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Craniomaxillofacial Trauma & Reconstruction

Warren Schubert
No abstract text is available yet for this article.
June 2018: Craniomaxillofacial Trauma & Reconstruction
Paul N Manson
No abstract text is available yet for this article.
June 2018: Craniomaxillofacial Trauma & Reconstruction
Paolo Cariati, Blas Garcia Medina, Pablo Galvez, Almudena Cabello Serrano, Miguel Garcia Martin, Guillermo Valencia Moya
Temporomandibular joint (TMJ) is one of the most used joint of the body. Moreover, it is common knowledge that TMJ may show degenerative changes 10 years earlier than other joints. Recently, the use of arthroscopic surgery is revolutionizing the classic management of TMJ pathologies. In fact, the minimal invasiveness of this procedure allows faster results and fewer complications than other procedures. In this article, we present our arthroscopic technique. In this line, we would like to emphasize that we used this approach in different temporomandibular disorders such as anchored disk syndrome, habitual dislocation of TMJ, and internal derangement...
June 2018: Craniomaxillofacial Trauma & Reconstruction
Naveen B Shivanand, Mihir T Mohan, Shawn T Joseph
Reconstruction of floor of the mouth and ventral surface of the tongue defects can be challenging because inadequate correction can lead to mobility restriction of the tongue and resultant impairment of speech and swallowing. Ideal flap should be pliable, provide adequate bulk, be easy to harvest, and cosmetically acceptable. Commonly used ipsilateral facial artery-based myomucosal flaps may not be ideal if facial vessels need resection. We share our experience in a case of simultaneous primary mucoepidermoid carcinoma of right submandibular and sublingual glands, with a postsurgical defect involving floor of the mouth and ventral surface of the tongue, reconstructed with islanded facial artery myomucosal flap raised from left buccal mucosa and tunneled into the right floor of the mouth defect medial to mandible...
June 2018: Craniomaxillofacial Trauma & Reconstruction
Jaime Castro-Núñez, Jared M Shelton, Susan Snyder, Joseph Van Sickels
Severely atrophic mandible fractures are frequently a challenge to treat. Virtual surgical planning (VSP) uses three-dimensional computed tomographic (CT) scans that can be translated into stereolithographic models to fabricate surgical templates, facilitating intraoperative procedures. The purpose of this article is to describe the reconstruction of two cases of severe atrophic mandible fracture using VSP. Two elderly edentulous/partially dentate patients who presented with fractures of their mandibles and who underwent reconstruction using VSP were included...
June 2018: Craniomaxillofacial Trauma & Reconstruction
Siok Yoong Chin, Nazer Bin Berahim, Khairulzaman Bin Adnan, Sundrarajan Naidu Ramasamy
Temporomandibular joint (TMJ) dislocation is a common occurrence, but diagnosis can be missed if patients do not complain. Delayed presentation complicates the management of a straightforward reduction. We present a case of a 24-year-old man who had bilateral TMJ dislocation of unknown duration after motor vehicle accident. The accident left him bedridden with speech difficulty. He was totally dependent on Ryles' and percutaneous endoscopic gastrotomy tubes for feeding. Computed tomography revealed dislocation of condyles anterior to articular eminences...
June 2018: Craniomaxillofacial Trauma & Reconstruction
Tabishur Rahman
We describe a case of maxillofacial trauma in a pediatric patient in whom the mandibular condyle was superolaterally displaced into the temporal fossa, medial to the zygomatic arch which was intact. In addition, there was an associated mandibular symphyseal fracture. To our knowledge, this case is the first of its kind to be reported in the literature. We also observed a complication in the form of development of ankylosis in the involved joint which required another surgery.
June 2018: Craniomaxillofacial Trauma & Reconstruction
Yoshiki Nariai, Sho Odawara, Tomoko Ichiyama, Jun-Ichi Akutsu, Takahiro Kanno, Joji Sekine
Fracture of the clavicle following radical neck dissection (RND) and/or radiotherapy is a rare complication. Several causes of fracture of the clavicle after treatment of head and neck cancer were postulated in previous reports. We present a case of fracture of the clavicle after treatment of squamous cell carcinoma of the tongue. An 81-year-old Japanese woman underwent RND, subtotal glossectomy, reconstruction using a pectoralis major myocutaneous flap (PMMCF), and postoperative radiotherapy (50.4 Gy). One month after the primary treatment, fracture of the clavicle occurred...
June 2018: Craniomaxillofacial Trauma & Reconstruction
Payam Farzad
The use of virtual surgical planning and computer-aided design/computer-aided manufacturing has previously been reported to enhance the planning for the reconstruction of mandibular continuity defects and to reduce surgical time. Reported is a case of a large keratocystic odontogenic tumor (KOT) affecting right hemimandible including the condylar neck. This case was initially reconstructed with a condyle-bearing reconstruction plate, but because of fatigue fracture 15 years later, a new reconstruction with a custom-made total joint temporomandibular prosthesis was performed...
June 2018: Craniomaxillofacial Trauma & Reconstruction
Josep Rubio-Palau, Alejandra Prieto-Gundin, Leydi Mar de Abreu Graterol, Herman Vercruysse
Congenital maxillomandibular fusion or syngnathia is a rare craniofacial disorder with only 26 cases reported in the literature. We present a case of a congenital complex zygomatico-mandibular syngnathia associated with a palatal cleft, posterior maxilla and turbinate agenesia, mild hemifacial microsomia, and a disordered dental eruption. The patient has the highest age (15 years) at diagnosis described in the literature. 3D planning of the surgery was performed to study the patient's anatomy and design the necessary osteotomies to separate the jaws...
June 2018: Craniomaxillofacial Trauma & Reconstruction
Sanjay Rastogi, Tousif Ahmed, Kolli Giri, Ramakant Dandriyal, Niranjana Prasad Indra B, Ankur Joshi, Shouvik Choudhury, Sunil Mall
The aim of this prospective study was to appraise the role of embrasure wiring in the treatment of mandibular fractures over the arch bar as adjunctive techniques of maxillomandibular fixation (MMF). This study was conducted on 40 patients who were surgically treated for mandibular fractures with accessory use of MMF (embrasure: group A vs. arch bars: group B). All patients were evaluated for demographic data, etiology, and location of fracture. Characteristically, the complications, including wire injury, infection, and malocclusion, were recorded...
June 2018: Craniomaxillofacial Trauma & Reconstruction
Guilherme Dos Santos Trento, Felipe Andrade Pires, Fábio André Dos Santos, Delson João da Costa, Nelson Luis Barbosa Rebellato, Leandro Eduardo Klüppel
This study aimed to compare the biomechanical stability of the fixation of mandibular sagittal split osteotomy of the ramus by two types of titanium miniplates in sheep mandibles. Seven preserved sheep mandibles with similar weight and size were selected, dissected with complete removal of soft-tissue structures, and sectioned in their midline. After performing sagittal split osteotomy, 5 mm of advancement was standardized and samples were divided into two groups according to the type of titanium miniplate (GI = seven hemimandibles were fixed with straight titanium miniplate, GII = seven hemimandibles were fixed with L-shaped titanium miniplates), and then subjected to compressive load...
June 2018: Craniomaxillofacial Trauma & Reconstruction
Robert Nadeau, Kristopher Hasstedt, Ashley Brooke Sunstrum, Chad Wagner, Harold Tu
Prescription opioid medications continue to be abused on an epidemic level and have been shown to be a "gateway" drug to heroin abuse. Individuals experimenting with opioids commonly fall in the 10- to 19-year age range in which dentists are the highest prescribers. To reduce the number of excess opioids, the Department of Oral and Maxillofacial Surgery, University of Minnesota, developed and implemented an evidence-based opioid prescribing policy. Data were collected via electronic health record for the previous year and compared with the year following the protocol implementation...
June 2018: Craniomaxillofacial Trauma & Reconstruction
David Carpenter, Ronnie Shammas, Adam Honeybrook, C Scott Brown, Nikita Chapurin, Charles R Woodard
Obtaining postoperative images of maxillofacial fractures does not affect the clinical management of asymptomatic patients; however, few studies have evaluated the role of postoperative imaging in the context of orbital floor fractures. In this study, we evaluate current practice techniques and the role of postoperative imaging in the management of orbital floor fractures in isolation and with concomitant facial fractures. Retrospective review of patients who underwent open reduction and internal fixation of orbital floor fractures between 2005 and 2015 at a single medical institution...
June 2018: Craniomaxillofacial Trauma & Reconstruction
Manoj Abraham, Arvind Badhey, Shirley Hu, Sameep Kadakia, J K Rasamny, Augustine Moscatello, Yadranko Ducic
Head and neck patients undergoing microvascular reconstruction are at high risk for thromboembolism. While the prevention of thromboembolism has become an essential aspect of care, within the field of microsurgery, concern for anastomotic complications have hindered the creation of an accepted regimen. The aim of this review was to evaluate the risks and benefits of prophylactic agents for thromboprophylaxis. A literature search was conducted in MEDLINE, Cochrane Library, and PubMed/NCBI databases. Articles discussing thromboprophylaxis in otolaryngology, head and neck surgery, or microvascular reconstruction were considered in the review from the past 30 years...
June 2018: Craniomaxillofacial Trauma & Reconstruction
Kristopher M Day, Paul M Phillips, Larry A Sargent
We describe a case of complex, posttraumatic skull and orbital deformities that were evaluated and treated with advanced computer technology, including virtual surgical planning, three-dimensional (3D) modeling, and printed patient custom implants (PCI) fabricated by 3D printing. A 50-year-old man presented to our craniofacial referral center 1 year after failed reduction of complex left orbital, zygomatic, and frontal bone fractures due to a motorcycle collision. The patient's chief complaint was debilitating diplopia in all fields of gaze...
March 2018: Craniomaxillofacial Trauma & Reconstruction
Moustafa Mourad, Jared C Inman, David M Chan, Yadranko Ducic
The objective of this review is to provide an overview on the diagnosis and management of traumatic cerebrospinal fluid (CSF) leaks. This comprehensive review explores controversies associated with the management of CSF leaks as well as a review of the most contemporary literature. The scope of this article covers both traumatic CSF leaks of the middle and anterior cranial fossae.
March 2018: Craniomaxillofacial Trauma & Reconstruction
Nicolas E Sierra, Paula Diaz-Gallardo, Jorge Knörr, Vasco Mascarenhas, Eloy García-Diez, Montserrat Munill-Ferrer, Maria S Bescós-Atín, Francisco Soldado
The free vascularized fibular graft is nowadays the preferred technique for pediatric mandibular reconstruction. Despite the versatility and proven efficacy for restoring the facial appearance and maxillomandibular function, those mandibular reconstructions with free vascularized fibula associate difficulties for a simultaneous restoration of the alveolar height and facial contour, which are derived from the height discrepancy between the fibula and the native mandible. In addition, the donor-site growth and morbidity are of special concern in the pediatric patient...
March 2018: Craniomaxillofacial Trauma & Reconstruction
Gary A Forgach, Stephen P R MacLeod
Ectopic molars within the mandibular ramus/condyle unit, although rare, present a unique challenge to the surgeon. Multiple approaches have been described in the literature for their removal. A review of the English literature on the subject of mandibular ectopic molars and their epidemiology, etiology, indications for removal, and surgical techniques was completed. In addition, a case report is presented of an ectopic mandibular molar in the mid-ramus region which was removed via a minimally invasive, intraoral, technique combining the use of endoscopy and piezoelectric surgery...
March 2018: Craniomaxillofacial Trauma & Reconstruction
Manlio Galiè, Giulia Carnevali, Giovanni Elia, Massimo Pedriali, Luigi C Clauser
Fibrous dysplasia (FD) is a disturbance of the mesenchymal tissue that accounts for 2.5% of all bone tumors and more than 7% of nonmalignant bone tumors. In the craniomaxillofacial region, FD affects the calvaria, skull base, zygoma, and jaws, the prevalent site being the maxilla (50% of cases). Therapy for craniomaxillofacial FD is surgical. The goals of surgery are to prevent functional disorders and restore facial symmetry, volume, and contour. In this article, we present a case of a young female patient affected by right orbital-zygomatic-maxillary FD...
March 2018: Craniomaxillofacial Trauma & Reconstruction
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