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Craniofacial fractures

Roger W Byard, Matthew Cox, Peter Stockham
The body of a 19-year-old male was found apparently concealed underneath bushes with recent head and facial trauma, and multiple superficial abrasions. Subsequently, it was discovered that the decedent had been running into objects and buildings following the ingestion the evening before of what was thought to be lysergic acid diethylamide (LSD). Blood staining of a nearby wall close to where the body was lying was in keeping with the described behavior. Toxicology revealed 3,4-methylenedioxymethamphetamine (Ecstasy), in addition to two only recently available drugs 2-(4-bromo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine, (25B-NBOMe), and 1-(3,4-methylenedioxyphenyl)-2-(1-pyrrolidinyl)-1-butanone, (MDPBP)...
October 10, 2016: Journal of Forensic Sciences
Sven-Olrik Streubel, David M Mirsky
Facial trauma causes significant of morbidity in the United States. With injuries varying widely, the clinical benefits of antibiotics use in facial fracture treatment are not easily determined. The pediatric population is more predisposed to craniofacial trauma secondary to their increased cranial mass to body ratio. All patients with traumatic injury should be assessed according to the Advanced Trauma Life Support protocol. This article discusses the types and prevalence of injuries and approaches to management...
November 2016: Facial Plastic Surgery Clinics of North America
B C J Majoor, N M Appelman-Dijkstra, M A J van de Sande, H M Kroon, N A T Hamdy, P D S Dijkstra
Fibrous dysplasia is a rare genetic bone disorder with a wide variation in clinical expression, ranging from asymptomatic patients to severely affected patients with extensive bone disease, pain, repetitive fractures and deformities and serious endocrinological symptoms (McCune-Albright syndrome). Here, we report on three different cases of fibrous dysplasia. First, a 46-year-old woman with a small solitary lesion in the proximal femur. Second, a 25-year-old man with polyostotic disease of the left leg who received both surgical and medical treatment...
2016: Nederlands Tijdschrift Voor Geneeskunde
Garrett G A Casale, Brian A Fishero, Stephen S Park, Mark Sochor, Sara B Heltzel, J Jared Christophel
Importance: The practice of facial trauma surgery would benefit from a useful quantitative scale that measures the extent of injury. Objective: To develop a facial trauma scale that incorporates only reducible fractures and is able to be reliably communicated to health care professionals. Design and Setting: A cadaveric tissue study was conducted from October 1 to 3, 2014. Ten cadaveric heads were subjected to various degrees of facial trauma by dropping a fixed mass onto each head...
September 29, 2016: JAMA Facial Plastic Surgery
Bas C J Majoor, Natasha M Appelman-Dijkstra, M Fiocco, Michiel A J van de Sande, P D Sander Dijkstra, Neveen A T Hamdy
INTRODUCTION: McCune-Albright syndrome (MAS) is a rare bone disorder characterized by fibrous dysplasia (FD), endocrinopathies and café-au-lait patches. FD patients have been shown to respond favourably to treatment with bisphosphonates, but data are scarce in the more severe polyostotic form (PFD), including MAS, and factors determining treatment outcome are not known, particularly in the long-term. METHODS: We evaluated the biochemical (bone turnover markers; BTMs) and clinical (pain reduction) outcome of bisphosphonate therapy in eleven patients with MAS and 30 patients with PFD: median duration of treatment 6 years (range 2-25)...
September 20, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Paul J Donald
Much of craniofacial trauma involves the frontal sinuses. Because of its response to injury, the frontal sinus mucosa has an innate ability to develop mucoceles, and if infected, mucopyocoeles. This article presents a therapeutic algorithm for all forms of craniofacial trauma with concentration on the most severe injury-the through and through fracture and its surgical remediation.
October 2016: Journal of Neurological Surgery. Part B, Skull Base
Beth A Earhart, Marian E Williams, Irina Zamora, Linda Marie Randolph, Jodie K Votava-Smith, Stephanie N Marcy
Duplication 7q11.23 syndrome is the reciprocal of Williams-Beuren deletion syndrome. Studies have reported a recognizable phenotype, including autism, intellectual disability, speech, and language delay, social anxiety, and behavioral difficulties in these individuals. Previous studies revealed a variety of craniofacial abnormalities, brain malformations, and cardiac abnormalities, including aortic dilation. This patient series evaluates five family members aged 2 months to 35 years, all with confirmed 7q11...
September 12, 2016: American Journal of Medical Genetics. Part A
Sarah J Upson, Simon W Partridge, Ion Tcacencu, David A Fulton, Ian Corbett, Matthew J German, Kenneth W Dalgarno
We synthesised methacrylate-terminated PLGA (HT-PLGA, 85:15 LA:GA, 169kDa), for potential use as an adhesively attached craniomaxillofacial fracture fixation plate. The in vitro degradation of molecular weight, pH and flexural modulus were measured over 6weeks storage in PBS at 37°C, with commercially available high (225kDa, H-PLGA) and low (116kDa, L-PLGA) molecular weight 85:15 PLGAs used as comparators. Molecular weights of the materials reduced over 6weeks, HT-PLGA by 48%, H-PLGA by 23% and L-PLGA by 81%...
December 1, 2016: Materials Science & Engineering. C, Materials for Biological Applications
Rongyao Xu, Zongyun Fu, Xue Liu, Tao Xiao, Ping Zhang, Yifei Du, Hua Yuan, Jie Cheng, Hongbing Jiang
Estrogen-deficient osteoporosis is an aging-related disease with high morbidity that not only significantly increases a woman's risk of fragility fracture but is also associated with tooth and bone loss in the supporting alveolar bone of the jaw. Emerging evidence suggests that the aging of bone marrow stromal cells (BMSCs) contributes to the development of osteoporosis. In this study, we aimed to investigate the role of the special AT-rich sequence-binding protein 2 (SATB2), a stemness and senescence regulator of craniofacial BMSCs, in rat ovariectomy-induced alveolar osteoporosis...
November 2016: Experimental Gerontology
B L Foster, P Kuss, M C Yadav, T N Kolli, S Narisawa, L Lukashova, E Cory, R L Sah, M J Somerman, J L Millán
Loss-of-function mutations in ALPL result in hypophosphatasia (HPP), an inborn error of metabolism that causes defective skeletal and dental mineralization. ALPL encodes tissue-nonspecific alkaline phosphatase, an enzyme expressed in bone, teeth, liver, and kidney that hydrolyzes the mineralization inhibitor inorganic pyrophosphate. As Alpl-null mice die before weaning, we aimed to generate mouse models of late-onset HPP with extended life spans by engineering a floxed Alpl allele, allowing for conditional gene ablation (conditional knockout [cKO]) when crossed with Cre recombinase transgenic mice...
August 31, 2016: Journal of Dental Research
Bruno Zanotti, Nicola Zingaretti, Angela Verlicchi, Massimo Robiony, Alex Alfieri, Pier Camillo Parodi
Cranioplasty remains a difficult procedure for all craniofacial surgeons, particularly when concerning the reconstruction of large lacunae in the skull. Considering the significant clinical and economic impact of the procedure, the search for materials and strategies to provide more comfortable and reliable surgical procedures is one of the most important challenges faced by modern craniofacial medicine.The purpose of this study was to compare the available data regarding the safety and clinical efficacy of materials and techniques currently used for the reconstruction of the skull...
August 19, 2016: Journal of Craniofacial Surgery
Justin A Ledogar, Paul C Dechow, Qian Wang, Poorva H Gharpure, Adam D Gordon, Karen L Baab, Amanda L Smith, Gerhard W Weber, Ian R Grosse, Callum F Ross, Brian G Richmond, Barth W Wright, Craig Byron, Stephen Wroe, David S Strait
The evolution of the modern human (Homo sapiens) cranium is characterized by a reduction in the size of the feeding system, including reductions in the size of the facial skeleton, postcanine teeth, and the muscles involved in biting and chewing. The conventional view hypothesizes that gracilization of the human feeding system is related to a shift toward eating foods that were less mechanically challenging to consume and/or foods that were processed using tools before being ingested. This hypothesis predicts that human feeding systems should not be well-configured to produce forceful bites and that the cranium should be structurally weak...
2016: PeerJ
Waldemar Reich, Alexey Surov, Alexander Walter Eckert
Undiagnosed cervical spine injury can have devastating results. The aim of this study was to analyse patients with primary maxillofacial trauma and a concomitant cervical spine injury. It is hypothetised that cervical spine injury is predictable in maxillofacial surgery. A monocentric clinical study was conducted over a 10-year period to analyse patients with primary maxillofacial and associated cervical spine injuries. Demographic data, mechanism of injury, specific trauma and treatments provided were reviewed...
September 2016: Journal of Cranio-maxillo-facial Surgery
Jeffrey Cranford, Sameep Kadakia, Raja Sawhney, Yadranko Ducic
Subcondylar fractures encompass a large portion of mandible fractures. Owing to their proximity to the temporomandibular joint and difficulty achieving surgical exposure, treatment of these fractures has been challenging and highly debated throughout the literature. While no one modality is the accepted gold standard, there are multiple options for addressing these fractures that can yield satisfying results for both patient and surgeon alike. A thorough literature review was conducted using PubMed, analyzing articles in the past 15 years for relevance to the subject matter...
August 2016: Facial Plastic Surgery: FPS
Achille Tarsitano, Giovanni Badiali, Angelo Pizzigallo, Claudio Marchetti
OBJECTIVE: Enophthalmos is a severe complication of primary reconstruction of orbital floor fractures. The goal of secondary reconstruction procedures is to restore symmetrical globe positions to recover function and aesthetics. The authors propose a new method of orbital floor reconstruction using a mirroring technique and a customized titanium mesh, printed using a direct metal laser-sintering method. METHODS: This reconstructive protocol involves 4 steps: mirroring of the healthy orbit at the affected site, virtual design of a patient-specific orbital floor mesh, CAM procedures for direct laser-sintering of the customized titanium mesh, and surgical insertion of the device...
October 2016: Journal of Craniofacial Surgery
Curtis Hanba, Amar Gupta, Peter F Svider, Adam J Folbe, Jean Anderson Eloy, Giancarlo F Zuliani, Michael A Carron
OBJECTIVES/HYPOTHESIS: As our population ages, injuries attributable to falls continue to increase, impacting healthcare delivery. Evaluation of craniofacial trauma with focus on elderly patients remains an underappreciated concern. Our objectives were to evaluate injury trends associated with elderly bathroom falls, as this information may be useful for counseling and preventive purposes. STUDY DESIGN: Database review. METHODS: The National Electronic Injury Surveillance System was evaluated for craniofacial trauma among patients 60 years and older presenting to the emergency department (ED) (2010-2014)...
July 14, 2016: Laryngoscope
Sanjay Naran, Zoe MacIsaac, Evan Katzel, Michael Bykowski, Sameer Shakir, Jesse Goldstein, Ian M Pollack, Joseph E Losee
BACKGROUND: The pediatric craniofacial skeleton fractures in patterns distinct from those typical in adults; this has implications pertinent to management that may go unrecognized. The authors reviewed multilevel pediatric craniofacial fractures presenting to their institution, surmising that they would display an oblique trajectory of fracture patterns, and would be at increased risk of growing skull fractures (GSFs), compared with adults. METHODS: A retrospective review was performed of pediatric patients presenting with multilevel craniofacial fractures between 2004 and 2010...
September 2016: Journal of Craniofacial Surgery
Jorge Orlando Guerrissi
From 2000 to 2010, 720 patients with facial trauma were admitted in Plastic Surgery Service of Argerich Hospital, Buenos Aires, Argentina; 58 of them with panfacial fractures were included in this study. Height velocity impact is the principal etiology, and most concomitant extrafacial injuries are neurocranium and cervical spine. Common affected areas were orbits, nose, and malar-zygoma. The timing of the treatment was airway evaluation, control of bleeding and consciousness, treatment of associated injuries, and finally facial reconstruction...
July 2016: Journal of Craniofacial Surgery
Guijuan Feng, Ke Zheng, Donghui Song, Senbin Wu, Songsong Zhu, Jing Hu
OBJECTIVE: This work investigated mesenchymal stem cells (MSCs) modified with Runt-related transcription factor 2 (Runx2) therapy for bone regeneration in rabbit mandibular distraction osteogenesis. METHODS: Forty-eight New Zealand mature white rabbits were randomly divided into three groups after the rabbit model of mandibular distraction osteogenesis was established: reconstruction plasmid modified with Runx2 (group A), plasmid without Runx2 (group B), and the same dose of saline as control (group C)...
April 2016: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
Robert M Brody, Nirnimesh C Pandey, Andrés M Bur, Bert W O'Malley, Christopher H Rassekh, Gregory S Weinstein, Ara A Chalian, Jason G Newman, Steven B Cannady
BACKGROUND: The anterolateral thigh (ALT) free flap is one of the most commonly used donor sites in head and neck reconstruction, however, it is not typically considered when an osseous component is needed. METHODS: Soft tissue harvests, cadaveric study, and retrospective analysis of a series of 10 patients undergoing angiography were performed to assess vascular supply to the femoral cortex. In 6 patients, corticocancellous split-femur was incorporated into the ALT to reconstruct bony defects of the head and neck...
June 16, 2016: Head & Neck
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