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Gokharman FD, Kadirhan O, Celik Aydin O, Yalcin AG, Kosar P, Aydin S. A Comprehensive Look at Maxillofacial Traumas: On the Basis of Orbital Involvement. Diagnostics (Basel) 2023; 13:3429. [PMID: 37998566 PMCID: PMC10670346 DOI: 10.3390/diagnostics13223429] [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: 09/17/2023] [Revised: 10/28/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION Orbital wall fractures that may develop in maxillofacial traumas (MFTs) may cause ophthalmic complications (OCs). The aim of this study is to determine the frequency of orbital fractures (OFs) accompanying MFTs and findings suspicious for orbital traumatic involvement. MATERIALS AND METHODS Computed tomography (CT) images of 887 patients who presented to the emergency department within a 1-year period with a history of MFT were retrospectively scanned. During the examination, patients with orbital wall fractures, craniofacial bone fractures, and posttraumatic soft tissue changes were recorded. RESULTS OF was observed in 47 (5.3%) of the patients admitted for MFT. In cases with OFs, accompanying nasal (25.5%), ethmoid (2.1%), frontal (19.1%), maxillary (38%), and zygomatic bone fracture (10.6%), sphenoid (4.3%), and soft tissue damage (55.3%) were observed. It was observed that the pathologies mentioned at these levels were significantly higher than in patients without orbital involvement (p < 0.05). In our study, mild (48.9%) and moderate-severe (2.12-4.25%) OCs accompanying OFs were observed after MFT. CONCLUSIONS The frequency of MFT varies depending on various factors, and such studies are needed to take preventive measures. Knowing the risk and frequency of orbital damage accompanying MFTs may help reduce complications by allowing rapid and accurate diagnosis.
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Affiliation(s)
- Fatma Dilek Gokharman
- Department of Radiology, SBU Ankara Education and Research Hospital, Ankara 06660, Turkey; (A.G.Y.); (P.K.)
| | - Ozlem Kadirhan
- Department of Radiology, Erzincan University, Erzincan 24100, Turkey; (O.K.); (S.A.)
| | - Ozlem Celik Aydin
- Department of Pharmacology, Erzincan University, Erzincan 24100, Turkey;
| | - Arzu Gulsah Yalcin
- Department of Radiology, SBU Ankara Education and Research Hospital, Ankara 06660, Turkey; (A.G.Y.); (P.K.)
| | - Pınar Kosar
- Department of Radiology, SBU Ankara Education and Research Hospital, Ankara 06660, Turkey; (A.G.Y.); (P.K.)
| | - Sonay Aydin
- Department of Radiology, Erzincan University, Erzincan 24100, Turkey; (O.K.); (S.A.)
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Nikunj A, Ingole SN, Kazi NN, Kujur S, Deshpande MD, Ranadive PA. A Changing Trend in Pattern of Maxillofacial Trauma in Mumbai: A Prospective Study. Indian J Dent Res 2023; 34:387-390. [PMID: 38739817 DOI: 10.4103/ijdr.ijdr_731_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 09/22/2023] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Maxillofacial skeleton is the most vulnerable site for trauma due to its prominence. The aim of our study was to analyse the cause and pattern of maxillofacial injuries & to correlate the aetiology and pattern of facial injury. MATERIALS AND METHODS This prospective study includes 304 patients with facial trauma, who reported to our institute within a time span of 2 years. Data were collected on basis of sociodemographic status plus additional data obtained on type of injury, aetiology, location and status of the victim. RESULT The most frequent cause of maxillofacial trauma (MFT) was fall (43.3%) followed by RTA (34.2%) and assault (15.1%). In upper 3rd face region frontal bone fracture was prevalent with 1.3%, while in the midface, zygomatic complex (ZMC) fracture (3.9%) and in lower 3rd part of face, mandible fracture (42.8%) and dentoalveolar fracture (30.2%). Mandible was the most prevalent site for trauma. Although fall was the main aetiological factor in our study, midfacial injuries were mainly due to assault and RTA. Combination of mandibular fracture and soft tissue injury were mainly seen in RTA and injury due to fall. Conservative management was mainly employed for treatment with 46.1% followed by ORIF with 36.2%. CONCLUSION Changing trend in aetiology of MFT was noted. Furthermore, study should be conducted for better understanding, and to carry out preventive measure for the same.
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Affiliation(s)
- Anand Nikunj
- Department of Oral and Maxillofacial Surgery, Government Dental College, Raipur, Chhattisgarh, India
| | - Snehal N Ingole
- Department of Oral and Maxillofacial Surgery, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Noaman N Kazi
- Department of Oral and Maxillofacial Surgery, M A Rangoonwala College of Dental Science and Research Centre, Pune, Maharashtra, India
| | - Shirish Kujur
- Department of Periodontics, Government Dental College, Raipur, Chhattisgarh, India
| | - Mohan D Deshpande
- Department of Oral and Maxillofacial Surgery, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Pallavi A Ranadive
- Department of Oral and Maxillofacial Surgery, Nair Hospital Dental College, Mumbai, Maharashtra, India
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Sneha A, Pendem S, Krishnan M, Dhasarathan P, Aravindan V. Impacted Mandibular Fracture: A Report of a Rare Case. Cureus 2023; 15:e38999. [PMID: 37323316 PMCID: PMC10262923 DOI: 10.7759/cureus.38999] [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: 05/13/2023] [Indexed: 06/17/2023] Open
Abstract
Representing unusual fracture patterns is extremely important to understand. A 27-year-old male patient with a known history of a road traffic accident with sustained injury reported to the Department of Oral and Maxillofacial Surgery in Saveetha Dental College with pain in the left and right lower jaw region of three days duration. The patient provided a history of frontal impact in the symphysis region after a fall from a two-wheel vehicle. Clinical examination revealed a laceration of 2 cm in the chin region with bilateral pre-auricular swelling and trismus with an anterior open bite. The computed tomography scan revealed a bilateral dicapitular condyle fracture with an oblique impacted fracture of the symphysis with a displaced inferior border and left lingual cortical displacement. Apart from this, an incomplete fracture was evidenced, extending along the inferior border to the right body of the mandible. The fracture site was exposed through the laceration. The impacted mandibular fracture segments were mobilized and fixation was done using a 2 mm five-hole plate at the lower border across the sagittally split segment after placement of maxillomandibular fixation with an arch bar at the alveolar border as a part of tension banding. The oblique lingual fracture was reduced and fixed with a 2 x 14 mm bicortical screw. The primary objective of the current case report is to elucidate an unusual fracture of the mandible and discuss the management of such impacted mandibular fractures.
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Affiliation(s)
- Alladi Sneha
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Chennai, IND
| | - Sneha Pendem
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Chennai, IND
| | - Murugesan Krishnan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Chennai, IND
| | - Pradeep Dhasarathan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Chennai, IND
| | - Vedha Aravindan
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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Balla SC, Jha KN, Ramanujam S, Srikanth K, Rajalakshmi AR. Maxillofacial trauma and ocular injuries: reports from a prospective study from Pondicherry, India. Orbit 2021; 41:457-463. [PMID: 34253120 DOI: 10.1080/01676830.2021.1939727] [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: 10/20/2022]
Abstract
PURPOSE To report the spectrum and the factors affecting the visual outcome of ocular injuries associated with maxillofacial trauma. METHODOLOGY A prospective observational study was carried out from January 2019 to June 2020 on patients of maxillofacial trauma at a rural tertiary care centre, in Pondicherry, India. Detailed history was obtained. Investigations including imaging was done as indicated. Predictors of eye injuries and prognostic factors for vision were assessed. RESULTS A total of 135 eyes of 126 patients were evaluated. Males constituted 92.06%. Road traffic accident (RTA), domestic injuries, assault, and work-place-related injuries accounted for 86.5%, 4.7%, 2.3%, and 2.3%. Alcohol consumption (42.06%) and lack of eye protective device (94.4%) and injury to posterior segment were the major risk factors. On presentation 80.6% had visual acuity ≥ 6/12. Orbital and maxillofacial fractures were noted in 70.6% of cases. Closed-globe injury was seen in 83 (61.4%) and open-globe injury in 2 (1.4%). Majority (86.7%) suffered soft tissue injuries. Common sight-threatening injuries were traumatic optic neuropathy (4.4%), vitreous haemorrhage (0.7%), retrobulbar haemorrhage (0.7%), and commotio retinae (0.7%). CONCLUSION Most of the injuries in this population occurred from RTA, with associated fractures, adnexal and globe injuries. Alcohol consumption and lack of eye protective device were the major risk factors. Patients with open-globe injuries and injuries with posterior segment involvement had poor visual outcome.
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Affiliation(s)
- Shravya Choudhary Balla
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV), Deemed-to-beUniversity, Pondicherry, IndiabeUniversity, Pondicherry, India
| | - Kirti Nath Jha
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV), Deemed-to-beUniversity, Pondicherry, IndiabeUniversity, Pondicherry, India
| | - Sathyanarayanan Ramanujam
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV), Deemed-to-beUniversity, Pondicherry, IndiabeUniversity, Pondicherry, India
| | - Krishnagopal Srikanth
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV), Deemed-to-beUniversity, Pondicherry, IndiabeUniversity, Pondicherry, India
| | - Adithyapuram Ramachandran Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV), Deemed-to-beUniversity, Pondicherry, IndiabeUniversity, Pondicherry, India
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Rajaran JR, Nazimi AJ. Bilateral isolated mylohyoid groove fracture progressing as submandibular abscess: an usual fracture pattern of mandible. BMJ Case Rep 2021; 14:14/3/e239542. [PMID: 33731407 PMCID: PMC7978104 DOI: 10.1136/bcr-2020-239542] [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: 11/03/2022] Open
Abstract
The mylohyoid ridges or lines are pairs of anatomical bony structures located on the internal or lingual surface of mandible. They are the origin for the mylohyoid muscle. These bony structures are distinct in the mandibular molar region, well protected and gradually become undiscernible towards anterior mandible. Bilateral, isolated fracture of the mylohyoid ridges without concomitant mandibular fracture is rare and, to the best of the authors knowledge, was never previously described. This case report describes an isolated bilateral mylohyoid groove fracture, where one side of a necrotic bone fragment at the fracture site progress to became a nidus of infection, which later caused submandibular space abscess requiring emergency surgical intervention. Diagnosis, possible theory to explain the occurrence of isolated mylohyoid groove fracture and management of these condition are explained in this report.
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Affiliation(s)
- Jothi Raamahlingam Rajaran
- Department of Oral and Maxillofacial Surgery, Fakulti Pergigian, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - A J Nazimi
- Department of Oral and Maxillofacial Surgery, Fakulti Pergigian, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Colsoul N, Marin C, Corbeels K, Kerckhofs G, Van der Schueren B, Vandamme K. Alteration of the Condylar Oral Bone in Obese and Gastric Bypass Mice. Calcif Tissue Int 2020; 107:371-380. [PMID: 32740692 PMCID: PMC7497324 DOI: 10.1007/s00223-020-00732-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/17/2020] [Indexed: 01/22/2023]
Abstract
Obesity is the main cause of type 2 diabetes mellitus (T2DM). Roux-en-Y gastric bypass (RYGB) surgery is an effective treatment for this obesity-related health problem. However, the adverse effects of T2DM on bone tissue persist or even aggravate after this surgical procedure. As studies on the mandibular condyle bone are scarce, the aim of the present study was to assess its compositional characteristics in T2DM and RYGB conditions. Thirty-two male C57BL/6 mice at 8 weeks of age were randomly assigned to receive either a high-fat or low-fat diet. After 14 weeks of high-fat diet intake, seven obese mice were subjected to RYGB surgery. All animals were euthanized at the age of 30 weeks. Mandibular bones were removed and the trabecular condyle region was assessed using Raman spectroscopy. A decreased mineralization was observed for both T2DM and RYGB condyle bones when compared to controls, with elevated carbonate substitutions for the RYGB group. No compositional differences in crystallinity and presence of advanced glycation end products were found between the groups, with the exception of an increased presence of N-carboxymethyl-lysine in RYGB bone compared to their T2DM counterpart. Site-specific measurements revealed a non-uniform bone composition, with increasing mineralization and carbonate substitutions towards the centre of the mandibular condyle. T2DM and RYGB surgery affect the mandibular condyle bone quality, as investigated at compositional level. Assessment of bone structural properties and remodelling should be carried out to further explore the effects of T2DM and RYGB surgery on this skeleton area.
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Affiliation(s)
- Nicolas Colsoul
- Biomaterials - BIOMAT, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Carlos Marin
- Biomaterials - BIOMAT, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
- Prometheus - Division of Skeletal Tissue Engineering Leuven, KU Leuven, Leuven, Belgium
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium
| | - Katrien Corbeels
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Greet Kerckhofs
- Prometheus - Division of Skeletal Tissue Engineering Leuven, KU Leuven, Leuven, Belgium
- Department of Material Science and Engineering, KU Leuven, Leuven, Belgium
- Biomechanics Lab, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
- Institute for Experimental and Clinical Research, UClouvain, Woluwe, Belgium
| | - Bart Van der Schueren
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Katleen Vandamme
- Biomaterials - BIOMAT, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.
- Prometheus - Division of Skeletal Tissue Engineering Leuven, KU Leuven, Leuven, Belgium.
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Abstract
BACKGROUND The purpose of this study was to review the different types of maxillary fractures and highlight their diagnostic and therapeutic differences. METHODS A retrospective chart review of patients who sustained maxillary fractures was conducted through the Einstein Healthcare Network during the years 2016-2017. Descriptive statistics and chi-square analysis were used to categorize continuous and categorical variables, respectively. RESULTS The cohort of patients (n = 141) were predominately African American (62%) and male (75%) with a mean age 45.3 years. The most common maxillary fracture was maxillary sinus (29%), followed by zygomaticomaxillary complex (ZMC) (26%), frontal process (20%), dentoalveolar (16%), and LeFort (9%). Dentoalveolar fractures were mostly evaluated by the oral maxillofacial surgery service (74%), while ZMC and LeFort fractures were more commonly referred to an otolaryngologist (56% and 67%, respectively). Patients with dentoalveolar fractures were more likely to undergo wire splinting (61%). All patients with frontal process and maxillary sinus fractures were managed non-operatively. Most patients with ZMC fractures were managed non-operatively (78%) while the remainder underwent open reduction internal fixation (ORIF) (22%). Patients with LeFort fractures more commonly underwent maxillomandibular fixation (MMF)/ORIF (83%). Dentoalveolar fractures were the most likely to be operated on the same day (93%) while ZMC and LeFort fractures were repaired within 1 week (88% and 100%, respectively). CONCLUSION Maxillary trauma is very heterogenous in comparison to other maxillofacial trauma patterns. Each fracture type is treated uniquely and can involve one or more provider teams depending on the extent and severity of the injury, as well as hospital resources.
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