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Midface fractures

Kai Lee, Michael Qiu
PURPOSE: Excessive indulgence in alcohol is a key causative factor in facial fractures especially in settings of interpersonal violence (IPV) and motor vehicle accidents. This study aims to explore characteristics of alcohol-involved facial fractures in the state of Victoria, Australia, over a 10-year period. MATERIALS AND METHODS: This retrospective study analyzed data from the Victorian Admitted Episodes Dataset between 2004 and 2014; the Victorian Admitted Episodes Dataset is a standardized database reported by all Victorian hospitals for every admission...
December 18, 2016: Journal of Oral and Maxillofacial Surgery
Shao-Rui Liu, Xue-Fei Song, Zheng-Kang Li, Qin Shen, Xian-Qun Fan
OBJECTIVE: With orbital floor fracture incidence rates increasing year by year, many patients require surgical treatment to improve diplopia, limitation of extraocular muscle movement (EOM), enophthalmos, and midface appearance. With the use of high-density polyethylene, titanium screws, titanium plate, and titanium mesh to repair an orbital floor fracture, enophthalmos and midfacial deformity correction procedures have made great progress. However, attenuating diplopia and the limitation of EOM are still difficult problems to prevent...
November 2016: Journal of Craniofacial Surgery
Brandaan G R Zigterman, Maurice Y Mommaerts
CONTEXT: Slotplates were specifically designed to meet the special requirements of corrective surgeries of the facial skeleton. This design enables small readjustments of bone fragments in the midface and chin area during surgery without complete removal of plates and screws. OBJECTIVE, DESIGN, AND SETTING: The aim of this study was to compare morbidity rates of slotplates versus meshplates after Le Fort I osteotomy, genioplasty and/or zygoma 'sandwich' osteotomy performed in a tertiary care centre...
November 2, 2016: Journal of Cranio-maxillo-facial Surgery
Ahmed Gaber Hassanein, Ahmed M A Abdel Mabood
PURPOSE: During surgery for major maxillofacial fractures, orotracheal intubation can interfere with some surgical procedures and nasal intubation can be contraindicated or impossible. That is why tracheotomy is presented as a solution, although it carries a relatively high incidence of complications. In this study, the use of submandibular tracheal intubation is basically evaluated as an alternative to tracheotomy in such circumstances. MATERIALS AND METHODS: This prospective study was performed in patients undergoing surgery for major maxillofacial fractures in which oral intubation and/or nasal intubation have been unsuitable, impossible, or contraindicated...
November 2, 2016: Journal of Oral and Maxillofacial Surgery
Shao-Rui Liu, Xue-Fei Song, Zheng-Kang Li, Qin Shen, Xian-Qun Fan
OBJECTIVE: With orbital floor fracture incidence rates increasing year by year, many patients require surgical treatment to improve diplopia, limitation of extraocular muscle movement (EOM), enophthalmos, and midface appearance. With the use of high-density polyethylene, titanium screws, titanium plate, and titanium mesh to repair an orbital floor fracture, enophthalmos and midfacial deformity correction procedures have made great progress. However, attenuating diplopia and the limitation of EOM are still difficult problems to prevent...
October 14, 2016: Journal of Craniofacial Surgery
S Y Kim, C L Chan, D M Hyam
Football injuries are responsible for many of the maxillofacial injuries sustained during sporting activities. In the Australian Capital Territory (ACT), the four major types of Australian football are played in large numbers and up to a high standard. Our objective was to analyse maxillofacial fractures that were sustained during rugby league, rugby union, Australian rules, and soccer matches. We retrospectively studied 134 patients with maxillofacial fractures during the five-year period 2010-14. All patients were assessed and treated at Canberra Hospital, the major trauma centre in the ACT...
October 2016: British Journal of Oral & Maxillofacial Surgery
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
Guilherme Dos Santos Trento, Lucas Borin Moura, Luis Fernando de Oliveira Gorla, Valfrido Antônio Pereira Filho
Midface fractures usually affect the orbital cavity. This trauma may result in severe and rare consequences such as retrobulbar hemorrhage. This condition requires immediate diagnosis and early intervention to avoid blindness. The treatment usually requires evaluation of an oral and maxillofacial surgeon. This patient report aims to describe a facial trauma resulting in blindness after 4 days. An 83-year-old woman fell and hit her face on the floor. The initial evaluation only found a contusion on her left orbit, and an ophthalmologic examination was not made...
September 2016: Journal of Craniofacial Surgery
G Spagnol, M Palinkas, S C H Regalo, P B de Vasconcelos, C E Sverzut, A E Trivellato
This study evaluated the bite force, electromyographic activity, and mandibular mobility in patients undergoing surgery for facial fracture treatment that required a coronal approach. Ten men were divided into two groups: group I, coronal approach with pre-auricular extension (n=4, average age 34.5 years); group II, coronal approach (n=6, average age 24.8 years). The maximum bite force was measured using a dynamometer and mandibular mobility using a calliper. The electromyographic activity of the right masseter (RM), left masseter (LM), right temporal (RT), and left temporal (LT) muscles was evaluated using a Myosystem-Br1 apparatus...
June 24, 2016: International Journal of Oral and Maxillofacial Surgery
Alf L Nastri, Ben Gurney
PURPOSE OF REVIEW: Management of midface trauma is complex and challenging and requires a clear understanding of the facial buttress system, subunit anatomy and inter-relationships. Too often clinicians attempt surgical repair without adequate knowledge of the common complications associated with poor reduction and improper sequencing of fracture repair. This review outlines a working approach to the identification and management of such injuries, and the definitive management of common injury patterns...
August 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Fabio Roccia, Matteo Savoini, Guglielmo Ramieri, Emanuele Zavattero
AIM: The aim of this work is to analyze the risk factors in interpersonal violence and to describe the epidemiology, patterns and management of maxillofacial fractures in high volume trauma center of the northern Italy. MATERIAL: This retrospective study recorded patients hospitalized with maxillofacial fractures, at the division of maxillofacial surgery, Città della Scienza e della Salute University Hospital, Torino, Italy, since January 2001. METHODS: Only patients who presented with "violence" in the database field for "cause of injury" and with "interpersonal violence" as a subtype of etiology were considered...
August 2016: Journal of Cranio-maxillo-facial Surgery
Fadekemi Olufunmilayo Oginni, Taoreed Oladejo, Dayo Paul Alake, Jolaiya Olufunke Oguntoba, Olawande Funmilola Adebayo
AIMS: Traumatic injuries remain a major cause of morbidity, mortality and economic loss worldwide. An audit of maxillofacial injuries presenting and managed at any facility is key to understanding the trends, strategies for prevention and improving outcome of care. We sought to study the pattern and treatment of facial bone fractures managed at the Department of Maxillofacial Surgery, Obafemi Awolowo University Teaching Hospital, Ile-Ife, between 2005 and 2013. Also, to compare these with the pattern in the preceding 29 years...
June 2016: Journal of Maxillofacial and Oral Surgery
Irfan Ul Hassan Haji, Surinder Pal Singh Sodhi, Badr Bin Abdulrahman Al-Jandan, Mohamed Jaber
We report a patient with multiple fractures of the midface and Guerin sign bilaterally after maxillofacial trauma. To the best of our knowledge, this is the first time that this rare presentation of Guerin sign has been published.
May 30, 2016: British Journal of Oral & Maxillofacial Surgery
Jonatan Hernandez Rosa, Nathaniel L Villanueva, Paymon Sanati-Mehrizy, Stephanie H Factor, Peter J Taub
From 2002 to 2006, more than 117,000 facial fractures were recorded in the U.S. National Trauma Database. These fractures are commonly treated with open reduction and internal fixation. While in place, the hardware facilitates successful bony union. However, when postoperative complications occur, the plates may require removal before bony union. Indications for salvage versus removal of the maxillofacial hardware are not well defined. A literature review was performed to identify instances when hardware may be salvaged...
June 2016: Craniomaxillofacial Trauma & Reconstruction
Kun Hwang, Jong Hwan Choi, Joo Ho Kim
The aim of this study is to see whether the nasojugal groove and wrinkles can be improved following a skin-muscle flap elevation through a subciliary approach to the orbital rim.Fifty-seven patients having fractures of the orbital floor, wall, or orbital rim were included. A subciliary incision was made 3 to 5 mm below the cilia. A skin-muscle flap was elevated and a 5-mm width of the periosteum of the anterior surface of the maxilla was exposed. Thereafter, the origin of the orbicularis oculi muscle was released from the underlying bony origin...
May 2016: Journal of Craniofacial Surgery
H Sun, P S Wu, L Y Song, J Y Hu, S Dong, W Lu
OBJECTIVE: To investigate the clinical outcomes following early repair for orbital fracture and soft tissue simultaneously for open orbital fractures. METHODS: Retrospective clinical study. This study comprised of 19 patients(20 eyes) with open orbital fracture who underwent surgery within 48 hours in the Second Hospital of Dalian Medical University between August 2011 and August 2014. The wounds were evaluated at the same time and the surgical debridement was done...
April 11, 2016: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
Christian Brandtner, Johannes Hachleitner, Gian Battista Bottini, Heinz Buerger, Alexander Gaggl
We have assessed the role of the medial femoral condylar flap in 107 patients who had reconstructions of the head and neck. We retrospectively reviewed their medical records for indications, complications, and outcomes. The flap was primarily used for coverage of alveolar ridge defects (n=67), secondly for defects of the facial bone, calvaria, or skull base (n=35), and thirdly for partial laryngeal defects (n=5). Two flaps were lost. One patient fractured a femur 5 weeks postoperatively. The duration of follow up ranged from 6 months to 12 years...
July 2016: British Journal of Oral & Maxillofacial Surgery
Helen Moses, David Powers, Jarrod Keeler, Detlev Erdmann, Jeff Marcus, Liana Puscas, Charles Woodard
The provision of trauma care is a financial burden, continually associated with low reimbursement, and shifts the economic burden to major trauma centers and providers. Meanwhile, the volume of craniomaxillofacial (CMF) trauma and the number of surgically managed facial fractures are unchanged. Past financial analyses of cost and reimbursement for facial trauma are limited to mandibular and midface injuries, consistently revealing low reimbursement. The incurred financial burden also coincides with the changing landscape of health insurance...
March 2016: Craniomaxillofacial Trauma & Reconstruction
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
Srinivas M Susarla, Katherine Duncan, Nicholas R Mahoney, Shannath L Merbs, Michael P Grant
The advent of computer-assisted technology has revolutionized planning for complex craniofacial operations, including orbital reconstruction. Orbital reconstruction is ideally suited for virtual planning, as it allows the surgeon to assess the bony anatomy and critical neurovascular structures within the orbit, and plan osteotomies, fracture reductions, and orbital implant placement with efficiency and predictability. In this article, we review the use of virtual surgical planning for orbital decompression, posttraumatic midface reconstruction, reconstruction of a two-wall orbital defect, and reconstruction of a large orbital floor defect with a custom implant...
October 2015: Middle East African Journal of Ophthalmology
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