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Wang Z, Chen D. Impact of different fracture types in the pyriform buttress area on nasal airway function. Eur Arch Otorhinolaryngol 2024; 281:1301-1306. [PMID: 37863857 PMCID: PMC10857949 DOI: 10.1007/s00405-023-08290-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/10/2023] [Indexed: 10/22/2023]
Abstract
INTRODUCTION Fractures in the pyriform buttress area adversely affect facial appearance and nasal airway patency. Nasal airway function has received less attention than aesthetic problems in the literature. This retrospective study classified the different fracture types in this area and determined their impact on nasal airway function. MATHODS Three-dimensional computed tomography images of patients with fractures in the pyriform buttress area were analyzed to identify the exact fracture pattern. The nasal airway functions were evaluated and compared between patients with different fracture patterns using acoustic rhinometry, rhinomanometry, and the nasal obstruction symptom evaluation scale. RESULTS Overall, 47 patients, including 16 with type I fractures (high fracture line; group I), 16 with type II fractures (intermediate fracture line; group II), and 15 with type III fractures (low fracture line; group III), were included in the study. The mean minimal cross-sectional area (MCA), total nasal inspiratory resistance (Tri) and total nasal expiratory resistance (Tre) of group I were 0.51 ± 0.06 cm2, 1.67 ± 0.11 kPa L-1 s-1, and 1.66 ± 0.12 kPa L-1 s-1, respectively; those of group II were 0.48 ± 0.07 cm2, 1.89 ± 0.15 kPa L-1 s-1, and 1.88 ± 0.14 kPa L-1 s-1, respectively; and those of group III were 0.36 ± 0.04 cm2, 1.94 ± 0.21 kPa L-1 s-1, and 2.01 ± 0.34 kPa L-1 s-1, respectively. The nasal obstruction symptom evaluation (NOSE) scale scores for groups I, II, and III were 7.188, 9.813, and 13.27, respectively. CONCLUSION Therefore, the severity of the nasal airway obstruction depends on the displacement of the fractured bones in patients with fractures in the pyriform buttress area. The most profound nasal obstruction occurs in patients with the lowest fracture line.
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Affiliation(s)
- Zhongying Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases, Shanghai, China
| | - Dong Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases, Shanghai, China.
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Kapoor S, Gupta A, Bansal P, Sharma SD, Gupta H, Srivastava R. Clinical Outcomes of ULTRA EZY Bar vs Erich Arch Bar in Conservative Management of Maxillofacial Fractures: A Randomized Controlled Trial. J Maxillofac Oral Surg 2024; 23:122-128. [PMID: 38312966 PMCID: PMC10831013 DOI: 10.1007/s12663-022-01821-3] [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: 02/26/2021] [Accepted: 11/06/2022] [Indexed: 12/23/2022] Open
Abstract
Objective Various techniques have been employed from time to time to achieve maxillomandibular fixation, and arch bars provide an effective and versatile means of maxillomandibular fixation, and however, some of the issues occurring with it have been eliminated with the introduction of Ultralock EZY bar. The aim of the present study is to compare the advantages and disadvantages of Ultralock Ezy bar over the Erich arch bar in mid-face fracture or maxillary fracture or mandibular fracture or both requiring conservative treatment. Materials and Methods A total of 20 patients reported to the Department of Oral and Maxillofacial Surgery in Sudha Rustagi Dental College and Hospital, Faridabad, with mid-face fracture/maxillary fracture, mandibular fracture or both. The treatment plan required intermaxillary fixation. As a part of treatment plan, group was selected randomly divided into 20 arches in each group that is test arch group and control arch group.Test arch group included arches in which Ultralock EZY bar was done. Control arch group included arches in which Erich arch bar was done. The parameters compared in both the groups were surgical time taken, injuries due to wires, arch bar stability, oral hygiene index, patient acceptance and comfort, pulp vitality, and complication (if any). Results The average surgical time taken was less, and oral hygiene status and patient acceptance were better in test group. There was not much statistically significant difference in pulp vitality but number of cases with absence of pulp vitality were more in test group. Conclusion This study emphasizes the use of Ultralock Ezy bar as a quick and easy method than Erich arch bar. Oral hygiene maintenance was comparatively better in patients with Ultralock Ezy bar than those with Erich arch bar. For the patients who require long-term IMF, Ultralock Ezy bars can be a viable option. Supplementary Information The online version contains supplementary material available at 10.1007/s12663-022-01821-3.
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Affiliation(s)
- Shivangini Kapoor
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana India
| | - Ashish Gupta
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana India
| | - Pankaj Bansal
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana India
| | - Sneha D. Sharma
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana India
| | - Himani Gupta
- Department of Oral and Maxillofacial Surgery Sudha Rustagi College of Dental Sciences, Faridabad, Haryana India
| | - Rachit Srivastava
- Department of Oral and Maxillofacial Surgery Sudha Rustagi College of Dental Sciences, Faridabad, Haryana India
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Pham TD, Holmes SB, Coulthard P. A review on artificial intelligence for the diagnosis of fractures in facial trauma imaging. Front Artif Intell 2024; 6:1278529. [PMID: 38249794 PMCID: PMC10797131 DOI: 10.3389/frai.2023.1278529] [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: 08/16/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Patients with facial trauma may suffer from injuries such as broken bones, bleeding, swelling, bruising, lacerations, burns, and deformity in the face. Common causes of facial-bone fractures are the results of road accidents, violence, and sports injuries. Surgery is needed if the trauma patient would be deprived of normal functioning or subject to facial deformity based on findings from radiology. Although the image reading by radiologists is useful for evaluating suspected facial fractures, there are certain challenges in human-based diagnostics. Artificial intelligence (AI) is making a quantum leap in radiology, producing significant improvements of reports and workflows. Here, an updated literature review is presented on the impact of AI in facial trauma with a special reference to fracture detection in radiology. The purpose is to gain insights into the current development and demand for future research in facial trauma. This review also discusses limitations to be overcome and current important issues for investigation in order to make AI applications to the trauma more effective and realistic in practical settings. The publications selected for review were based on their clinical significance, journal metrics, and journal indexing.
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Affiliation(s)
- Tuan D. Pham
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Thomas AB, Pawar SS. Approaches to the Maxillofacial Skeleton: Application of Standard and Minimally Invasive Techniques. Otolaryngol Clin North Am 2023; 56:1079-1088. [PMID: 37353367 DOI: 10.1016/j.otc.2023.05.003] [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] [Indexed: 06/25/2023]
Abstract
Management of maxillofacial trauma is complex and challenging and requires a clear understanding of facial anatomy and function. There are multiple approaches that can be used to access each anatomical region, each with specific indications and complication profiles. Open, "invasive" approaches are being replaced or augmented with minimally invasive and endoscopic approaches when possible. Thorough knowledge of indications, surgical techniques, and potential complications allows surgeons to make appropriate decisions for access and repair of fractures. This article is a comprehensive review of standard and minimally invasive approaches, with description of techniques and pros and cons for their use.
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Affiliation(s)
- Abigail B Thomas
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
| | - Sachin S Pawar
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, 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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Amran AJ, Rizqiawan A, Mulyawan I, Prasetio O, Subagio EW, Rahman MZ. Quality of Life Evaluation of Postsurgical Mandibular Fracture Patients with Oral Health Impact Profile 14 and General Oral Health Assessment Index Parameters. Eur J Dent 2023; 17:1309-1315. [PMID: 36977476 PMCID: PMC10756817 DOI: 10.1055/s-0043-1761450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE Mandibular fracture is the most common maxillofacial fracture accompanied by complaints of malocclusion and pain. This causes a decrease in the quality of life. Mandibular fracture management can be done with open reduction and internal fixation or intermaxillary fixation. The Oral Health Impact Profile (OHIP 14) and the General Oral Health Assessment Index (GOHAI) were used to evaluate the quality of life after surgical treatment based on the distribution of age, sex, type of neglect, and surgical management. MATERIALS AND METHODS This research is an analytic study with an analytical observational method with total sampling. The total sample used was 15 patients during the 2006 to 2020 period. The results of this study were scored, and then, the data were processed using the eta test. RESULTS The results of the study based on the OHIP 14 parameters showed the results of each distribution, namely, age: p = 0.154, gender: p = 0.080, neglected type: p = 0.080, and management: p = 0.419. Meanwhile, the GOHAI parameters showed the results of each distribution, namely, age: p = 0.105, gender: p = 0.356, neglected type: p = 0.356, and management p = 0.286. The results of this distribution showed that there was no significant difference between patients' quality of life based on age, sex, neglected type, and treatment using both OHIP 14 and GOHAI parameters. CONCLUSIONS The results obtained in this study using characteristics of age, gender, type of fracture, type of neglect, and management did not have a significant effect on the level of patient satisfaction after surgery, using both OHIP 14 and GOHAI questionnaires.
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Affiliation(s)
- Ardian Jayakusuma Amran
- Postgraduate Program, Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Muslim Indonesia, Indonesia
| | - Andra Rizqiawan
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Oral and Maxillofacial Surgery Dental Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - Indra Mulyawan
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Oral and Maxillofacial Surgery Dental Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - Okky Prasetio
- Department of Oral and Maxillofacial Surgery, M. Soewandhie Hospital, Surabaya, Indonesia
| | - Eko Wicaksono Subagio
- Postgraduate Program, Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Mohammad Zeshaan Rahman
- Department Oral and Maxillofacial Surgery, Pioneer Dental College and Hospital, Dhaka, Bangladesh
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7
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Goh EZ, Beech N, Johnson NR. E-Scooters and Craniofacial Trauma: A Systematic Review. Craniomaxillofac Trauma Reconstr 2023; 16:245-253. [PMID: 37975032 PMCID: PMC10638976 DOI: 10.1177/19433875221118790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Study Design Systematic review. Objective Standing electric scooters (e-scooters) provide a cheap and environmentally friendly transport alternative, but also elicit substantial concern regarding their volume of associated injuries especially in the craniofacial region. This review aims to explore the demographics, risk factors, types of injury and surgical management of craniofacial trauma associated with e-scooters. Methods PubMed and Scopus databases were systematically searched. Inclusion criteria were clinical studies investigating craniofacial trauma associated with e-scooters. Exclusion criteria were duplicates; non-English publications; non-full-text publications; studies with insufficient data. Results Of the 73 articles identified, 10 eligible articles representing 539 patients were included. The mean age was 31.5 years. Most cases were male (63.7%). Common risk factors were alcohol/drug intoxication, absence of distal extremity injuries and lack of helmet use. The most common mechanism of injury was mechanical falls (72.4%). The most common facial fracture pattern was middle third fractures (58.3%). Surgical management was required for 43.3% of fractures. Other types of injuries reported were traumatic brain injuries (17.6%), soft tissue injuries (58.3%), dental injuries (32.9%) and ophthalmological injuries (20.6%). Conclusions The findings of this review suggest common presentations for craniofacial trauma associated with e-scooters. Robust longitudinal evaluations with standardised descriptions of types of injuries are required. Gaps in knowledge relate to surgical management, post-operative complications and associated risk factors.
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Affiliation(s)
- Elizabeth Z. Goh
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Nicholas Beech
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Nigel R. Johnson
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Oral and Maxillofacial Department, Princess Alexandra Hospital, Brisbane, QLD, Australia
- School of Dentistry, University of Queensland, Brisbane, QLD, Australia
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8
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Shome D, Surana M, Male SR, Kumar V, Vyavahare SS, Abrol A, Kapoor R. Patterns and Trends of Facial Fractures at a Tertiary Care Trauma Center in India - A 13 years Retrospective Study. Craniomaxillofac Trauma Reconstr 2023; 16:112-120. [PMID: 37222983 PMCID: PMC10201195 DOI: 10.1177/19433875221084172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Study Design Retrospective study. Objective The purpose of this study was to retrospectively analyze the prevalence, pattern, diagnosis, and treatment of the facial fractures falling under ambit of facial plastic surgery in a multi-specialty hospital at India from the year 2006-2019. Methods This retrospective study analyzed 1508 patients, having orbital fractures (from 2006 to 2019) for demographic data, cause of trauma, type of fracture, and the treatment given. The data were compiled in excel and analyzed by using SPSS version 21.0. Results Out of these 1508 patient (1127 (74.73%)-males and 381 (25.27%)-females), the etiology of injuries was Road traffic accident (RTA) (49.20%), assault (26.52%), and sports injuries (11.47%). The most common fracture pattern was Isolated Orbit and/or Orbital Floor fracture in 451 patients (32.08%), followed by Mid-facial fractures (21.93%). Also, 105 patients (6.96%) experienced ocular/retinal trauma along with other fractures. Conclusions Orbit, peri-ocular, and mid-face trauma comprised a large position of this study. It requires a great deal of expertise to treat such complex trauma, which is not covered in one specialty alone. Hence, a holistic approach of craniofacial fracture management, rather than limiting these skills to water-tight craniofacial compartments becomes necessary. The study highlights the critical need of multidisciplinary approach for predictable and successful management of such complex cases.
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Affiliation(s)
- Debraj Shome
- Department of Facial Plastic
Surgery & Facial Cosmetic Surgery & Director, The Esthetic Clinics, India
| | - Monika Surana
- Fellow, Facial Plastic Surgery
& Facial Cosmetic Surgery, The Esthetic Clinics, India
| | - Shiva Ram Male
- PhD research scholar, Optometry and
vision sciences, School of Medical sciences, University of Hyderabad, India
| | - Vaibhav Kumar
- Clinical Research Coordinator, The Esthetic Clinics, India
| | - Supriya S. Vyavahare
- Faculty, Late Shri Yashwantrao Chavan Memorial
Medical & Rural Development Foundation’s Dental
College, Ahmednagar, India
| | - Arundha Abrol
- Fellow, Dermatology, Cosmetic
Dermatology & Dermato-Surgery, The Esthetic Clinics, India
| | - Rinky Kapoor
- Department of Dermatology, Cosmetic
Dermatology & Dermato-Surgery & Director, The Esthetic Clinics, India
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Isolated paediatric orbital fractures: a case series and review of management at a major trauma centre in the UK. Oral Maxillofac Surg 2022:10.1007/s10006-022-01056-z. [PMID: 35312892 PMCID: PMC8936037 DOI: 10.1007/s10006-022-01056-z] [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: 01/20/2022] [Accepted: 03/06/2022] [Indexed: 11/08/2022]
Abstract
Purpose Paediatric orbital fractures are rare. Existing literature demonstrates wide variation in estimates of incidence, aetiology, management protocols and outcomes. Despite this, it is generally acknowledged that orbital fractures with entrapment of the extraocular muscles constitute a surgical emergency due to the potential for persistent diplopia secondary to muscle ischaemia and necrosis. Methods This retrospective study was conducted to determine the characteristics and outcomes of management of orbital fractures amongst the paediatric population. It involved patients presenting to a major trauma unit in London between 2010 and 2020. Results Thirteen patients with isolated orbital fractures presented to our unit in this period. The average age was 13 years. Surprisingly the predominant aetiology was interpersonal violence. The most common fracture pattern involved the orbital floor and medial wall. One medial wall fracture case was missed in the emergency department. Eight patients required surgical intervention due to diplopia caused by muscular entrapment of extraocular muscles; the final patient had a large defect resulting in enophthalmos requiring a large titanium plate. A transconjuctival approach was preferred for surgical access and resorbable sheet was used in the remaining cases. Five patients had nausea, vomiting or bradycardia associated with the oculocardiac reflex. Surgical intervention occurred within 24–48 h of injury in 6 cases. Resolution of diplopia occurred in 7 patients within 6 months. Conclusion Paediatric patients with orbital fractures should be assessed on the day of injury by a maxillofacial surgeon. Due to the risk of persistent diplopia, urgent surgical intervention in patients with entrapment of extraocular muscles should occur as soon as possible.
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Singh S, Nyberg EL, O'Sullivan AN, Farris A, Rindone AN, Zhang N, Whitehead EC, Zhou Y, Mihaly E, Achebe CC, Zbijewski W, Grundy W, Garlick D, Jackson ND, Taguchi T, Takawira C, Lopez J, Lopez MJ, Grant MP, Grayson WL. Point-of-care treatment of geometrically complex midfacial critical-sized bone defects with 3D-Printed scaffolds and autologous stromal vascular fraction. Biomaterials 2022; 282:121392. [DOI: 10.1016/j.biomaterials.2022.121392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/07/2022] [Accepted: 01/24/2022] [Indexed: 12/30/2022]
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Nadershah M. Orbital Floor Fracture Repair by Calvarial Graft for An 18-Month-Old Baby Using Piezosurgery. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/m10njbapec] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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12
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Esonu O, Sardesai MG. Initial Assessment of the Facial Trauma Patient. Semin Plast Surg 2021; 35:225-228. [PMID: 34819803 DOI: 10.1055/s-0041-1735817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The initial evaluation of the craniofacial trauma patient must be systematic, thorough, and consistent to ensure that injuries are not missed. Life-threatening conditions are first identified using ATLS principles, and focused head and neck examination conducted by a specialist then follows. Imaging is used to guide operative planning, as many craniofacial injuries ultimately benefit from repair to prevent permanent cosmetic or functional deformity. Peri-operative care is often multi-disciplinary in nature, and specialist consultation should be performed in an efficient fashion. Finally, it should be noted that surgeons operating in the maxillofacial region are at high risk for transmission of COVID-19, and risk of COVID-19 sequelae must be balanced with risks associated with the delay of treatment of craniofacial injury.
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Affiliation(s)
- Onyi Esonu
- Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, Washington
| | - Maya G Sardesai
- Department of Otolaryngology - Head and Neck Surgery, UW School of Medicine, Seattle, Washington
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13
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Sikkerimath BC, Anshu A, Jose A, Jain S. Evaluation of Postoperative Sensory and Motor Deficit Following Craniomaxillofacial Reconstruction Using Bicoronal Flap: An Evaluative Study. Ann Maxillofac Surg 2021; 11:21-26. [PMID: 34522649 PMCID: PMC8407612 DOI: 10.4103/ams.ams_426_20] [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: 12/14/2020] [Revised: 04/08/2021] [Accepted: 04/17/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The ideal surgical approach to treat craniomaxillofacial skeleton should provide maximum exposure of the facial skeleton, ensure less potential for injury to facial structures and allow for good cosmetic result. Several designs have been described such as hemicoronal, preauricular, lateral eyebrow, and bicoronal approach. Although the bicoronal flap gives superior long-term cosmetic results, it has a few disadvantages. We conducted this study to assess neurosensory disturbances and motor deficit following craniomaxillofacial reconstruction using bicoronal flap. Materials and Methods: A prospective study was carried out in the Department of Oral and Maxillofacial Surgery, North Karnataka, India. Forty patients with craniomaxillofacial trauma requiring fixation of fracture or reconstruction were included in the study. Postoperative neurosensory evaluation is carried out at intervals of 1 week, 1 month, 3 months, and 6 months clinically using mechanoreceptive and nociceptive testing. Results: Among 40 cases, 11 (27.5%) had postoperative paraesthesia affecting the supraorbital region; 9 (22.5%) of them had return of normal sensation within 6 months and 2 (5%) patients became normal after one year. Four patients had unilateral frontalis weakness on the right side for a period of 6 months. Discussion: The bicoronal flap is a preferred approach for access to the craniofacial skeleton and orbit with minimal sensory and motor complications. However, before choosing the same, the advantage of raising such a wide flap should be weighted comparing the benefits and complications.
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Affiliation(s)
- B C Sikkerimath
- Department of Oral and Maxillofacial Surgery, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Aditya Anshu
- Department of Oral and Maxillofacial Surgery, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Anu Jose
- Department of Oral and Maxillofacial Surgery, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Saurabh Jain
- Department of Oral and Maxillofacial Surgery, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
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Blankson PK, Amanor EM, Dai-Kosi AD, Amoako E, Konadu AB, Boamah MO, Amoah GK, Parkins GE. Paediatric maxillofacial fractures in Ghana: Pattern, household cost, and distress. Int J Paediatr Dent 2021; 31:613-618. [PMID: 33002267 DOI: 10.1111/ipd.12734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/08/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Maxillofacial fractures in the paediatric population are peculiar in risks, management, and potential complications. AIM To determine the pattern, psychological distress to parents, and economic cost of paediatric maxillofacial fractures in Ghana. DESIGN This study combined a retrospective evaluation with a cross-sectional cost-of-illness (COI) analysis to describe the pattern and economic cost of paediatric maxillofacial fractures in Ghana. The DASS 21 was used to assess psychological distress to parents. Descriptive summaries were generated, and cross-tabulations done, with consequent tests of associations. RESULTS In all, 253 patients were included in the study, with 68 households responding to the COI evaluation. Consisting of 179 (70.8%) males and 74 (29.2%) females, the ages ranged from 10 months to 17 years (mean age of 9.0 ± 5.0 years). Maxillofacial fractures frequently resulted from falls (56.5%), while traffic injuries accounted for 27.3%. The average household cost for paediatric maxillofacial fractures in Ghana was US$ 148.77, with the direct cost component accounting for 76% of this amount. At least half of the parents had some degree of psychological distress from the injury sustained. CONCLUSION Knowledge of the pattern and disease burden of maxillofacial fractures in children is vital in informing preventive strategies, especially for evolving health systems in sub-Saharan Africa.
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Affiliation(s)
- Paa Kwesi Blankson
- Oral and Maxillofacial Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana.,University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Efua M Amanor
- University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred D Dai-Kosi
- University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Emmanuella Amoako
- Department of Child Health, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Akua B Konadu
- Oral and Maxillofacial Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana.,University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Matthew Owusu Boamah
- Oral and Maxillofacial Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana.,University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Gyaami K Amoah
- University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Grace E Parkins
- Oral and Maxillofacial Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana.,University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
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15
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Burlak K, Shukla L, Kavnoudias H, Schoenwaelder M, Morgan D, Ramakrishnan A. Radiological assessment of facial fractures: a comparative study between surgeon and radiologist. ANZ J Surg 2021; 91:962-968. [PMID: 33844452 DOI: 10.1111/ans.16848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/20/2021] [Accepted: 03/21/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The authors aimed to examine the differences in CT facial bone interpretation by the faciomaxillary surgeon and the radiologist, in order to improve communication gaps and subsequently, the quality and consistency of patient care. METHODS This study was conducted at a level I tertiary trauma centre. Patients with facial trauma who were referred to the faciomaxillary unit following a facial CT examination from August 2017 to September 2018 were eligible for inclusion. The inclusion period was extended to 5 years for panfacial trauma patients. All consecutive patients that fulfilled the study inclusion criteria for each type of injury were included in the study (a total of 120 patients assigned to the following six categories: orbits, skull and skull base, zygomaticomaxillary complex, Le Fort pattern, mandible and pan-facial fractures). Faciomaxillary surgeons, blinded to the radiology report, were asked to provide a verbal description of the fractures. The surgical interpretation was compared to the radiology report and further analysed. RESULTS Of the 120 cases, the same fractures were reported in 43 cases (35.8%). Both types of specialists noted the predominant and clinically relevant fractures in 106 cases (88.3%). The reports did not match in 14 cases (11.7%) and different terminology was used in 76 cases (63.3%), with agreement in 25% (95% CI: 18-34%), partial agreement in 11.7% (95% CI: 5.9-17.4%) and no agreement in 63.3% (95% CI: 54.7-72.0%) cases. CONCLUSION Radiologists and faciomaxillary surgeons frequently differ in their assessment of facial fractures.
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Affiliation(s)
- Kateryna Burlak
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Lipi Shukla
- Department of Plastics, Hand and Faciomaxillary surgery, Alfred Hospital, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia
| | - Helen Kavnoudias
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia.,Adjunct Senior Lecturer/Senior Research Fellow, Department of Surgery and Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Mark Schoenwaelder
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
| | - David Morgan
- Department of Plastics, Hand and Faciomaxillary surgery, Alfred Hospital, Melbourne, Victoria, Australia
| | - Anand Ramakrishnan
- Department of Plastics, Hand and Faciomaxillary surgery, Alfred Hospital, Melbourne, Victoria, Australia.,Honorary Senior Fellow, Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
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16
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Mittal G, Agarwal A, Garg R, Sharma S, Rathi A, Kapse P. Efficacy of Microplates versus Miniplates in the Management of Maxillofacial Fractures. Ann Maxillofac Surg 2020; 10:31-36. [PMID: 32855911 PMCID: PMC7433951 DOI: 10.4103/ams.ams_30_20] [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: 01/31/2020] [Revised: 03/16/2020] [Accepted: 03/20/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction: Increased facial trauma has led to advances in techniques of internal fixation, improvements in plating system, refinements in exposure of facial skeleton fueling the rapid use of internal fixation for the management of facial fractures. Evaluating 40 patients with confirmed midfacial (Le Fort I and II) and mandibular fractures, this study presents the efficacy of microplate in comparison with miniplate in terms of load bearing capacity, stability at the fracture site and postoperative palpability. Objectives: To evaluate the efficacy of microplates in comparison with miniplates in maxillofacial trauma. Materials and Methods: Study sample consists 40 subjects, 20 each in two groups clinically and radiographically diagnosed with Group 1 (maxillary) and Group 2 (mandibular fractures) which were subdivided into 10 each treated with miniplate and microplate respectively. Postoperatively, stability of fracture, bite force, need for postop MMF, pain, infection, wound dehiscence, mouth opening, occlusion and palpability was noted. All cases have been evaluated clinically for various parameters for minimum of 3 months to assess any postoperative complications. Results: We found microplates are stable enough and have adequate load bearing capacity. Due to close adaptability and less hardware, postoperative palpability is less but larger sample study with long term follow up is necessary to conclude its efficacy in load bearing fracture sites.
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Affiliation(s)
- Gaurav Mittal
- Department of Oral and Maxillofacial Surgery, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Anmol Agarwal
- Department of Oral and Maxillofacial Surgery, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Ritesh Garg
- Department of Oral and Maxillofacial Surgery, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Siddharth Sharma
- Department of Oral and Maxillofacial Surgery, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Abhishek Rathi
- Department of Oral and Maxillofacial Surgery, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Pooja Kapse
- Department of Oral and Maxillofacial Surgery, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
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Meng X, Wen Q, Gu J, Wang Y. Endoscopic endonasal open reduction for fractures of the frontal process of the maxilla. J Int Med Res 2020; 48:300060520920043. [PMID: 32345079 PMCID: PMC7221172 DOI: 10.1177/0300060520920043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/16/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study was performed to evaluate the clinical efficacy of endoscopic endonasal open reduction of fractures of the frontal process of the maxilla (FFPM). METHODS We performed a retrospective study of patients who underwent endoscopic endonasal open reduction of FFPM from December 2013 to October 2018. The preoperative assessment included nasal endoscopy, computed tomography imaging, and three-dimensional craniofacial reconstruction. The clinical results were evaluated with a visual analog scale at 2 days and 1 year postoperatively. RESULTS Thirty-two patients (25 male, 7 female) with an average age of 39 years were included in the study. All patients successfully underwent a surgical operation via the endoscopic endonasal approach with a nasal mucosal incision, and the nasal deformities were corrected. At the 1-year follow-up, six (18.8%) and 26 (81.2%) patients were somewhat satisfied and very satisfied with the aesthetic result, respectively, and five (15.6%) and 27 (84.4%) were somewhat satisfied and very satisfied with the functional result, respectively. CONCLUSION Endoscopic endonasal open reduction can be considered a reliable method for anatomical reduction of FFPM. This technology provides a viable choice for the treatment of FFPM.
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Affiliation(s)
- Xiangming Meng
- Department of Otorhinolaryngology, Wuxi Huishan
District People’s Hospital, Wuxi, P.R. China
| | - Qingbo Wen
- Department of Otorhinolaryngology, Wuxi Huishan
District People’s Hospital, Wuxi, P.R. China
| | - Jianhong Gu
- Department of Otorhinolaryngology, Wuxi Huishan
District People’s Hospital, Wuxi, P.R. China
| | - Yangyang Wang
- Department of Otorhinolaryngology, Wuxi Huishan
District People’s Hospital, Wuxi, P.R. China
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Ramanathan M, Panneerselvam E, Krishna Kumar Raja V. 3D planning in mandibular fractures using CAD/CAM surgical splints — A prospective randomized controlled clinical trial. J Craniomaxillofac Surg 2020; 48:405-412. [DOI: 10.1016/j.jcms.2020.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/18/2020] [Accepted: 02/10/2020] [Indexed: 10/25/2022] Open
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19
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Hassanein AG. Trends and Outcomes of Management of Mandibular Fractures. J Craniofac Surg 2019; 30:1245-1251. [DOI: 10.1097/scs.0000000000005469] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Trauma Airway Management: Induction Agents, Rapid Versus Slower Sequence Intubations, and Special Considerations. Anesthesiol Clin 2018; 37:33-50. [PMID: 30711232 DOI: 10.1016/j.anclin.2018.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Trauma patients who require intubation are at higher risk for aspiration, agitation/combativeness, distorted anatomy, hemodynamic instability, an unstable cervical spine, and complicated injuries. Although rapid-sequence intubation is the most common technique in trauma, slow-sequence intubation may reduce the risk for failed intubation and cardiovascular collapse. Providers often choose plans with which they are most comfortable. However, developing a flexible team-based approach, through recognition of complicating factors in trauma patients, improves airway management success.
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