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L Dubois, R Schreurs, O Lapid, P Saeed, G F Adriaensen, F M Hoefnagels, V M de Jong
BACKGROUND: Approximately one quarter of polytrauma patients has facial injuries, which usually lead to loss of form and function. Several specialties are involved in the acute and reconstructive phases of facial injuries, such as oral and maxillofacial surgery, otorhinolaryngology, plastic surgery, ophthalmology and dentistry. CASE DESCRIPTION: A 25-year-old man with severe facial injuries was brought to the shock room after sustaining high-energy trauma. He had a panfacial fracture that required reconstruction...
2017: Nederlands Tijdschrift Voor Geneeskunde
Kausar Ali, Salvatore C Lettieri
Traumatic panfacial fracture repair is one of the most complex and challenging reconstructive procedures to perform. Several principles permeate throughout literature regarding the repair of panfacial injuries in a stepwise fashion. The primary goal of management in most of these approaches is to restore the occlusal relationship at the beginning of sequential repair so that other structures can fall into alignment. Through proper positioning of the occlusion and the mandibular-maxillary unit with the skull base, the spatial relationships and stability of midface buttresses and pillars can then be re-established...
May 2017: Seminars in Plastic Surgery
Sylvio Luiz Costa de Moraes, Alexandre Maurity de Paula Afonso, Roberto Gomes Dos Santos, Ricardo Pereira Mattos, Bruno Gomes Duarte
The carotid-cavernous fistula (CCF) is a rare complication in patients victimized by craniofacial trauma. It involves multidisciplinary medical action. Owing to its potential complications, it is essential that maxillofacial surgery and neurosurgery specialists diagnose this condition so that appropriate treatment can be performed. The authors present a report of a case 11 years after the surgery.
March 2017: Craniomaxillofacial Trauma & Reconstruction
Shino Bay Aguilera, Sean Branch, Luis Soro
The authors present a reproducible and effective technique utilizing poly-L-lactic acid for panfacial revolumization. The variable dilution ratios, reconstitution times, injection techniques and rates of nodule formation with poly-L-lactic acid can be intimidating to even experienced injectors. While there is no single cookie-cutter approach to facial volumization, this 6-step "Precise Sculpt" technique can be used as a template to reliably achieve optimal results while minimizing the risk of adverse events...
December 1, 2016: Journal of Drugs in Dermatology: JDD
S K Kamra, H K Khandavilli, P Banerjee
Maxillofacial trauma patients present with airway problems. Submandibular intubation is an effective means of intubation to avoid tracheostomy for operative procedures. Airway is secured with oral endotracheal intubation in paralyzed patient and tube is then transplaced in sub mental or submandibular region. However there may be instances when paralyzing such trauma patients is not safe and short term tracheostomy is the only airway channel available for conduction of anesthesia. We report a case of submandibular intubation in awake patient of maxillofacial trauma with anticipated intubation problems...
October 2016: Saudi Journal of Anaesthesia
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...
January 1, 2017: JAMA Facial Plastic Surgery
Praveer K Banerjee, Abhineet Jain, Bikram Behera
BACKGROUND AND AIMS: Airway management in anaesthesia for maxillofacial surgical procedures is tricky at times when the nasal/oral routes are contraindicated or are impossible. Tracheostomy as an alternative inherits its own complications. We present a case series of the submandibular route for tracheal intubation as an alternative. METHODS: The procedure was performed in ten selected adult patients with maxillofacial/mandibular fractures associated with a fracture of skull base or nasal bone...
August 2016: Indian Journal of Anaesthesia
David A Hyman, Sandeep Saha, Harry S Nayar, John F Doyle, Suresh K Agarwal, Scott R Chaiet
Importance: Facial fractures after motor vehicle collisions are a significant source of facial trauma in patients seen at trauma centers. With recent changes in use of seat belts and advances in airbag technology, new patterns in the incidence of facial fractures after motor vehicle collisions have yet to be quantified. Objectives: To evaluate the incidence of facial fractures and assess the influence of protective device use in motor vehicle collisions in patients treated at trauma centers in the United States...
December 1, 2016: JAMA Facial Plastic Surgery
Ravi Raja Kumar, Suresh Vyloppilli, Shermil Sayd, Annamala Thangavelu, Benny Joseph, Auswaf Ahsan
OBJECTIVES: To assess submental route intubation as an alternative technique to a tracheostomy in the management of the airway in cranio-maxillofacial trauma, along with an assessment of its morbidity and complications. MATERIALS AND METHODS: Submental intubation was performed in 17 patients who had maxillofacial panfacial trauma and management was done under general anesthesia during a period of one year from 2013 to 2014 at Departments of Oral and Maxillofacial Surgery and Dentistry, the Malankara Orthodox Syrian Church Medical College, Kochi, India...
June 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
Degala Saikrishna, S Shyam Sundar, K S Mamata
Anteromedial fracture dislocation of the mandibular condyle is common but a superolateral dislocation of an intact condyle is quite rare. This type of dislocation is often misdiagnosed or completely overlooked and hence inadequately addressed. We report a case of a 41-year-old male patient who experienced superolateral dislocation of the intact condyle with symphysis fracture and panfacial fracture following a road-traffic accident, and review of literature of superolateral dislocations from 1967 to 2014.
July 2016: Journal of Maxillofacial and Oral Surgery
R Keerthi, Abdulhaseeb Quadri
Fractures of hyoid bone resulting from trauma other than strangulation are very rare; hyoid bone fracture associated with panfacial trauma are even rarer. They occur more frequently in young individuals, and in men more than in women [1]. We report a comprehensive review of a case of hyoid bone fracture associated with head and neck trauma, induced by a direct blunt trauma onto the anterior neck.
July 2016: Journal of Maxillofacial and Oral 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
Mohanavalli Singaram, Ilango Ganesan, Radhika Kannan, Rajesh Kumar
OBJECTIVES: Submental intubation has been advocated as an alternative to classical tracheostomy for certain indicated panfacial trauma surgeries. Surgeons should have various options for airway management in maxillofacial trauma patients. Most maxillofacial injuries involve occlusal derangements, which might require intraoperative occlusal corrections; hence, orotracheal intubation is not ideal. Maxillofacial surgeons generally prefer nasotracheal intubation; however, in cases with concomitant skull base fracture or nasal bone fracture, nasotracheal intubation might not be suitable; in these situations, tracheostomy is typically performed...
April 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
Al Haitham Al Shetawi, C Anthoney Lim, Yash K Singh, Jason E Portnof, Stephen M Blumberg
PURPOSE: To review the epidemiology and management of facial fractures in a pediatric population. MATERIALS AND METHODS: This study was a retrospective review of patients younger than 18 years who presented to a pediatric emergency department during a 5-year period in an urban, academic, level 1 designated trauma center. RESULTS: Of the 156 patients identified, most were boys (87%) and the mean age was 13.5 years (standard deviation, 4.9 yr; interquartile range, 12 to 17 yr)...
July 2016: Journal of Oral and Maxillofacial Surgery
K A Jeevan Kumar, B Pavan Kumar, A P Mohan, Aruna Kishore Masram, David Tyro, Divya Gandla
No abstract text is available yet for this article.
March 2016: Journal of Maxillofacial and Oral Surgery
Gerhard S Mundinger, Justin L Bellamy, Devin T Miller, Michael R Christy, Branko Bojovic, Amir H Dorafshar
BACKGROUND: This study investigates the hypothesis that mechanisms of injury, fracture patterns, and burden to the health care system differ between geriatric and nongeriatric populations sustaining blunt-force craniofacial trauma. METHODS: A 5-year retrospective chart review of patient records and computed tomographic imaging was performed. Demographic and outcome data were extracted for equally numbered samples of blunt-mechanism facial fracture patients aged 60 years or older (geriatric), and adult patients aged 18 to 59 years (adult nongeriatric)...
February 2016: Plastic and Reconstructive Surgery
Saikrishna Degala, S Shyam Sundar, K S Mamata
PURPOSE: To compare the sequence bottom-up inside-out with top-down outside-in, in the treatment of pan facial fractures and to evaluate the outcome of these approaches. PATIENTS AND METHODS: The data from 11 patients with panfacial fracture are prospectively analysed. Five cases are treated with bottom-up approach and six patients with top-down approach. RESULTS: There were 11 male patients (six in top-down approach and five in bottom-up approach), ranging in age from 24 to 50 years...
December 2015: Journal of Maxillofacial and Oral Surgery
Nark-Kyoung Rho, Yao-Yuan Chang, Yates Yen-Yu Chao, Nobutaka Furuyama, Peter Y C Huang, Martina Kerscher, Hee-Jin Kim, Je-Young Park, Hsien Li Peter Peng, Paisal Rummaneethorn, Berthold Rzany, Hema Sundaram, Chin Ho Wong, Yuli Yang, Adri Dwi Prasetyo
BACKGROUND: Although the use of filling agents for soft-tissue augmentation has increased worldwide, most consensus statements do not distinguish between ethnic populations. There are, however, significant differences between Caucasian and Asian faces, reflecting not only cultural disparities, but also distinctive treatment goals. Unlike aesthetic patients in the West, who usually seek to improve the signs of aging, Asian patients are younger and request a broader range of indications...
November 2015: Plastic and Reconstructive Surgery
Andrew Breithaupt, Rebecca Fitzgerald
Over the last decade, many studies of the structural changes observed in the aging face (in bone, fat pads, facial ligaments, muscle, skin) have increased our understanding that facial rejuvenation is more complex and nuanced than simply filling lines and folds or cutting and lifting soft tissue and skin. This, in addition to the many new products introduced to the marketplace over the same period, has fueled the evolution of panfacial rejuvenation and restoration using fillers. This article discusses current techniques used with calcium hydroxylapatite and poly-l-lactic acid to safely and effectively address changes observed in the aging face...
November 2015: Facial Plastic Surgery Clinics of North America
Sourav Sharma, Vandana Dhanasekaran
Patients with multiple fractures involving upper third of the face, the mid-face and the lower third are generally referred to as Pan-facial fractures and managing these cases is extremely complicated. Proximity of the maxillofacial region to the important features or senses such as visual function (diplopia), olfaction, respiration (airway management), chewing or mastication (occlusion), deglutition and aesthetics; makes the scenario a little more complex for the surgeon operating in this particular region than the surgeon operating any other part of the body...
August 2015: Journal of Clinical and Diagnostic Research: JCDR
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