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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
Heike Huempfner-Hierl, Andreas Schaller, Thomas Hierl
BACKGROUND: Severe facial trauma is often associated with intracerebral injuries. So it seemed to be of interest to study stress propagation from face to neurocranium after a fistlike impact on the facial skull in a finite element analysis. METHODS: A finite element model of the human skull without mandible consisting of nearly 740,000 tetrahedrons was built. Fistlike impacts on the infraorbital rim, the nasoorbitoethmoid region, and the supraorbital arch were simulated and stress propagations were depicted in a time-dependent display...
2015: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
La-Salete Alves, Irene Aragão, Maria-José Carneiro Sousa, Ernestina Gomes
The incidence of facial trauma is high. This study has the primary objective of documenting and cataloging maxillofacial fractures in polytrauma patients. From a total of 1229 multiple trauma cases treated at the Emergency Room of the Santo Antonio Hospital - Oporto Hospital Center, Portugal, between August 2001 and December 2007, 251 patients had facial wounds and 209 had maxillofacial fractures. Aged ranged form 13 to 86 years. The applied selective method was based on the presence of facial wound with Abbreviated Injury Scale ≥1...
November 2014: Brazilian Dental Journal
Christoph Kunz, Laurent Audigé, Carl-Peter Cornelius, Carlos H Buitrago-Téllez, John Frodel, Randal Rudderman, Joachim Prein
The AOCMF Classification Group developed a hierarchical three-level craniomaxillofacial classification system with increasing level of complexity and details. The highest level 1 system distinguish four major anatomical units including the mandible (code 91), midface (code 92), skull base (code 93), and cranial vault (code 94). This tutorial presents the level 2 system for the midface unit that concentrates on the location of the fractures within defined regions in the central (upper, intermediate, and lower) and lateral (zygoma, pterygoid) midface, as well as the internal orbit and palate...
December 2014: Craniomaxillofacial Trauma & Reconstruction
Jose Rodriguez-Feliz, Karan Mehta, Ash Patel
Nasoorbitoethmoid (NOE) fractures are rare in the pediatric population. A recent study reported that NOE fractures account for 1% to 8% of all pediatric craniofacial fractures based on the National Trauma Data Bank. Although infrequent, NOE fractures must be appropriately identified and treated because of potential severe esthetic and functional complications. In this report, we discuss our experience treating the uncommon case of a 9-year-old girl who was involved in a motor vehicle accident and had traumatic injuries to the midface, including a type 1 NOE fracture...
September 2014: Journal of Craniofacial Surgery
Heike Huempfner-Hierl, Andreas Schaller, Alexander Hemprich, Thomas Hierl
Naso-orbitoethmoid fractures account for 5% of all facial fractures. We used data derived from a white 34-year-old man to make a transient dynamic finite element model, which consisted of about 740 000 elements, to simulate fist-like impacts to this anatomically complex area. Finite element analysis showed a pattern of von Mises stresses beyond the yield criterion of bone that corresponded with fractures commonly seen clinically. Finite element models can be used to simulate injuries to the human skull, and provide information about the pathogenesis of different types of fracture...
November 2014: British Journal of Oral & Maxillofacial Surgery
V Jeevan Prakash, Chitra Chakravarthy, Abdul Hameed Attar
Patients with severe panfacial injuries usually require long-term airway management. Nasal intubation may be contraindicated in case of nasoorbitoethmoidal fractures and also there may be a need for intraoperative and short-term postoperative intermaxillary fixation to achieve optimum reduction of fractures. The need for unobstructed access to the perinasal area during bimaxillary orthognathic procedures is felt many a time and to avoid a tracheostomy with its attending morbidity, many techniques have evolved that involve a submandibular/transmylohyoid or submental approach for temporary oroendotracheal intubation...
June 2014: Journal of International Oral Health: JIOH
Daniel J Meara
Nasal injuries coupled with midface fractures of the orbit and ethmoids constitute a nasoorbitoethmoid (NOE) fracture pattern, which is typically the most challenging facial fracture to repair. Hard and soft tissue defects of this region may require advanced reconstruction techniques, including local rotational flaps, free tissue transfer, and even prosthetics. The restoration of form and function dictates treatment, and the success of primary repair is paramount, because secondary correction is challenging in this area of the midface...
May 2013: Oral and Maxillofacial Surgery Clinics of North America
Reza Mehravaran, Golsa Akbarian, Cyrus Mohammadi Nezhad, Rasool Gheisari, Mehdi Ziaei, Fatemeh Gorji Zadeh
PURPOSE: To evaluate the relation between patterns and numbers of midfacial bone fracture patterns and amaurosis in traumatized patients. MATERIALS AND METHODS: This is a cross-sectional study of traumatized patients with midfacial fractures who presented to Shahid Rajaee and Chamran hospitals (Shiraz, Iran) from 2010 through 2011. The predictor variable was midfacial fractures and the outcome variable was amaurosis. P < .05 was considered statistically significant...
June 2013: Journal of Oral and Maxillofacial Surgery
Tae-Gon Kim, Kyu-Jin Chung, Yong-Ha Kim, Jong-Hyo Lim, Jun-Ho Lee
BACKGROUND: Telecanthus occurs because of the disruption of the medial canthal tendon (MCT). The deformity of medial canthus can result from nasoorbitoethmoid fractures, tumor resection, craniofacial exposure, congenital malposition, or aging. Repair of the MCT using transnasal wiring is regarded as a method of choice to treat telecanthus. We have introduced an oblique transnasal wiring using Y-V epicanthoplasty incision rather than the well-known classical bicoronal approach. METHODS: Eight patients with telecanthus were treated with this method...
February 2014: Annals of Plastic Surgery
Marilyn Nguyen, John C Koshy, Larry H Hollier
Nasoorbitoethmoid fractures account for ∼5% of adult and 15% of pediatric facial fractures. The appropriate management of these injuries requires an understanding of the anatomic features of the region, the classification of injury severity, assessment, and treatment methods. The purpose of this article is to provide a general overview of the topic, with a more specific focus on the pearls of managing these fractures. Prompt and proper management of these injuries can achieve both adequate functional and aesthetic outcomes...
November 2010: Seminars in Plastic Surgery
James Y Liau, Justin Woodlief, John A van Aalst
The pediatric craniofacial trauma literature largely focuses on the management of mandible fractures, with very little information focusing on pediatric midface fractures, specifically nasoorbitethmoid (NOE) fractures. Because the diagnosis and surgical treatment plan for adult NOE fractures is well established in the literature, the treatment algorithms for NOE are essentially a transfer of adult practices to pediatric patients. This article reviews the differences between the pediatric and adult facial skeleton and the pathology and presentation of NOE fractures in the pediatric craniomaxillofacial skeleton...
September 2011: Journal of Craniofacial Surgery
Ayelet Priel, Kanjana Leelapatranurak, Sang-Rog Oh, Bobby S Korn, Don O Kikkawa
BACKGROUND: Medial canthal degloving injury causes a spectrum of damage to the soft tissues of the nasoorbitoethmoid complex. The authors present a case series of medial canthal degloving injuries and discuss clinical findings and treatment options. METHODS: The medical records of nine patients who presented to the University of California, San Diego Ophthalmic Plastic Service with medial canthal degloving injuries between 1999 and 2010 were reviewed retrospectively...
October 2011: Plastic and Reconstructive Surgery
Ergur Ipek, Korman Esin, Kiray Amac, Guvencer Mustafa, Arman Candan
The nasolacrimal canal is placed at the anterior part of the inferior lateral wall of the orbit and opens to the inferior nasal meatus. The canal can be obstructed by acquired diseases such as dacryocystitis and posttraumatic epiphora due to nasoorbitoethmoidal fractures. Furthermore in nasolacrimal canal obstructions, dacryocystorhinostomy with balloon dilatation is used frequently. In evaluation of the nasolacrimal canal's acquired diseases, obstruction etiologies and during the reopening of the canal with balloon dilatation, knowing the lacrimal groove's morphology and morphometry play an important role...
December 2007: Anatomical Science International
Alan S Herford, Thomas Ying, Brandon Brown
PURPOSE: Nasoorbitoethmoid (NOE) fractures are complex and often challenging to repair. Inadequate treatment may result in secondary deformities which are difficult to treat. Severely comminuted fractures require repositioning of the medial canthal tendon. The purpose of this study was to evaluate all results in treating these challenging injuries. The work is to be used as a basis for continuing quality improvement of our surgical technique. PATIENTS AND METHODS: [corrected] Ten consecutive patients who sustained a comminuted NOE (type III) fracture were included in this study...
September 2005: Journal of Oral and Maxillofacial Surgery
D Remmler, A Denny, A Gosain, S Subichin
Successful management of nasoorbitoethmoidal (NOE) fractures requires early diagnosis and accurate determination of the extent of injury. Although the anatomic complexity of the NOE region merits a clear interpretation of the spatial relationships associated with each injury, the role of three-dimensional (3D) computed tomography (CT) in the assessment of these fractures remains unclear. To clarify the diagnostic value of 3D CT, this retrospective analysis compares statistically the accuracy of two-dimensional (2D) CT against 3D CT in the detection of NOE fracture line tracts in 21 consecutive patients with surgically confirmed NOE fractures...
May 2000: Annals of Plastic Surgery
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