Blast injuries from bombings: what craniofacial and maxillofacial surgeons need to know

Saving lives and restoring hope: Enhancing outcomes through comprehensive understanding of maxillofacial surgery in disaster medicine

This article delves into the profound impact of various types of disasters, examining some specific contexts. It provides insights into the unique challenges posed by different disasters, ultimately highlighting the invaluable role of maxillofacial surgery in addressing the critical healthcare needs of affected populations. A comprehensive review of the literature was conducted to analyze the role of maxillofacial surgery in disaster management. Relevant studies were examined to gather evidence supporting the criticality of maxillofacial surgeons in disaster response. Continuous training, coordination, and international collaboration among maxillofacial surgeons were reported as key factors in enhancing preparedness and improving post-disaster recovery. Sharing experiences, implementing best practices, and staying updated with advancements in the field seemed crucial for maximizing the impact of maxillofacial surgery in disaster medicine. By prioritizing the inclusion of maxillofacial surgeons in disaster response teams, lives can be saved, functional outcomes can be improved, and hope can be restored in affected communities. Understanding the intricacies and patterns associated with various types of disasters can be crucial details for successful rescue operations.

Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge

Penetrating foreign bodies of different origins in the head and neck are rare and potentially dangerous injuries, which might pose problems for their detection, primary care, and final treatment. Depending on the severity of the underlying trauma, some injuries present a higher risk for the presence of foreign bodies. Minor wounds, including common lacerations, are likely to be contaminated with loose gravel debris or dental fragments, and need to be distinguished from severe wounds caused by impalement, shootings, stabbings, and explosions. Blast injuries resulting from terror attacks are challenging recent therapeutic concepts. Even though these injury patterns are uncommon, they carry the risk of impacted objects with dramatic consequences. Despite improving medical imaging techniques, detection remains a challenge as it is dependent on the material of the foreign body, the affected anatomical site, and the injury severity. Therefore, a detailed history of the circumstances leading to trauma is essential when foreign objects are not visible during clinical examination. Precise detection of the foreign body, its anatomical position, and the affected surrounding structures are vital, especially for impalement injuries of the head and neck area. Therefore, an interdisciplinary planning approach is essential prior to removal of the foreign object. Finally, tension-free anatomical adaptation of the corresponding structures is crucial for maintaining and restoring aesthetic and function. Here, we give an overview of the diagnosis and treatment of cases of foreign body injuries encountered in our department.

The Implications of Physical Injury on Otovestibular and Cognitive Symptomatology following Blast Exposure

Objective

Identify a potential difference in the spectrum of otovestibular and cognitive symptoms in blast-exposed patients comparing individuals with or without significant extremity injuries.

Study Design

Case series with chart review.

Setting

A military tertiary care medical center.

Subjects and Methods

All new patient referrals for otovestibular evaluation after a blast injury or exposure were identified in the electronic medical record. One hundred consecutive patients meeting these criteria were studied. Data including presence of severe extremity injuries, diagnosis of mild traumatic brain injury, symptoms of imbalance, vertigo, headache, tympanic membrane perforation, hearing loss, and tinnitus were collected and analyzed.

Results

Of 100 patients included, 38 suffered severe extremity injuries. Those patients with severe extremity injuries were more likely to suffer from tympanic membrane perforations (58% vs 23%, P < .001, odds ratio [OR], 4.71, 95% confidence interval [CI], 1.96-11.33) and hearing loss (53% vs 23%, P = .002, OR, 3.81, 95% CI, 1.59-9.11). However, those without severe extremity injuries were more likely to suffer from imbalance (79% vs 32%, P < .001, OR, 8.17, 95% CI, 3.26-20.44) and vertigo (47% vs 2%, P < .001, OR, 32.52, 95% CI, 4.19-252.07) and more likely to have been diagnosed with a mild traumatic brain injury following blast exposure (66% vs 26%, P < .001, OR, 5.47, 95% CI, 2.24-13.36).

Conclusion

Blast-exposed individuals who sustained severe extremity injuries reported significantly fewer cognitive and vestibular symptoms. In the aftermath of a blast, those who can walk away may have still sustained a significant injury. Specifically, they may suffer more long-term cognitive and vestibular symptoms than those with severe physical injuries.