PTSD). However, PTSD often remains unrecognized and un/undertreated. The goal of the current systematic review was to determine the incidence of PTSD after maxillofacial trauma, associated risk factors, assessment tools employed, and management. METHODS A literature search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library databases following PRISMA guidelines up to March 2024. Collected variables included the number of patients included, PSTD assessment tool, PTSD incidence, and risk factors and management. The meta-analysis was conducted using random effect models in STATA 16. RESULTS The review included 14 studies (1633 patients, male=1025, female=230, not mentioned=378). Assessment tools varied widely among studies. Meta-analysis revealed a pooled incidence of PTSD of 27 % (n = 14, 95 % CI, 24 %-30 %) at 1-3 months post-trauma and 10 % (n = 3, 95 % CI, 3 %-17 %) at the 6-12 months follow-up, with a statistically significant 60 % reduction between these periods. CONCLUSION The overall incidence of PTSD following maxillofacial trauma was 27 % at 1-3 months and decreased to 10 % after 6 months. The emphasis should be given to the importance of early intervention strategies and awareness among the treating surgeon to prevent PTSD.
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Affiliation(s)
- Babu Lal
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Keshav Ganesh
- All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Ragavi Alagarsamy
- Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung hospital, New Delhi, India.
| | - Snehil Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Mohit Kumar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Kumar S, Kashyap S, Singh S, Sharma R, Singh YP, Naik HY. Maxillofacial trauma among Indians. Bioinformation 2023; 19:876-880. [PMID: 37908612 PMCID: PMC10613808 DOI: 10.6026/97320630019876] [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] [Received: 08/01/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 11/02/2023] Open
Abstract
Orofacial injuries constitute the medico-legal cases reported, especially, in cases associated with road traffic accidents, assaults, and violence making it an emerging healthcare problem. Therefore, it is of interest to document data on the maxillofacial trauma and fractures among Indians. 150 subjects within the age of 15 to 60 years with maxillofacial fractures, detailed medical history including demographics, radiographs, medical history, associated injuries, and etiology of fractures were used for this study. Sites for both maxillary and mandibular fractures were noted. The type of intubation (medical insertion procedure) used and post-operative complications were also recorded. Lefort I, II, and III fractures were seen in 4%, 12%, 6% subjects respectively, whereas, ZMC fracture was seen in 66% study subjects. Mandibular fractures were most commonly seen in the para-symphysis region with 30% subjects followed by condylar region with 28.66% subjects. Data shows that maxillofacial trauma has a high incidence in India with RTA (road traffic accidents being the most common reason for the trauma seen in young males with significant concomitant injuries. Most common fracture is seen in mandible region. However, they can be managed well with very few postoperative complications.
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Affiliation(s)
- Saurabh Kumar
- />Department of Dentistry, Public Health Center, Bind, Nalanda, Bihar Government, Bihar, India
| | - Sandeep Kashyap
- />Department of Dentistry, Sikkim Manipal University, Gangtok, Sikkim, India
| | - Saurabh Singh
- />Department of General Surgery, Rama Medical College Hospital And Research Centre, Kanpur, Uttar Pradesh, India
| | - Rohit Sharma
- />Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Yatendra Pratap Singh
- />Department of Otorhinolaryngology, Saraswati Medical College, Unnao, Uttar Pradesh, India
| | - Hani Yousuf Naik
- />Department of Oral and Maxillofacial Surgery, Pacific Dental College and Research Centre, Udaipur, Rajasthan, India
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Sundheepkumar V, Saravanan R, Krishnan B. INFECTIOUS COMPLICATIONS IN COMPOUND MANDIBULAR FRACTURES UNDERGOING A DELAYED SURGICAL INTERVENTION - A PROSPECTIVE OBSERVATIONAL STUDY. Br J Oral Maxillofac Surg 2023; 61:302-308. [PMID: 37061417 DOI: 10.1016/j.bjoms.2023.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
The aim of this prospective study was to analyse if a delay in the time from injury to definitive surgical intervention of open reduction and internal fixation (ORIF) of compound mandibular fractures predisposed to an increase in postoperative infectious complications. ORIF beyond 72 hours from injury was considered to be delayed intervention. Postoperative surgical site infections (SSI) and non-infectious complications (NIC) were recorded. The Mann-Whitney U test was used to compare the delay in ORIF with SSI. The chi squared test/Fisher's exact test was used to find the association of the infectious complication status with predetermined risk factors. Eighty-three patients underwent a delayed ORIF with a median (range) of 8 (4-19) days. SSI was documented in eight patients (9.6%) and could be managed as outpatient medical and surgical intervention. Two patients needed repeat surgical intervention due to non-union of the fracture. The median (range) time to ORIF was 6.5 (5-12) days in patients who developed SSI; the Mann-Whitney U test did not show a statistically significant association between delayed ORIF and SSI (p = 0.7). The univariate analysis did not establish a significant relationship between SSI and predetermined risk factors. The delay to definitive surgical intervention was not observed to be an independent attributing factor in postoperative infectious complications of compound mandibular fractures.
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Hosseini SH, Mousavi Shalmaei SMA, Mohtasham-Amiri Z, Homaie Rad E, Khodadadi-Hassankiadeh N. Psychiatric symptoms and pain in maxillofacial injury following motor vehicle accidents: A comparative study. Dent Traumatol 2023; 39:31-37. [PMID: 36317713 DOI: 10.1111/edt.12793] [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: 06/06/2022] [Revised: 08/16/2022] [Accepted: 08/20/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND/AIM Post-traumatic stress disorders, depression, and pain are rarely discussed in the literature on maxillofacial injuries, and psychiatric symptoms and pain are not identified and managed in such patients. The aim of this study was to determine the symptoms of post-traumatic stress disorders, depression, and pain in people with maxillofacial injuries following motor vehicle accidents. MATERIAL AND METHODS In this cross-sectional study, people injured in motor vehicle accidents from March to September 2015 who were referred to a medical educational center in the northern part of Iran for treatment follow-up were sampled. The existing symptoms of post-traumatic stress disorder by PSS, depression by BDI-II, and pain by NRS were assessed. SPSS software version 21 was used for analysis. RESULTS Maxillofacial injured patients had significant differences in terms of post-traumatic stress disorder (p = .006), depression (p = .001), pain (p = .001), and length of hospital stay (p = .002) than patients without maxillofacial injuries. CONCLUSIONS Motor vehicle accident victims with maxillofacial injuries suffered significantly more from post-traumatic stress disorders and depression, pain and length of hospital stay than patients with other injuries.
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Affiliation(s)
- Seyed Hadi Hosseini
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Zahra Mohtasham-Amiri
- Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Enayatollah Homaie Rad
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Adeleke AI, Hlongwa M, Makhunga S, Ginindza TG. Mapping Evidence on the Epidemiology and Cost Associated with Maxillofacial Injury among Adults in Sub-Saharan Africa: A Scoping Review Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1531. [PMID: 36674286 PMCID: PMC9865531 DOI: 10.3390/ijerph20021531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: Maxillofacial injury (MI) occurs universally, for it disregards preference for age, gender, and geographical region. The global incidence and prevalence of facial fractures rose by 39.45% and 54.39%, respectively, between the years 1990 to 2017. Projections indicate that the burden of injuries will persist in sub-Saharan Africa (SSA) in the next twenty years. This scoping review aims to map the literature on MI epidemiology and the economic burden on society in SSA. (2) Methods: The methodology presented by Arksey and O'Malley and extended by Levac and colleagues will be employed in the scoping review. The researcher will report the proposed review through the Preferred Reporting Items for Systematic Review, and Meta-Analysis extension for scoping reviews (PRISMA-ScR). The review will include studies encompassing MI in sub-Saharan African adults 18 years and above. (3) Results: This will be presented as a thematic analysis of the data extracted from the included studies, and the Nvivo version 12 will be employed. (4) Discussion: We anticipate searching for related literature on the prevalence, incidence, risk factors, mortality, and cost associated with MI in the adult population of SSA. The conclusion from the review will assist in ascertaining research gaps, informing policy, planning, authorizing upcoming research, and prioritizing funding for injury prevention and management.
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Affiliation(s)
- Adekunle I. Adeleke
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Mbuzeleni Hlongwa
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7925, South Africa
| | - Sizwe Makhunga
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Themba G. Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
- Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
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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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Wu J, Min A, Wang W, Su T. Trends in the incidence, prevalence and years lived with disability of facial fracture at global, regional and national levels from 1990 to 2017. PeerJ 2021; 9:e10693. [PMID: 33552726 PMCID: PMC7821785 DOI: 10.7717/peerj.10693] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022] Open
Abstract
Background Facial fracture is one of the most common injuries globally. Some types of facial fractures may cause irreversible damage and can be life-threatening. This study aimed to investigate the health burden of facial fractures at the global, regional, and national levels from 1990 to 2017. Methods Facial fracture data, including the incidence, prevalence, and years lived with disability (YLDs) from 1990 to 2017, were obtained from the Global Burden of Disease study. We calculated the estimated annual percentage changes (EAPCs) to assess the changes of facial fractures in 195 countries or territories and 21 regions. Results From 1990 to 2017, the change in cases of facial fracture incidence was 39% globally, while the age-standardized incidence rate showed a downtrend with an EAPC of 0.00. Syria experienced a ten-fold increase in incidence cases with an EAPC of 9.2, and this condition is largely responsible for the global health burden of facial fractures. The prevalence and YLDs showed a similar trend worldwide as the incidence. Additionally, we found that the incidence, prevalence, and YLDs showed a discrepancy among various age groups with a gradual change of proportion over the past 28 years. The age-standardized rates (ASRs) of facial fractures were nearly twice for male than those for female from 1990 to 2017. Conclusions EAPC showed a correlation with the ASRs of facial fractures and had no relationship with socio-demographic index. The proportion of children and elderly suffering from facial fractures slightly changed with time. The ratio of facial fractures between males and females was 2:1. These findings suggest that more targeted and specific strategies based on age and gender should be established in various countries and regions.
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Affiliation(s)
- Jin Wu
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Anjie Min
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Weiming Wang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Tong Su
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital of Central South University, Changsha, Hunan, China.,Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, China
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