Mandibular fractures in association with chin trauma in pediatric patients

Traumatic Fractures of the Tympanic Plate: A Literature Review and Case Report

Fracture of the tympanic plate resulting from posterior dislocation of the mandibular condyle is an uncommon diagnosis. Presented is a clinical case in which computerized tomography was used as a diagnostic resource in a conservative therapeutic and clinical controlled one-year study. A review of the literature revealed 23 cases clinically reported with symptoms, diagnosis, and types of therapy utilized.

Fracture in the chin area: An unusual case of mandibular torus fracture

Mandibular torus fracture as a result of accidental trauma has not been reported to date in the dental literature. This study describes the case of a young adult male who suffered multiple fractures affecting the teeth and mandibular torus secondary to chin area trauma due to a bicycle accident; the first manifestation of bone damage being left unilateral paraesthesia of the lip. An occlusal x-ray study of the affected area was made to evaluate possible fracture, as unlike centred periapical x-rays and orthopantomography, it is able to reveal the existence of a fracture line of the alveolar wall. In the associated presence of paraesthesia, a computed tomographic study is advisable.

Another cause for bilateral haemorrhagic otorrhoea following trauma

Bleeding from the external auditory meatus (haemorrhagic otorrhoea) following head trauma is usually attributed to a basal skull fracture. However, it may also result from unsuspected facial trauma. We describe a case that highlights an usual but important differential diagnosis for bilateral haemorrhagic otorrhoea.

Bicycle riding and oral/maxillofacial trauma in young children

OBJECTIVES

To investigate the frequency of oral/maxillofacial injuries in children who have had a bicycle incident and to relate this to the wearing of a protective helmet.

DESIGN

Part of a larger prospective study in which self-administered questionnaires were completed by each child with bicycle-related injuries and their parents or caregivers.

SETTING

Two tertiary-referral children's hospitals (between 1 April 1991 and 30 June 1992) and three general hospitals (between 1 August 1991 and 30 June 1992) in Brisbane.

PARTICIPANTS

813 children aged under 15 years who presented to the accident and emergency departments with bicycle-related injuries.

RESULTS

There were 321 children (39.5%) who sustained oral/maxillofacial injuries. Of 1355 injuries, 340 (25.1%) were to the facial region. Of the 153 children admitted to hospital for bicycle-related injuries, 94 (61.4%) had oral/maxillofacial injury as the primary reason for admission (including those with a reduced level of consciousness). Of the 66 children with a reduced level of consciousness, 53 had concomitant facial injuries. The most common oral/maxillofacial injuries were facial abrasions, cuts and lacerations (50.3%); soft tissue injuries to the mouth (30.9%); and dentoalveolar trauma (9.7%). Over half of these children were wearing bicycle helmets. Of the 15 facial fractures (mandibular, nasal, and zygomatico-orbital), 10 were in children wearing helmets.

CONCLUSIONS

Oral/maxillofacial injuries are frequent among child bicycle riders, even for those who wear Australian Standards-approved bicycle helmets. Bicycle helmets need design modifications (e.g., lightweight chin protectors) to more adequately protect the face and jaw.

CT evaluation of otorrhagia associated with condylar fractures

To assess a simplified CT evaluation of otorrhagia due to condylar fracture, 16 patients with post-traumatic otorrhagia underwent axial CT of the petrous bones and coronal CT of the temporo-mandibular joints (TMJs). Bilateral high condylar fractures were demonstrated in seven patients. Unilateral subcondylar fracture dislocations with contralateral high condylar fractures were demonstrated in the other nine patients. The otorrhagia was always ipsilateral to a high condylar fracture. Otorrhagia due to condylar fractures occurred when the fracture was bilateral and ipsilateral to a high condylar fracture. The diagnostic procedure of choice is coronal CT of the TMJs which should be carried out if axial CT of the petrous bones showed them to be intact.