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Craniofacial fractures

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https://www.readbyqxmd.com/read/29325790/how-do-oral-and-maxillofacial-surgeons-manage-concussion
#1
D Hammond, R Welbury, G Sammons, E Toman, M Harland, S Rice
Craniofacial trauma results in distracting injuries that are easy to see, and as oral and maxillofacial surgeons (OMFS) we gravitate towards injuries that can be seen and are treatable surgically. However, we do tend not to involve ourselves (and may potentially overlook) injuries that are not obvious either visually or radiographically, and concussion is one such. We reviewed the records of 500 consecutive patients who presented with facial fractures at the Queen Elizabeth Hospital, Birmingham, to identify whether patients had been screened for concussion, and how they had been managed...
January 8, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29306766/clinical-management-of-traumatic-superior-orbital-fissure-and-orbital-apex-syndromes
#2
Hai Jin, Shun Gong, Kaiwei Han, Junyu Wang, Liquan Lv, Yan Dong, Danfeng Zhang, Lijun Hou
OBJECTIVES: Both traumatic orbital apex syndrome (OAS) and traumatic superior orbital fissure syndrome (SFOS) are rare conditions after craniofacial injury. Few types of researches investigate the difference in clinical characteristics and outcome between them. We describe clinical features and cranial nerves functional recovery of traumatic OAS or SOFS and to discuss surgical decompression of these patients. PATIENTS AND METHODS: A retrospective study was performed of 15 patients diagnosed with traumatic OAS and 39 patients with traumatic SOFS from July 2010 to July 2017 in our hospital...
December 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29304328/use-of-intraoperative-computed-tomography-in-craniomaxillofacial-trauma-surgery
#3
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/29251712/prediction-of-traumatic-carotid-cavernous-sinus-fistula-via-non-contrast-ct-by-fracture-pattern-and-abnormality-of-venous-system
#4
Shih-Hsuan Mao, Tzu-Chin Lin, Chih-Hao Chen, Pang-Yun Chou, Shang-Yu Wang, Yon-Cheong Wong, Chien-Tzung Chen
BACKGROUND: Traumatic carotid-cavernous sinus fistula (tCCF) is infrequent but with high morbidity if delayed diagnosed or managed. Due to the lack of screening criteria and requirement of advanced and invasive radiological examinations, diagnosis is often delayed or underdiagnosed. METHODS: A matched case-control study with univariate and multivariate analysis was conducted to predict tCCFs. Forty-six patients diagnosed with tCCFs were included and matched with 138 patients of craniofacial trauma without tCCF as control at a ratio of 1:3...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29234230/traumatic-eye-ball-luxation-a-stepwise-approach-to-globe-salvage
#5
Himika Gupta, Srivalli Natarajan, Sushrut Vaidya, Shipra Gupta, Dinesh Shah, Raj Merchant, Shrikant Deshpande
Craniofacial trauma is often associated with orbital and ocular injuries. We report a case of a 21-year-old male with motor vehicular accident, orbital roof blow-in fracture, cerebrospinal fluid (CSF) leak, and left sided globe luxation with corneal abrasion and complete conjunctival denuding. The patient was managed by a multispeciality team and the eyeball was protected by amniotic membrane graft (AMG) biological dressing with novel use of inverted sterile metallic bowl as mechanical protection till the patient stabilized...
October 2017: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/29177168/le-fort-fractures-a-collective-review
#6
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."  Articles were selected based on relevance and examined regarding etiology, epidemiology, diagnosis, treatment, complications, and outcomes in adults...
October 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29170837/post-traumatic-carotid-cavernous-fistula-in-a-pediatric-patient-a-case-based-literature-review
#7
Barbara Albuquerque Morais, Vitor Nagai Yamaki, Jose Guilherme Mendes Pereira Caldas, Wellingson Silva Paiva, Hamilton Matushita, Manoel Jacobsen Teixeira
BACKGROUND: Carotid-cavernous fistula (CCF) is a shunt between the carotid artery and the cavernous sinus. Traumatic CCFs are diagnosed in 0.2% of head traumas being only 4.6% of the pediatric population. Classified by Barrow in 1985, type A CCF is the most frequent, occurring in 75% of cases. Type A is characterized by direct and high-flow CCF that generally can occur as a result of traumatic injury or rupture of an intracavernous aneurysm. CASE PRESENTATION: The subject was an 8-year-old boy with penetrating trauma to his left eye...
November 23, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29137056/optic-nerve-injury-associated-blunt-cerebrovascular-injury-three-case-reports
#8
Dan-Dong Li, Liu-Xun Hu, Linyuan Sima, Shang-Yu Xu, Jian Lin, Nu Zhang, Bo Yin
RATIONALE: Blunt cerebrovascular injury (BCVI) is a rare complication that may occur after craniocervical trauma. The current literature is limited to extracranial carotid artery injuries; however, no reports have been published on blunt intracranial carotid injury (BICI), especially those associated with optic nerve injury. PATIENT CONCERNS: Here we report on 3 BICI cases that demonstrated optic nerve injuries after craniofacial injuries. All 3 patients showed post-trauma vision loss on the injured side...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049140/metopism-a-study-of-the-persistent-metopic-suture
#9
Matthew J Zdilla, Michelle L Russell, Aaron W Koons, Kaitlyn N Bliss, Kelsey R Mangus
Metopism, the persistence of the metopic suture in adulthood, is a clinically significant radiographic finding. In addition to masquerading as a fracture of the frontal bone, a persistent metopic suture may be associated with other clinically significant anatomical variations including frontal sinus abnormalities. Several geographically and craniofacially distinct populations have yet to be assessed for the prevalence of metopism. This study aimed to determine the prevalence of metopic sutures in adult crania of diverse populations among which scant research exists...
October 18, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29030173/a-novel-miniature-wireless-neurostimulator-in-the-management-of-chronic-craniofacial-pain-preliminary-results-from-a-prospective-pilot-study
#10
Richard L Weiner, Carlos Montes Garcia, Niek Vanquathem
OBJECTIVE: To report a novel wireless neuromodulation system for treatment of refractory craniofacial pain. BACKGROUND: Previous studies utilizing peripheral nerve stimulation (PNS) of the occipital and trigeminal nerves reported positive outcomes for alleviating neuropathic pain localized to the craniofacial and occipital areas. However several technological limitations and cosmetic concerns inhibited a more widespread acceptance and use of neuromodulation. Also, a relatively high incidence of adverse events like electrode erosions, dislocation, wire fracture and/or infection at the surgical site mandates a change in our approach to neuromodulation technology and implant techniques in the craniofacial region...
October 10, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29022055/illness-perceptions-are-associated-with-quality-of-life-in-patients-with-fibrous-dysplasia
#11
B C J Majoor, C D Andela, C R Quispel, M Rotman, P D S Dijkstra, N A T Hamdy, A A Kaptein, N M Appelman-Dijkstra
Fibrous dysplasia (FD) is a rare bone disorder in which normal bone is replaced by fibrous tissue resulting in pain, deformities, pathological fractures or asymptomatic disease. Illness perceptions are patients' cognitions and emotions about their illness and its treatment, which may impact on Quality of Life (QoL). Here, we explore illness perceptions in patients with FD compared to other disorders, identify factors associated with illness perceptions and evaluate their relationship with QoL. Ninety-seven out of 138 eligible patients from the LUMC FD cohort completed the Illness Perception Questionnaire-Revised (IPQ-R) and the Short Form-36 (SF-36)...
October 11, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28971234/a-novel-dominant-col11a1-mutation-in-a-child-with-stickler-syndrome-type-ii-is-associated-with-recurrent-fractures
#12
M G Vogiatzi, D Li, L Tian, J P Garifallou, C E Kim, H Hakonarson, M A Levine
This case describes a child with blindness, recurrent low-impact fractures, low bone mass, and intermittent joint pain who was found to have a novel missense mutation in COL11A1, consistent with Stickler syndrome type II. The case illustrates the phenotypic variability of the syndrome, which may include increased fragility in childhood. INTRODUCTION: Stickler syndrome type II is an autosomal dominant disorder caused by mutations in the gene that encodes the type XI collagen chain α1 (COL11A1)...
October 3, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28967188/bioactive-nano-fibrous-scaffold-for-vascularized-craniofacial-bone-regeneration
#13
Rahul Damodaran Prabha, David Christian Evar Kraft, Linda Harkness, Birte Melsen, Harikrishna Varma, Prabha D Nair, Jorgen Kjems, Mousthapha Kassem
There has been a growing demand for bone grafts for correction of bone defects in complicated fractures or tumors in the craniofacial region. Soft flexible membrane like material that could be inserted into defect by less invasive approaches; promote osteoconductivity and act as a barrier to soft tissue in growth while promoting bone formation is an attractive option for this region. Electrospinning has recently emerged as one of the most promising techniques for fabrication of extracellular matrix (ECM) like nano-fibrous scaffolds that can serve as a template for bone formation...
October 2, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28941602/clinical-and-experimental-aspects-of-notch-receptor-signaling-hajdu-cheney-syndrome-and-related-disorders
#14
Ernesto Canalis
BACKGROUND: There are four Notch transmembrane receptors that determine the fate and function of cells. Notch is activated following its interactions with ligands of the Jagged and Delta-like families that lead to the cleavage and release of the Notch intracellular domain (NICD); this translocates to the nucleus to induce the transcription of Notch target genes. Genetic disorders of loss- and gain-of-NOTCH function present with severe clinical manifestations. BASIC PROCEDURES: In this article, current knowledge of Hajdu Cheney Syndrome (HCS) and related disorders is reviewed...
August 24, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28941510/issues-in-pediatric-craniofacial-trauma
#15
REVIEW
Srinivasa R Chandra, Karen S Zemplenyi
Pediatric maxillofacial fractures are rare owing to anatomic differences between juvenile and adult skulls. Children's bone is less calcified, allowing for "greenstick fractures." The overall ratio of cranial to facial volume decreases with age. In children, tooth buds comprise the majority of mandibular volume. The most common pediatric craniomaxillofacial fractures for children ages 0 to 18 years old are mandible, nasal bone, and maxilla and zygoma. Growth potential must be considered when addressing pediatric trauma and often a less-is-more approach is best when considering open versus closed treatment...
November 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28941505/advances-in-the-reconstruction-of-orbital-fractures
#16
REVIEW
Scott E Bevans, Kris S Moe
Orbital reconstruction is one of the most challenging tasks for surgeons who treat craniofacial trauma. Suboptimal outcomes carry a high level of morbidity, with functional, emotional, and aesthetic implications. However, advances in reconstruction techniques, including the use of orbital endoscopy, computer-guided navigation, and mirror image overlay techniques, have been shown to provide significant improvements in outcomes. This article provides practical advice for applying these techniques to orbital reconstruction following trauma...
November 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28913762/the-role-of-computed-tomography-ct-in-predicting-diplopia-in-orbital-blowout-fractures-bofs
#17
Michaela Cellina, Chiara Floridi, Marta Panzeri, Oliva Giancarlo
PURPOSE: The management of orbital blowout fractures (BOFs) is controversial: the evaluation of diplopia is the most important criterion for planning whether to undertake surgery. Our aim was to determine CT findings that may suggest the presence of diplopia when patients with BOFs cannot be adequately examined to plan an orbital repair. METHOD AND MATERIALS: We retrospectively evaluated CT of all patients presented to our Emergency Department for blunt craniofacial trauma (N = 3334) from January 2014 to March 2016, selecting patients with CT-demonstrated BOFs...
September 14, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28913295/management-of-le-fort-i-fracture
#18
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/28906368/traumatic-fractures-as-a-result-of-falls-in-children-and-adolescents-a-retrospective-observational-study
#19
Hongwei Wang, Hailong Yu, Yue Zhou, Changqing Li, Jun Liu, Lan Ou, Yiwen Zhao, Guoli Song, Jianda Han, Yu Chen, Liangbi Xiang
The aim of this study is to investigate the incidence and pattern of traumatic fractures (TFs) as a result of falls in a population of children and adolescents (≤18 years old) in China.This was a cross-sectional study. We retrospectively reviewed 1412 patients who were children and adolescents with TFs as a result of falls admitted to our university-affiliated hospitals in China from 2001 to 2010. Etiologies included high fall (height ≥2) and low fall (height <2 m). The incidence and pattern were summarized with respect to different age groups, year of admission, etiologies, genders, and the neurological function...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28857992/solitary-frontal-sinus-fractures-compared-to-multiple-facial-fractures-energy-impact-dependency
#20
Efi Weitman, Dekel Shilo, Omri Emodi, Adi Rachmiel
Frontal sinus fractures account for 2% to 15% of maxillofacial injuries. Up to 66% to 87% of the patients with frontal sinus fractures experience associated facial fractures. The majority of classifications used today categorize frontal sinus fractures depending on the integrity of the anterior table, posterior table, and the nasofrontal outflow. A retrospective study was performed, which included 24 patients diagnosed with frontal sinus fractures. Treatment in all patients consisted of open reduction and bone fixation...
October 2017: Journal of Craniofacial Surgery
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