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Craniomaxillofacial Trauma & Reconstruction

Yash Avashia, Peter Bittar, Visakha Suresh, David B Powers
Self-induced masticatory trauma is an unfortunate complication of a variety of neurologic disorders, including epileptic seizures, cerebral palsy, mental retardation, psychiatric disease, and brain trauma, in addition to other described etiologies. While single or occasional occurrences of tongue biting are relatively benign, recurrent self-injury can pose major issues and predispose a patient to chronic, severe complications. To prevent the complications associated with ongoing trauma to the tongue, steps must be taken to protect individuals from chronic self-injurious behavior...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Samuel Helman, Sameep Kadakia, Ashley Guthrie, Moustafa Mourad, Grigoriy Mashkevich
Nasoseptal perforations can be a challenging defect for the reconstructive surgeon, with repair limited by the surrounding tissue availability and the defect size. In patients with a history of cocaine use, often the integrity of surrounding vasculature is questionable and large defects may not be well suited for local reconstruction. In the otolaryngology literature, several reconstructive options using local tissue and synthetic materials have been described, but there have been no reports of microvascular free flaps utilized in this regard...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Yifan Guo, Joseph Lopez, Robin Yang, Alexandra Macmillan, Amir H Dorafshar
Facial skeletal reconstruction of patients with severe Treacher Collins syndrome (TCS) requires correction of both midface and mandibular deficiencies. Implementing virtual surgical planning can provide an accurate three-dimensional analysis of craniofacial abnormalities, creating calvarial donors that match the anatomy of the desired malar augmentation and facilitating bimaxillary movements, positioning, and fixation in orthognathic surgery. We present a case of an 18-year-old patient with TCS, who underwent staged zygomaticomaxillary reconstruction and double-jaw osteotomy with sliding genioplasty, using computer-assisted surgical planning...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Jaime Castro-Núñez, Trent Clifton, Joseph Van Sickels
Orbital blow-out fractures are very common. Goals of surgical treatment are to reestablish form and function with excellent cosmetic results. Materials used for orbital floor repair include autologous grafts and a variety of alloplastic materials. In this article, we present a case of subacute granulation tissue of the fornix that developed as a foreign body reaction 4 months after placing a resorbable implant to repair an orbital floor fracture. The implant was removed and the patient continued to heal uneventfully...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Leyre Margallo, Estibaliz Ortiz de Zárate, Maria Franco, Maria Garcia-Iruretagoyena, Rosa Cherro, Luis Barbier, Josu Mendiola, Thomas Constantinescu
The mortality associated with high-energy trauma has several time peaks and variable prognosis. In the particular case of isolated head and neck trauma, management initially includes stabilizing the patient, especially the airway and circulation, and then proceeding to treat injured structures with debridement and often fracture fixation and coverage. We present a case of a male patient who suffered a severe facial trauma at his workplace. He underwent an initial uneventful emergency surgery for control of bleeding and mandibular osteosynthesis...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Felipe Ladeira Pereira, Luísa de Marilac de Alencar Pinheiro, Phelype Maia Araújo, Letícia Liana Chihara, Renato Luiz Maia Nogueira, Eduardo Sant'Ana
Facial asymmetry, following early childhood condylar trauma, is a common complaint among patients who seek surgical treatment. G.D.M., a 27-year-old male patient, sought professional help to correct his cosmetic flaw, caused by a condylar fracture when he was 8-years-old. After the proper orthodontic treatment, he underwent a double jaw orthognathic surgery and, 9 months later, a second one to correct the remaining asymmetry. Two years after this second procedure, the patient is still under surveillance and has no complaints...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Virendra Singh, Neeraj Kumar, Amrish Bhagol, Neha Jajodia
The aim of the study is to evaluate closed and open treatment in the management of unilateral displaced mandibular subcondylar fractures. Twenty patients with unilateral subcondylar fractures of the mandible were evaluated with degree of displacement of more than 20 degrees and ramal height shortening of more than 10 mm. They were informed of the need for 6-month follow-up. Patients were thoroughly informed, explaining the possible advantages and disadvantages of the open and closed treatment options. Radiographic parameters included the level of fracture, deviation of fragment, and ramal height shortening...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Balasubramanian Krishnan, Ravi Philip Rajkumar
The aim of this article is to identify the prevalence of posttraumatic psychological symptoms following maxillofacial trauma among an Indian population sample and assess changes in these symptoms over a period of time. Forty-eight adult patients were assessed within 2 weeks of injury with two follow-up visits (4-6 weeks and 12-14 weeks). Patients were administered three self-reporting questionnaires in local language (GHQ-12; HADS; TSQ) on all occasions. Relevant sociodemographic and clinical data were obtained...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Marwa El Kassaby, Khaled Abd El Kader, Nahed Khamis, Alaa Al Hammoud, Alaa Ben Talb, Yasser Nabil El Hadidi
Distraction osteogenesis (DO) bone regenerate usually suffers from an inferior quality especially with rapid rate. This study was conducted to investigate the effect of mesenchymal stem cells (MSCs) application on different rates of distraction bone quality. Twenty-four goats were divided into group A with standard DO and group B with rapid distraction osteogenesis (RDO) both aided by MSCs. Group C with standard DO and group (D) with RDO were controls. Kruskal-Wallis test and Conover's post hoc analysis was used to evaluate significance ( p  = 0...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Venkatesh Anehosur, Abhijit Joshi, Saravanan Rajendiran
Management of condylar fractures is a highly controversial and debatable area. Open reduction and internal fixation (ORIF) using an extraoral approach has certain benefits over the nonsurgical treatment. Risk of damage to the facial nerve and an extraoral scar remains constant deterrents. An endoscopic-assisted ORIF offers an intraoral approach, thus eliminating consequences such as scarring. Though this technique offers unparalleled advantages, it is associated with a steep learning curve. Surgical results improve only with patience and experience...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Jan Oliver Voss, Nadine Thieme, Christian Doll, Stefan Hartwig, Nicolai Adolphs, Max Heiland, Jan-Dirk Raguse
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...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Babak Alinasab, Karl-Johan Borstedt, Rebecka Rudström, Michael Ryott, Abdul Rashid Qureshi, Pär Stjärne
To clarify the conflicting recommendations for care of blowout fracture (BOF), a prospective randomized study is required. Here, we present a prospective randomized pilot study on BOF. This article aimed to evaluate which computed tomography (CT) findings predict late functional and/or cosmetic symptoms in BOF patients with ≥ 1.0 mL herniation of orbital content into maxillary and/or ethmoidal sinuses. It also aimed to evaluate which patients with BOF would benefit from surgical treatment or observational follow-up...
September 2018: 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
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