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Pan facial fracture

Amir Wolff, Gabriel F Santiago, Micah Belzberg, Omri Emodi, Chad R Gordon
INTRODUCTION: Combined mid-face and nasal apparatus trauma injuries pose a significant challenge to airway patency (AW), in the immediate postoperative setting following fracture reduction. As such, the authors describe a modified technique with the goal of maintaining a patent nasal AW, while at the same time, minimizing nasopharyngeal bleeding and nasal AW edema-which can complicate patients requiring intermaxillary fixation (IMF) in the setting of pan-facial trauma. METHODS: A modified technique was devised to assist the reconstruction surgeon in avoiding the risks associated with tracheostomy placement...
March 20, 2018: Journal of Craniofacial Surgery
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
Abhishek Bhattacharjee, Prashanth Rajaram, Abhishek Khatua, K B Rudresh, Pallavi B Krishnamurthy
Trigeminocardiac reflex is a sudden physiologic response due to mechanical manipulation of any of the branches of trigeminal nerve. Trigeminocardiac reflex occurs due to pressure effect or stretching of trigeminal nerve which causes fall in blood pressure and decrease in heart rate. In this reflex arc, the trigeminal nerve serves as afferent pathway and vagus nerve, which is cardio inhibitory in nature, serves as efferent pathway. Two episodes of trigeminocardiac reflex during maxillofacial trauma surgery is not a common phenomenon...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
Ross Keat, Paul Leavy, Mathew Thomas
The festive season presents oral and maxillofacial surgery (OMFS) dental core trainees (DCTs) with the challenges of managing an eclectic mix of emergencies. We present three such patients in this case series. First, Patient A, a 39-year-old homeless male who presented with a maxillary extra-oral draining sinus. Secondly, Patient B, a 38-year-old intra-venous (IV) drug user who suffered pan-facial fractures following an alcohol-fuelled assault. Finally, Patient C, a 38-year-old male who sustained a left zygomatic complex fracture a week previously, in attendance for corrective surgery...
December 2016: Dental Update
Sqn Ldr Jimish Desai
Common peroneal nerve palsy in maxillofacial surgery setting is an uncommon and rarely reported complication. A patient who developed common peroneal nerve palsy following reduction and fixation of pan facial fractures under general anesthesia is presented. The patient developed common peroneal nerve palsy on the second postoperative day. He recovered with conservative treatment after 3 months. The authors consider that the nerve palsy was a result of compression of common peroneal nerve related to patient positioning in the perioperative period...
January 2017: National Journal of Maxillofacial Surgery
Jing Zhan Lock, Raghuraj Hegde, Stephanie Young, Thiam Chye Lim, Shantha Amrith, Gangadhara Sundar
With an increased popularity of sport and active living worldwide, our study aims to explore the incidence and features of sports-related orbital fractures in Singapore. 1421 computer tomography (CT) imaging scans of the face and orbits done at the National University Hospital over a 24-month period from January 2013 and December 2014 were reviewed retrospectively for orbital fractures. We identified 483 orbital fractures of which sports injury was the fourth most common etiology (n = 65; 13.5%) after road traffic accident (n = 131; 27...
July 18, 2017: Orbit
Chao-Ming Wu, Ying-An Chen, Han-Tsung Liao, Chih-Hao Chen, Chun-Hao Pan, Chien-Tzung Chen
BACKGROUND: Zygoma fracture is of clinical importance because malar prominence plays an essential role in facial appearance. Traditionally, most maxillofacial surgeons perform osteosynthesis with titanium plates and screws for rigid fixation. However, this procedure has certain disadvantages that include the possibility of implant exposure, palpability or loosening of the screws, painful irritation, temperature sensitization, and radiographic artifacts. In this study, we compared the function and satisfaction outcome between Bonamates(®) bioabsorbable implant and Leibinger titanium implant...
May 10, 2017: Asian Journal of Surgery
Stephanie M Cohen, Brian E Rosett, David A Shifrin
INTRODUCTION: Facial fractures, from straightforward closed nasal reductions to complex pan facial fractures, are commonly encountered in the Plastic Surgical community. However, very little has been discussed in the literature regarding the outcomes of facial fractures relating to contributing factors. Our aim was to evaluate a battery of independent variables in order to identify, which, if any, factors correlate with suboptimal outcomes in patients who have undergone facial fracture surgery...
May 2017: Journal of Craniofacial Surgery
Stephanie M Cohen, Brian E Rosett, David A Shifrin
INTRODUCTION: Facial fractures, from straightforward closed nasal reductions to complex pan facial fractures, are commonly encountered in the Plastic Surgical community. However, very little has been discussed in the literature regarding the outcomes of facial fractures relating to contributing factors. Our aim was to evaluate a battery of independent variables in order to identify, which, if any, factors correlate with suboptimal outcomes in patients who have undergone facial fracture surgery...
January 30, 2017: 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
De-Yi Yu, Chih-Hao Chen, Pei-Kwei Tsay, Aik-Ming Leow, Chun-Hao Pan, Chien-Tzung Chen
BACKGROUND: Orbital fractures and the concomitant soft tissue injuries within the bony orbit result in well-recognized complications such as diplopia and enophthalmos. Guidelines for timing and indications for surgery for achieving an optimal outcome remain elusive. This study examined the effects of timing and fracture type on the outcome of orbital fracture repair. MATERIAL AND METHODS: Data on 255 patients treated for orbital fractures were retrospectively reviewed to determine the effects of the facial bones involved in the fractures, the types of orbital wall fracture, the timing of surgical repair, and diplopia evident before and after corrective surgery on surgical outcomes...
March 2016: Annals of Plastic Surgery
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
Imran Khan, Deborah Sybil, Anurag Singh, Tarun Aggarwal, Rizwan Khan
Successful management of airway in complex maxillofacial injuries is quite challenging. The complications and the post-operative care associated with tracheotomy makes it an unpopular choice for airway management meant solely for surgery in these patients. A retrospective analysis of 12 patients from June 2008 to December 2011, seeking treatment for pan facial fractures who underwent transmylohyoid oroendotracheal (submental) intubation is discussed here. The stepwise procedure is explained along with problems of intubation in pan facial fractures...
July 2014: National Journal of Maxillofacial Surgery
Abhishek S Tidke, Rajiv M Borle, Ramnik S Madan, Nitin D Bhola, Anendd A Jadhav, Anjali G Bhoyar
The present study was planned to assess the efficacy, utility and complications of transmylohoid intubation in facial polytrauma patients, by setting and design: prospective study. This study was conducted between May 2008 and May 2011 and 35 patients of facial polytrauma were included irrespective of sex, caste and religion. All the selected 35 patients were male and the age of patients ranged between 15 to 45 years (mean age 31 years). All the patients were intubated with transmylohoid, orotracheal intubation using an armoured endotracheal tube (ETT)...
July 2013: Indian Journal of Otolaryngology and Head and Neck Surgery
Michael R Zachar, Carl Labella, Christopher P Kittle, Pamela Brown Baer, Robert G Hale, Rodney K Chan
PURPOSE: The mandible is the most commonly fractured bone in the craniomaxillofacial skeleton among military casualties. The purpose of this study was to characterize the nature and severity of mandibular fractures incurred by US military personnel during combat. MATERIALS AND METHODS: We queried the Joint Theater Trauma Registry from October 2001 to April 2011 using all pertinent International Classification of Diseases, Ninth Revision codes to identify fractures of the mandible...
April 2013: Journal of Oral and Maxillofacial Surgery
Balanand Subramanian, Srimathy Krishnamurthy, P Suresh Kumar, B Saravanan, M Padhmanabhan
OBJECTIVE: The aim of this study was to randomly compare four incisionssubciliary, subtarsal, infraorbital and transconjunctival with lateral canthotomy for treatment of orbital rim or floor fractures. METHODS: 40 patients with zygomatic complex fractures either isolated or in association with pan facial fractures, were selected for the study. They were divided into four groups of 10 patients each, Group I-Transconjunctival with lateral canthotomy, Group II-Subciliary [single eyelid incision], Group III-Subtarsal incision, and Group IV-Infraorbital incision...
June 2009: Journal of Maxillofacial and Oral Surgery
K Ranganath, H R Hemanth Kumar
Disfiguring post-traumatic deformities of the midface sometimes persist even after the treatment. Such deformities, after healing, are among the most formidable challenges faced by the surgeons, apart from the psychological impact on the patients. Following the basic principles of craniofacial reconstruction and with newer techniques, better results can be achieved. Symmetry is key to proper reconstruction in general and face in particular. Proper facial projection and height must be re-established with harmonious occlusion...
March 2011: Journal of Maxillofacial and Oral Surgery
Chetan B Raval, Mohd Rashiduddin
BACKGROUND: Airway management in maxillofacial injuries presents with a unique set of problems. Compromised airway is still a challenge to the anesthesiologist in spite of all modalities available. Maxillofacial injuries are the result of high-velocity trauma arising from road traffic accidents, sport injuries, falls and gunshot wounds. Any flaw in airway management may lead to grave morbidity and mortality in prehospital or hospital settings and as well as for reconstruction of fractures subsequently...
January 2011: Saudi Journal of Anaesthesia
Hai Jin, Sumin Wang, Lijun Hou, Chengguang Pan, Bo Li, Hui Wang, Mingkun Yu, Yicheng Lu
OBJECTIVE: To discuss the epidemiology, diagnosis and surgical treatment of cranial nerve injury following traumatic brain injury (TBI) for the sake of raising the clinical treatment of this special category of TBI. PATIENTS AND METHODS: A retrospective analysis was made of 312 patients with cranial nerve injury among 3417 TBI patients, who were admitted for treatment in this hospital. RESULTS: A total of 312 patients (9.1%) involving either a single nerve or multiple nerves among the 12 pairs of cranial nerves were observed...
September 2010: Injury
Yi Zhang
OBJECTIVE: To analyze the injury patterns in pan-facial fractures (PFF) which potentially lead to deficient treatment outcomes and then to propose a clinical classification. METHODS: Thirty-nine patients, 31 male and 8 female, with an average age of 33, treated from 1998 to 2007 in the Center of Maxillofacial Trauma, Peking University School and Hospital of Stomatology, were included. Zygomatic complex, maxilla and mandible were involved in the extensive fracture concomitant with nasal-orbital-ethmoid (NOE) fracture or not...
April 2008: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
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