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Le Fort Fractures

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https://www.readbyqxmd.com/read/29753777/surgically-assisted-rapid-palatal-expansion-in-class-iii-malocclusion-our-experience
#1
A Barrabé, C Meyer, H Bonomi, Weber Elise, N Sigaux, A Louvrier
INTRODUCTION: Maxillary transverse deficiency (MTD) is a common facial disharmony that may need surgical assisted rapid palatal expansion (SARPE). The aim of this study was to present our SARPE technique and to report about our experience. MATERIEL AND METHOD: Medical records of all class III patients who underwent SARPE in our department from 2010 to 2015 and for whom a follow-up of at least 1 year was available, were included in a retrospective study. The technic consisted, after short orthodontic preparation allowing for divergence of the upper central incisors, in a complete Le Fort I osteotomy without down fracture, and medial sagittal submucosal separation of the hard palate under general anesthesia in an inpatient procedure...
May 10, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29628302/separation-patterns-of-orbital-wall-and-risk-of-optic-canal-injury-in-le-fort-3-osteotomy
#2
Niyazi Aizezi, Tomohisa Nagasao, Tadaaki Morotomi, Motoki Tamai, Koji Imajo
PURPOSE: The authors hypothesized that the risks of optic canal injury in down-fracturing after Le Fort 3 osteotomy vary depending on the separation patterns of the orbital walls. This study verifies this hypothesis using biomechanical simulation. METHODS: Ten finite-element skull models were produced using computer tomography data from ten persons. These models were modified to simulate Le Fort 3 osteotomy models by removing junctions between the neurocranium and facial cranium...
May 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29561482/improving-postoperative-nasal-airway-patency-in-le-fort-based-maxillofacial-trauma-patients-via-a-modified-nasal-packing-technique
#3
Amir Wolff, Gabriel F Santiago, Micah Belzberg, Omri Emodi, Chad R Gordon
INTRODUCTION: Combined mid-face and nasal apparatus trauma injuries pose a significant challenge to airway patency (AW), in the immediate postoperative setting following fracture reduction. As such, the authors describe a modified technique with the goal of maintaining a patent nasal AW, while at the same time, minimizing nasopharyngeal bleeding and nasal AW edema-which can complicate patients requiring intermaxillary fixation (IMF) in the setting of pan-facial trauma. METHODS: A modified technique was devised to assist the reconstruction surgeon in avoiding the risks associated with tracheostomy placement...
March 20, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29481518/juvenile-nasopharyngeal-angiofibroma-with-sphenoid-sinus-invasion-and-protrusion-treatment-approach-with-le-fort-i-osteotomy
#4
Claiton Heitz, Alexandre Weber, Leandro Dini, Guilherme Pivatto Louzada, Eduardo Lombardo
Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumor that occurs predominantly in young males. The authors report the case of a 22-year-old male patient who presented with a painless, exophytic tumor mass protruding through the right nostril, with anterior lateral extension associated with severe posterior involvement, erosion of the sphenoid bone to the right of the pterygoid process, and significant epistaxis. The preoperative evaluation, surgical approach, postoperative results, and a review of the literature are presented...
February 23, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29402514/dynamic-analysis-of-maxillary-perfusion-during-le-fort-i-osteotomy-using-indocyanine-green
#5
S Salman, T Fattahi, R Fernandes, B Steinberg
The aim of this study was to evaluate the dynamic perfusion of the maxilla during various stages of a Le Fort I osteotomy using indocyanine green (ICG) dye angiography. This was a retrospective evaluation of patients who underwent a Le Fort I osteotomy. ICG was used to assess perfusion at specific time points during the procedure. Twenty-four patients underwent a Le Fort I osteotomy with dynamic perfusion ICG angiography. Statistically significant differences in perfusion were noted at all three locations assessed between preoperative (T0), post down-fracture (T1), and postoperative (T2) time points...
February 2, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29320322/multidetector-ct-of-midfacial-fractures-classification-systems-principles-of-reduction-and-common-complications
#6
David Dreizin, Arthur J Nam, Silviu C Diaconu, Mark P Bernstein, Uttam K Bodanapally, Felipe Munera
The advent of titanium hardware, which provides firm three-dimensional positional control, and the exquisite bone detail afforded by multidetector computed tomography (CT) have spurred the evolution of subunit-specific midfacial fracture management principles. The structural, diagnostic, and therapeutic complexity of the individual midfacial subunits, including the nose, the naso-orbito-ethmoidal region, the internal orbits, the zygomaticomaxillary complex, and the maxillary occlusion-bearing segment, are not adequately reflected in the Le Fort classification system, which provides only a general framework and has become less relevant in contemporary practice...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29304328/use-of-intraoperative-computed-tomography-in-craniomaxillofacial-trauma-surgery
#7
Karl Cuddy, Baber Khatib, R Bryan Bell, Allen Cheng, Ashish Patel, Melissa Amundson, Eric J Dierks
PURPOSE: The use of technology to aid in assessment, planning, and management of complex craniomaxillofacial injuries is increasingly common. Preoperative computed tomography (CT) evaluation is considered the standard of care, and intraoperative imaging is becoming increasingly accessible. Limited data exist regarding the implication of intraoperative CT on decision making in the management of all sites of facial fractures. The purposes of this study were to characterize the use of an intraoperative CT scanner for craniomaxillofacial surgery within our institution, to quantify the effect of intraoperative CT on surgical decision making, and to attempt to provide guidance on when to use this technology...
December 13, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29291388/how-do-le-fort-type-fractures-present-in-a-pediatric-cohort
#8
Alexandra Macmillan, Joseph Lopez, J D Luck, Muhammad Faateh, Paul Manson, Amir H Dorafshar
PURPOSE: Le Fort-type fractures are very rare in children, and there is a paucity of literature presenting their frequency and characteristics. The purpose of this study was to determine the etiology, frequency, and fracture patterns of children with severe facial trauma associated with pterygoid plate fractures in a pediatric cohort. PATIENTS AND METHODS: We performed a retrospective cohort study of all children aged younger than 16 years with pterygoid plate and facial fractures who presented to our institute between 1990 and 2010...
December 8, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29177168/le-fort-fractures-a-collective-review
#9
REVIEW
Bradley J Phillips, Lauren M Turco
Le Fort fractures constitute a pattern of complex facial injury that occurs secondary to blunt facial trauma.  The most common mechanisms of injury for these fractures, which are frequently associated with drug and alcohol use, include motor vehicle collisions, assault, and falls. A thorough search of the world's literature following PRISMA guidelines was conducted through PubMed and EBSCO databases. Search terms included "Le Fort fracture", "facial", "craniofacial", and "intracranial...
October 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29108846/predictors-of-pediatric-blunt-cerebrovascular-injury
#10
Avery C Rossidis, Sasha J Tharakan, Sourav K Bose, Karuna V Shekdar, Michael L Nance, Thane A Blinman
BACKGROUND/PURPOSE: Blunt cerebrovascular injury (BCVI) is clinically challenging because these injuries are hard to detect and can have serious neurological consequences, and optimal screening criteria have not been established for children. This study aims to determine risk factors for BCVI in pediatric patients and to evaluate screening practices in a single institutional series. METHODS: A retrospective review of all pediatric blunt trauma patients evaluated over a 10-year period was performed...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28913295/management-of-le-fort-i-fracture
#11
REVIEW
Hak Su Kim, Seong Eun Kim, Hyun Tae Lee
Among the classification of maxillary fracture, the Le Fort classification is the best-known categorization. Le Fort (1901) completed experiments that determined the maxilla areas of structural weakness which he designated as the "lines of weakness". According to these results, there are three basic fracture line patterns (transverse, pyramidal and craniofacial disjunction). A transverse fracture is a Le Fort I fracture that is above the level of the apices of the maxillary teeth section, including the entire alveolar process of the maxilla, vault of the palate and inferior ends of the pterygoid processes in a single block from the upper craniofacial skeleton...
March 2017: Archives of craniofacial surgery
https://www.readbyqxmd.com/read/28812415/quality-of-life-after-orbito-facial-trauma
#12
Gitanjali Sharma, Apjit Kaur
In the wake of high incidence of orbito-facial trauma, there has been a growing need to assess not only the visual outcome, but also the psychological impact of the traumatic event. This is a single questionnaire based evaluation of 100 consecutive patients with orbito-facial trauma (blow-out and Le fort type II and III fractures) at six months of trauma. 84% of the patients had a NEI VFQ- 25 score of less than 50, with 49% having a score less than 25, reflecting the grim impact the trauma has on the quality of life...
December 2017: Orbit
https://www.readbyqxmd.com/read/28705063/postoperative-ct-of-the-midfacial-skeleton-after-trauma-review-of-normal-appearances-and-common-complications
#13
REVIEW
Michael J Reiter, Ryan B Schwope, Jared M Theler
OBJECTIVE: The objective of this article is to describe the CT appearance of the midfacial skeleton after surgical repair of posttraumatic Le Fort, nasoorbitoethmoidal (NOE), and frontal sinus fractures. Several of the more commonly encountered complications will also be described. CONCLUSION: Surgery after midfacial trauma is aimed at restoring both form and function. Knowledge of the principal tenets of Le Fort, NOE, and frontal sinus fracture repair is vital for radiologists to accurately assess the adequacy of treatment on postoperative CT and provide meaningful reports for the surgeon...
October 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28663775/a-single-center-review-of-palatal-fractures-etiology-patterns-concomitant-injuries-and-management
#14
Ian C Hoppe, Jordan N Halsey, Frank S Ciminello, Edward S Lee, Mark S Granick
Introduction: Palatal fractures are frequently associated with facial trauma and Le Fort fractures. The complex anatomy of the midfacial skeleton makes diagnosing and treating these injuries a challenge. The goal of this study was to report our experience with the presentation, concomitant injuries, and management of palatal fractures at a level I trauma center in an urban environment. Methods: Data were collected for all palatal fractures diagnosed between January 2000 and December 2012 at the University Hospital in Newark, NJ...
2017: Eplasty
https://www.readbyqxmd.com/read/28642192/applications-of-3d-orbital-computer-assisted-surgery-cas
#15
P Scolozzi
INTRODUCTION: The purpose of the present report is to describe the indications for use of 3D orbital computer-assisted surgery (CAS). PATIENTS AND METHODS: We analyzed the clinical and radiological data of all patients with orbital deformities treated using intra-operative navigation and CAD/CAM techniques at the Hôpitaux Universitaires de Genève, Switzerland, between 2009 and 2016. We recorded age and gender, orbital deformity, technical and surgical procedure and postoperative complications...
September 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28642189/how-to-produce-pre-shaped-rigid-arch-bars-using-low-cost-3d-printing-technology%C3%A2-%C3%A2-a-technical-note
#16
C Druelle, S Touzet-Roumazeille, G Raoul, J Ferri, R Nicot
Numerous oral and maxillofacial procedures in dentate patients begin with the fixation of occlusions. While several techniques exist to perform mandibulo-maxillary fixation, many surgeons use arch bars in common practice. In cases of severe craniofacial traumas or jaw malformations, such as temporomandibular joint ankylosis, it may be impossible to use rigid arch bars. This technical note reports on the development of a technique to produce pre-shaped rigid arch bars using 3D printing technology. We take the case of a patient who presents Le Fort 1, Le Fort 2 and Le Fort 3 fractures as well as a central palatine disjunction, an angular mandibular fracture and bilateral zygomatic fractures...
September 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28493922/comparison-of-the-long-term-clinical-performance-of-a-biodegradable-and-a-titanium-fixation-system-in-maxillofacial-surgery-a-multicenter-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
B Gareb, N B van Bakelen, G J Buijs, J Jansma, J G A M de Visscher, Th J M Hoppenreijs, J E Bergsma, B van Minnen, B Stegenga, R R M Bos
BACKGROUND: Biodegradable fixation systems could reduce or eliminate problems associated with titanium removal of implants in a second operation. AIM: The aim of this study was to compare the long-term (i.e. >5 years postoperatively) clinical performance of a titanium and a biodegradable system in oral and maxillofacial surgery. MATERIALS AND METHODS: The present multicenter Randomized Controlled Trial (RCT) was performed in four hospitals in the Netherlands...
2017: PloS One
https://www.readbyqxmd.com/read/28488465/surgical-management-of-lower-limb-fractures-in-patients-with-spinal-cord-injury-less-associated-with-complications-than-non-operative-management-a-retrospective-series-of-cases
#18
Alban Fouasson-Chailloux, Raphael Gross, Marc Dauty, Guillaume Gadbled, Sophie Touchais, Marc Le Fort, Brigitte Perrouin-Verbe
OBJECTIVES: To evaluate the difference in terms of overall complications between surgical and non-surgical management of lower limb fractures in patients with chronic spinal cord injury (SCI). DESIGN: A 13-year retrospective study including patients with chronic spinal cord lesion admitted for sublesional lower limb fractures. SETTING: University hospital SCI reference departments (Rehabilitation department and orthopedic department). PARTICIPANTS: Forty patients with SCI were included, 24 men and 16 women...
May 10, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28399616/orthodontic-surgical-treatment-and-respiratory-function-rhinomanometric-assessment
#19
Guido Galbiati, Cinzia Maspero, Lucia Giannini, Guia C Guenza, Federica Zanoni, Giampietro Farronato
BACKGROUND: Several correlations between morphological and/or positional alterations of the jaws and respiratory functional impairments have been reported. Nasal airway obstruction represents a critical issue with no clearly defined gold standard as for its measurement. Rhinomanometry was adopted by multiple Authors to evaluate whether patients with malocclusion developed respiratory functional changes after an orthodontic-surgical treatment. However, there are contrasting findings in the literature regarding the possibility of improving the respiratory function by means of surgically-assisted rapid palatal expansion (SARPE) or bimaxillary repositioning of the bony bases...
June 2017: Minerva Stomatologica
https://www.readbyqxmd.com/read/28392948/advanced-implant-prosthetic-rehabilitation-how-to-obtain-a-correct-restoration-of-both-functions-and-aesthetics-in-patients-with-complex-combined-dental-and-maxillofacial-trauma-a-case-report-and-topical-review-of-the-literature
#20
M M Figliuzzi, A Giudice, L Fortunato
Aim. This study aims to explain the main steps that characterize the implant-prosthetic rehabilitation in complex combined dental and maxillofacial trauma. Material and Methods. A 20-year-old patient reported an extensive facial trauma which also involved the alveolar process of the maxillary bone. The patient reported a maxillofacial fracture and the loss of teeth 1.3, 1.2, 1.1, and 2.1. A "Le Fort" type 2 fracture was also reported, with the malar bone involvement. After reduction and containment of bone fractures, through appropriate mounting plates, appropriate functional and aesthetic rehabilitation of the patient were replaced thanks to a temporary removable prosthesis...
2017: Case Reports in Dentistry
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