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Facial fractures

Sarah M Jacobs, Colin P McInnis, Matthew Kapeles, Shu-Hong Chang
PURPOSE: Severe vision loss is a risk of orbital surgery which physicians should counsel patients about, but the overall risk rate is unknown. This research was conducted to determine the risk of severe vision loss related to orbital surgery. DESIGN: Retrospective review. PARTICIPANTS: Patients who underwent orbital surgery at either of 2 academic medical centers between January 1994 and December 2014. METHODS: A billing database search was conducted to identify all patients who had orbital surgery during the study period, cross-checked against diagnostic codes related to vision loss...
March 15, 2018: Ophthalmology
Ferid Krupić, Sahmir Sadić, Nail Seffo, Mirza Bišćevic, Mirsad Fazlić, Svemir Čustović, Kristian Samuelsson
Aim To explore the experience of registered nurses in assessing pain in hip fracture in patients with dementia in the postoperative setting. Methods The study questionnaire contained 23 items mainly addressing demographic and social data, information about communication and pain assessment, attention and awareness of the health-care professionals on the ward and suggestions for improving nursing. Results The nurses claimed that they began their assessment of pain in patients with dementia first by observing the patient and making a visual assessment of pain, after which they began to communicate with these patients; majority of dementia patients with hip fractures displayed more facial expressions of pain than patients without dementia...
February 1, 2018: Medicinski Glasnik
Xiaotian Lian, Jun Guo, Wei Zeng, Hai Qing, Rui Ju, Wei Tang
PURPOSE: The purpose of this study was to explore new landmark-independent methods suitable for determining the midsagittal plane (MSP) in patients with craniomaxillofacial trauma and its clinical application. MATERIALS AND METHODS: Preoperative computed tomography data of 25 patients with craniomaxillofacial trauma were imported into Mimics software (Materialise, Leuven, Belgium) to reconstruct 3-dimensional skull models. In the experimental group, the MSP was determined by different landmarks that were clear, were scattered, and did not have displacement according to the types of fractures...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
Tiago Gai Aita, Cecília Luiz Pereira Stabile, Cássia Cilene Dezan Garbelini, Glaykon Alex Vitti Stabile
PURPOSE: We aimed to evaluate whether the Facial Injury Severity Scale (FISS), proposed by Bagheri et al in 2006, can predict intervention needs in the operating room (OR), length of hospital stay, and need for support by other specialties. PATIENTS AND METHODS: Data were collected from the medical records of trauma patients from a public tertiary hospital between January 2009 and December 2015, related to age, gender, comorbidities, habits, history of maxillofacial trauma, etiology, and presence and location of fractures and lacerations, in addition to type of treatment performed and period of hospitalization...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
Said Algan, Murat Kara, Mehmet Akif Cakmak, Onder Tan, Hakan Cinal, Ensar Zafer Barin, Akin Inaloz
OBJECTIVE: Condylar and subcondylar fractures (CSFs) are among the most common mandible fractures. If reduction of these fractures is not carried out correctly, serious complications can result, including infection, damage to temporomandibular joint (TMJ) function, malocclusion, nonunion, malunion, and ankylosis of the TMJ. METHODS: We used a preauricular, mini-incision, open technique (PMIOT) for CSF of the mandible. 66 patients (48 males, 18 females), with a total of 72 CSFs of the mandible, were repaired with PMIOT between 2011 and 2016...
February 8, 2018: Journal of Cranio-maxillo-facial Surgery
Adekunle Elegbede, Silviu C Diaconu, Colton H L McNichols, Michelle Seu, Yvonne M Rasko, Michael P Grant, Arthur J Nam
Three-dimensional printing of patient-specific models is being used in various aspects of craniomaxillofacial reconstruction. Printing is typically outsourced to off-site vendors, with the main disadvantages being increased costs and time for production. Office-based 3-dimensional printing has been proposed as a means to reduce costs and delays, but remains largely underused because of the perception among surgeons that it is futuristic, highly technical, and prohibitively expensive. The goal of this report is to demonstrate the feasibility and ease of incorporating in-office 3-dimensional printing into the standard workflow for facial fracture repair...
March 8, 2018: Journal of Craniofacial Surgery
Omri Emodi, Saleh Nseir, Dekel Shilo, Hanna Srouji, Adi Rachmiel
Isolated orbital wall fractures account for 4% to 16% of all facial fractures. Even a modest change in the position of the bony walls can have a significant impact on orbital volume and globe position. Alloplastic materials or autogenous bone grafts such as the antral maxillary wall can be used to reconstruct small- to medium-size orbital fractures. The main advantage of an antral wall graft is the intraoral approach with minimal morbidity. Nine patients underwent repair of orbital floor fractures using the extraoral and the intraoral antral wall approach...
March 8, 2018: Journal of Craniofacial Surgery
Malcolm Harris, Tara Brantley, Douglas Hammond, Sabah Kalamchi
OBJECTIVE: The aim of this study was to investigate the demographic profile of Native American patients with concomitant facial fractures and closed head injuries (CHIs) and to explore the validation of the craniofacial crumple zone. STUDY DESIGN: This was a retrospective, observational, case-control study of 2131 maxillofacial fractures from 2010 to 2014, of which 173 (8%) had concomitant CHIs. RESULTS: Of the study patients, 133 (77%) were males (mean age 40...
January 31, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Kai H Lee, Michael Qiu, Jiandong Sun
OBJECTIVES: The algorithm for maxillofacial trauma management is well defined; however, provision of alcohol assessment for patients after trauma is not widely practiced. This study aims to investigate the rate of alcohol assessment achieved within the demographic characteristics of patients with facial trauma and the circumstances where this intervention was implemented. STUDY DESIGN: This study retrospectively examined the Victorian Admitted Episodes Data Set (VAED) from 2004 to 2013...
February 1, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Hyung-Joo Lee, Youn-Jung Kim, Dong-Woo Seo, Chang Hwan Sohn, Seung Mok Ryoo, Shin Ahn, Yoon-Seon Lee, Won Young Kim, Kyoung Soo Lim
OBJECTIVE: The detection of intracranial injury in patients with facial injury rather than traumatic brain injury (TBI) remains a challenge for emergency physicians. This study aimed to evaluate the incidence and risk factors of intracranial injury in patients with orbital wall fracture (OWF), who were classified with a chief complaint of facial injury rather than TBI. METHODS: This retrospective case-control study enrolled adult OWF patients (age ≥18 years) who presented at the hospital between January 2004 and March 2016...
February 24, 2018: Injury
Gil Graziani, Sigal Tal, Adi Adelman, Chen Kugel, Tali Bdolah-Abram, Alon Krispin
INTRODUCTION/BACKGROUND: Post-mortem CT (PMCT) is becoming an essential tool available to forensic pathologists worldwide, but its validity with respect to evidence for legal purposes still requires more comprehensive large-scale studies, comparing PMCT to autopsy. This article compares PMCT and autopsy findings of the head, neck, and spine during a period of five years. MATERIALS AND METHODS: The study included 203 cases for which both autopsy and PMCT were performed...
February 26, 2018: Journal of Forensic and Legal Medicine
Angelica W DesPain, Jennifer Chapman, Haroon Shaukat
We describe the case of a 6-year-old boy who presented to a tertiary care emergency department after a motor vehicle accident with facial trauma and bradycardia. The patient was found to have an orbital floor fracture and inferior rectus muscle entrapment with resulting bradycardia secondary to the oculocardiac reflex. The oculocardiac reflex is an uncommon cause of bradycardia in the setting of trauma but should be considered because it can necessitate surgical intervention.
February 28, 2018: Pediatric Emergency Care
Knut Nottrott, Cécile De Guio, Michael Schramme
We report an unusual case of a young Quarter Horse with a large dental fracture fragment displaced into the maxillary sinus, leaving an oroantral communication that caused food impaction and metaplastic calcification in the sinus and facial deformation with cutaneous fistulation. Oral extraction of a remaining tooth fragment from its alveolus was succeeded by a maxillary sinusotomy for removal of the abnormal sinus contents. Since the oroantral fistula did not heal spontaneously following the placement of a silicone dental prosthesis, minimally invasive transbuccal and transnasal endoscopic approaches were used to encourage closure of the oroantral fistula by alveolar granulation...
March 2018: Journal of Veterinary Dentistry
Maria C Closs Ono, André D de Morais, Renato da S Freitas, Gilvani A de Oliveira E Cruz
BACKGROUND: Condylar fractures are considered the most controversial mandibular fractures, regarding both the diagnosis and the treatment. With the increase in surgical indications for handling this type of fracture, it is important to discuss about the advantages and disadvantages of the several surgical approaches available. This article describes the surgical details and postoperative results of the mini-retromandibular transparotid approach for treating extracapsular condylar fractures of the mandible...
February 26, 2018: Journal of Craniofacial Surgery
Marília Gabriela Mendes de Alencar, Manoela Moura De Bortoli, Thiago Coelho Gomes da Silva, Emanuel Dias de Oliveira E Silva, José Rodrigues Laureano Filho
The mandibular fracture is one of the most commonly fractures of the facial bones. In high-energy traumas, a comminuted mandible fracture may occur. The closed reduction with external fixator is an interesting alternative for these types of fractures. The aim of this article is to report the case of a patient with comminuted fracture in the right mandibular body, whose surgical treatment was the noninvasive reduction of fracture and stabilization using a Colles' wrist external fixator. After 1 year of follow-up, the patient is without complaints, with satisfactory dental occlusion, adequate contour, and mandibular alignment...
February 23, 2018: Journal of Craniofacial Surgery
Willian Ricardo Pires, Gabriel Mulinari Santos, Erik Neiva Ribeiro de Carvalho Reis, André Hergesel de Oliva, Ricardo Garcia Mureb Jacob, Leonardo Perez Faverani, Francisley Ávila Souza, Idelmo Rangel Garcia Júnior
Facial fractures can be potentially fatal in polytraumatized patients due to retropositioning tissues to upper airway obstruction. In the first aids, this situation can be reversed using a tracheostomy procedure to break out the airways. However, fractures leading to airway obstruction are rare and according to Richards Classification can be classified into 5 types. The purpose of this article is to report a clinical patient with a bilateral condylar and mandibular symphysis fractures that resulted in airway obstruction and severe mandibular rear projection...
February 23, 2018: Journal of Craniofacial Surgery
Hongbo Chen, Jiaming Sun, Jiecong Wang
BACKGROUND: Several methods are available for mandibular reduction, and each method is characterized by unique limitations and complications. However, only a few studies have systematically analyzed these complications. This study aimed to investigate the effects of the outcome of performing curved mandibular angle ostectomy and outer cortex grinding in 1-stage operation and to examine the causes of different types and characteristics of complications. METHODS: The subjects consisted of 528 patients who were subjected to curved mandibular angle ostectomy and outer cortex grinding in 1-stage operation through an intraoral approach...
February 23, 2018: Annals of Plastic Surgery
Li Yao, Yuanyuan Zhang, Qijun Chen, Shuai Wang, Qingjian Wang, Jie Yi, Ligang Zhang, Ethan L Matz, Xiaohua Hu, Guilin Huang
Lymphoepithelial carcinoma (LEC) is an uncommon malignant neoplasm. Due to the complicated anatomical structure of the human head, standard imaging modalities including ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) scan remain limited in detection of salivary tumors. We used three-dimensional computed tomography angiography (3D-CT angiography) for the assessment and pre-operative surgical planning of facial fractures of a case with LEC. The study results demonstrated that 3D-CT angiography provided an insightful approach to preoperative evaluation in the treatment of salivary tumors...
2018: Journal of X-ray Science and Technology
Khuram Khan, Saqib Saeed, Alexius Ramcharan, Sanjiv Gray
INTRODUCTION: Traumatic brain injury (TBI) is one of the main causes of morbidity and mortality in young trauma patients with resultant multi-organ effects. Hypopituitarism following TBI can be debilitating and life threatening. TBI which causes hypopituitarism may be characterized by a single head injury, such as from a motor vehicle accident, or by chronic repetitive head trauma, as seen in combative supports including boxing, kick-boxing, and football. In the majority of cases, a diagnosis of hypopituitarism can be entirely missed resulting in severe neuro-endocrine dysfunction...
February 9, 2018: International Journal of Surgery Case Reports
Alok Thakar, Madan P Gupta, Achal Srivastava, Deepak Agrawal, Atin Kumar
Importance: Current recommendations envisage early surgical exploration for complete facial nerve paralysis associated with temporal bone fracture and unfavorable electrophysiologic features (response to electroneuronography, <5%). However, the evidence base for such a practice is weak, with the potential for spontaneous improvement being unknown, and the expected results from alternative nonsurgical treatment also undefined. Objective: To document the results of nonsurgical treatment for posttraumatic complete facial paralysis with undisplaced temporal bone fracture and unfavorable electrophysiologic features...
February 22, 2018: JAMA Otolaryngology—Head & Neck Surgery
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