Isolated Tympanic Plate Fracture Frequency and Its Relationship to Mandibular Trauma

2014 ◽  
Vol 65 (4) ◽  
pp. 360-365 ◽  
Author(s):  
Canan Altay ◽  
Nezahat Erdoğan ◽  
Ozan Batkı ◽  
Erdem Eren ◽  
Sedat Altay ◽  
...  
Keyword(s):  
Ct Images ◽  
Maxillofacial Trauma ◽  
Mandibular Fractures ◽  
Condylar Process ◽  
Plate Fracture ◽  
Maxillofacial Fractures ◽  
Significant Difference ◽  
Mandible Fractures ◽  
The Right ◽  
Communications System

PurposeThis study evaluated the prevalence of isolated tympanic fractures and their correlation with mandibular fractures by using maxillofacial computed tomography (CT).Materials and MethodsWe retrospectively evaluated the maxillofacial CT of 1590 patients who presented to our emergency department with maxillofacial trauma between December 2010 and December 2012. Maxillofacial CT was used as the criterion standard for evaluating patients with maxillofacial fractures. The CT images were evaluated by using an electronic picture archiving and communications system and interpreted independently by 2 radiologists.ResultsThe maxillofacial CT images revealed mandibular fractures in 167 of the patients and isolated tympanic plate fractures in 35 of these 167 patients. Four patients (11%) had a bilateral tympanic plate fracture, and 31 patients (89%) had unilateral tympanic plate fracture. Of all the tympanic plate fractures, 19 (54%) were on the right side and 16 (46%) were on the left side ( P > .05). In our results, a significant correlation between the presence of a right-sided tympanic plate fracture and fracture of the ipsilateral condylar process was found ( P = .036). However, a statistically significant difference between the presence of a tympanic plate fracture and other mandible fractures, additional soft-tissue findings, or the number of fractures was not determined ( P > .05). Sex had no impact on the presence of tympanic plate fracture ( P > .05).ConclusionThe frequency of isolated tympanic plate fractures in maxillofacial trauma is low, but it is an important anatomic location. Condyle fractures are significantly associated with isolated tympanic plate fractures. The presence of these injuries should raise suspicion of a concomitant isolated tympanic plate fracture.

scholarly journals Updates on the Epidemiology and Pattern of Traumatic Maxillofacial Injuries in a Nigerian University Teaching Hospital: A 12-Month Prospective Cohort In-Hospital Outcome Study

2015 ◽  
Vol 8 (1) ◽  
pp. 50-58 ◽  
Author(s):  
AdeolaAdenike Olusanya ◽  
AmosOlufemi Adeleye ◽  
TimothyOlukunle Aladelusi ◽  
AbiodunOlubayo Fasola
Keyword(s):  
University Teaching ◽  
Maxillofacial Trauma ◽  
Hospital Treatment ◽  
Mandibular Fractures ◽  
Associated Injuries ◽  
Maxillofacial Injuries ◽  
Facial Injuries ◽  
Low Resource ◽  
Maxillofacial Fractures ◽  
Clinical Records

Many studies have been undertaken in Nigeria on maxillofacial trauma. However, only a few have considered both the skeletal and soft tissue injuries (in general) involving all the aspects of the maxillofacial region or considered other etiological sources of trauma apart from road traffic crashes. Fewer still have reviewed the outcome of management of facial injuries in our low-resource environment. This study sets out to examine the recent trends in both the clinical and epidemiological patterns of all facial injuries from all causes seen in a low-resource practice of a developing country. It also assessed the in-hospital treatment outcomes, and the levels of the patients’ satisfaction with treatment received in this setting. Over a 12-month period, the clinical records of consecutive patients who were evaluated and treated for maxillofacial injuries in our unit were prospectively acquired, entered into predesigned forms and subsequently analyzed. There were 259 patients (79.5% males) during the study period. The mean age was 32.21(± 16.588) years. Overall, motor bike crashes, 42.1%, were the commonest source of these traumas; and armed robbery was the commonest form (69.0%) of assault. Mandibular fractures were the commonest maxillofacial fractures (37.8%) whereas head injury had the highest frequency among the associated injuries (71.4%). Closed reduction and immobilization was deployed in 88.0% of those who had treatment and majority was satisfied with the esthetic outcome of the treatment received. Mean length of hospital stay was 12.6 (± 4.423) days. Maxillofacial trauma poses a significant socioeconomic burden on affected individuals in this study population. This is made worse by the presence of associated injuries in the other body systems. More local studies on the outcome of management of maxillofacial trauma will improve the available literature in this region.

Prevalence of Maxillofacial Fractures in Southern Provinces of India

2017 ◽  
Vol 11 (1) ◽  
pp. 5-7
Author(s):  
VN Shankar ◽  
Ashwini LNU
Keyword(s):  
Oral Health ◽  
Common Type ◽  
Maxillofacial Trauma ◽  
Mandibular Fractures ◽  
Trauma Centers ◽  
Peak Incidence ◽  
Zygomatic Bone ◽  
Midface Fractures ◽  
Maxillofacial Fractures ◽  
Frequent Site

ABSTRACT Objective The study was conducted to evaluate the prevalence of maxillofacial fractures in southern provinces of India. Materials and methods Data of a total of 2,037 patients were analyzed retrospectively over a period of 3 years, i.e., from 2010 to 2013, from various maxillofacial trauma centers of Karnataka, India. Results Study revealed that the maxillofacial fractures had male (87.5%) preponderance and its peak incidence was during 20 to 30 years of age. Isolated mandibular fractures were the most common type of fractures with 1,035 patients (50.81%), followed by isolated midface fractures in 526 patients (25.82%). Among midface fractures, zygomatic bone and arch were most frequently involved. Conclusion Mandible was the frequent site involved. Among maxillary fractures, zygomatic bone and arch were more often involved. How to cite this article Shankar VN, Ashwini. Prevalence of Maxillofacial Fractures in Southern Provinces of India. J Oral Health Comm Dent 2017;11(1):5-7.

Resorbable Versus Titanium Rigid Fixation for Pediatric Mandibular Fractures: A Systematic Review, Institutional Experience and Comparative Analysis

2021 ◽  
pp. 194338752110225
Author(s):  
Matthew E. Pontell ◽  
Eva B. Niklinska ◽  
Stephane A. Braun ◽  
Nolan Jaeger ◽  
Kevin J. Kelly ◽  
...  
Keyword(s):  
Mixed Dentition ◽  
Surgical Removal ◽  
Mandibular Fractures ◽  
Rigid Fixation ◽  
Complication Rates ◽  
Facial Growth ◽  
Age Related ◽  
Significant Difference ◽  
Mandible Fractures ◽  
Unerupted Teeth

Study Design: Pediatric mandible fractures mandate special consideration because of unerupted teeth, mixed dentition, facial growth and the inability to tolerate maxillomandibular fixation. No consensus exists as to whether resorbable or titanium plating systems are superior with regards to clinical outcomes. Objective: This study aims to systematically review and compare the outcomes of both material types in the treatment of pediatric mandible fractures. Methods: After PROSPERO registration, studies from 1990-2020 publishing on outcomes of ORIF of pediatric mandible fractures were systematically reviewed according to PRISMA guidelines. An additional retrospective review was conducted at a pediatric level 1 trauma center. Results: 1,144 patients met inclusion criteria (30.5% resorbable vs. 69.5% titanium). Total complication rate was 13%, and 10% required a second, unplanned operation. Complication rates in the titanium and resorbable groups were not significantly different (14% vs. 10%; P = 0.07), and titanium hardware was more frequently removed on an elective basis (P < 0.001). Condylar/sub-condylar fractures were more often treated with resorbable hardware (P = 0.01); whereas angle fractures were more often treated with titanium hardware (P < 0.001). Within both cohorts, fracture type did not increase the risk of complications, and comparison between groups by anatomic level did not demonstrate any significant difference in complications. Conclusions: Pediatric mandible fractures requiring ORIF are rare, and hardware-specific outcomes data is scarce. This study suggests that titanium and resorbable plating systems are equally safe, but titanium hardware often requires surgical removal. Surgical approach should be tailored by fracture anatomy, age-related concerns and surgeon preference.

scholarly journals The Device of Ethylene Vinyl Acetate Sheet for Trismus Caused by Bilateral Mandible Fractures

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yoshiaki Ihara ◽  
Yuka Nakamichi ◽  
Yuichi Tashimo ◽  
Shinji Nozue ◽  
Kota Hayashi ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Vinyl Acetate ◽  
Mouth Opening ◽  
Ethylene Vinyl Acetate ◽  
Temporomandibular Joint Disorders ◽  
Mandibular Fractures ◽  
Training Device ◽  
Custom Made ◽  
Maxillofacial Fractures ◽  
Mandible Fractures

Trismus is commonly caused by temporomandibular joint disorders and maxillofacial fractures. We report the case of a 62-year-old woman with trismus and difficulty in mastication caused by bilateral mandibular fractures. She had a maximal interincisal opening distance (MID) of 22 mm. Mouth-opening training was administered using a novel dental mouth-training device custom-made using ethylene vinyl acetate sheets and according to the dentition and extent of mouth-opening of the patient. After 2 months of training, the MID increased to 42 mm. With adequate training, this device is effective in treating trismus due to scarring.

scholarly journals (A73) Burden of Maxillofacial Trauma at Level Trauma 1 Centre

2011 ◽  
Vol 26 (S1) ◽  
pp. s20-s21 ◽  
Author(s):  
S. Sagar ◽  
M. Singhal ◽  
K. Kataria ◽  
S. Kumar ◽  
A. Gupta ◽  
...  
Keyword(s):  
Road Traffic ◽  
Nasal Bone ◽  
Medical Problem ◽  
The Body ◽  
Maxillofacial Trauma ◽  
Mandibular Fractures ◽  
Emergency Rooms ◽  
Concomitant Injuries ◽  
Common Location ◽  
Maxillofacial Fractures

BackgroundThere is an upward trend in facial injuries following changes in population pattern, increasing industrialization and urbanization, hence maxillofacial trauma is becoming a burden and a leading medical problem in emergency rooms worldwide.MethodA retrospective study of patients with maxillofacial fractures seen and treated at the Jai Parkash Narayan Apex Trauma Center, AIIMS, New Delhi, India between January 2007 to June 2010. Data extracted from the patients' records include aetiology, age, sex, types and sites of fractures, treatment modality and concomitant injuries.ResultsThere were 795 fractures of the maxillofacial skeleton and 86 concomitant injuries from 542 patients. Road traffic accident (56.8%) was the most common aetiologic factor, followed by falls (22.3%) and fights (18.5%). The age range was from 3 years to 75 years (mean = 34.7) with a peak incidence in the 3rd decade with a male–female sex ratio of 3.7:1. The most common location of maxillofacial fractures was the mandible 615(77%) and middle third 205(23%). With regards to mandibular fractures, the body (29.6%) was the commonest sites, followed by the angle (24.4%), ramus (19.5%), dentoalveolar (14.6%), symphysis (11.0%), condyle (0.8%) while in the middle third, the nasal bone (36.7%) was the most common, followed by zygomatic bone (27.8), Lefort II (14.4), Lefort I (7.8%), dentoalveolar (10.0%) and Lefort III (3.3%). Majority of the patients were treated by Open reduction and internal fixation (70.6). Concomitant injuries were 10.8% with orthopaedic injuries accounting for the majority (63.9%). Head injury was associated with 16.3 % of cases.ConclusionMaxillofacial fractures are on the increase. We advocate the establishment of regionalized trauma centers with basic training available to all surgical residents for initial emergency room management.

scholarly journals A review of cervical spine injury associated with maxillofacial trauma at a UK tertiary referral centre

2015 ◽  
Vol 97 (1) ◽  
pp. 66-72 ◽  
Author(s):  
S Mukherjee ◽  
K Abhinav ◽  
PJ Revington
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Road Traffic ◽  
Trauma Centre ◽  
Maxillofacial Trauma ◽  
Spine Injury ◽  
Mandibular Fractures ◽  
Trauma Patients ◽  
Maxillofacial Fracture ◽  
Maxillofacial Fractures

Introduction The aim of this study was to determine the incidence and patterns of cervical spine injury (CSI) associated with maxillofacial fractures at a UK trauma centre. Methods A retrospective analysis was conducted of 714 maxillofacial fracture patients presenting to a single trauma centre between 2006 and 2012. Results Of the 714 maxillofacial fracture patients, 2.2% had associated CSI including a fracture, cord contusion or disc herniation. In comparison, 1.0% of patients without maxillofacial trauma sustained a CSI (odds ratio: 2.2, p=0.01). The majority (88%) of CSI cases of were caused by a road traffic accident (RTA) with the remainder due to falls. While 8.8% of RTA related maxillofacial trauma patients sustained a CSI, only 2.0% of fall related patients did (p=0.03, not significant). Most (70%) of the CSIs occurred at C1/C2 or C6/C7 levels. Overall, 455, 220 and 39 patients suffered non-mandibular, isolated mandibular and mixed mandibular/non-mandibular fractures respectively. Their respective incidences of CSI were 1.5%, 1.8% and 12.8% (p=0.005, significant). Twelve patients with concomitant CSI had their maxillofacial fractures treated within twenty-four hours and all were treated within four days. Conclusions The presence of maxillofacial trauma mandates exclusion and prompt management of cervical spine injury, particularly in RTA and trauma cases involving combined facial fracture patterns. This approach will facilitate management of maxillofacial fractures within an optimum time period.

scholarly journals Burden of Maxillofacial Trauma at Level 1 Trauma Center

2014 ◽  
Vol 7 (2) ◽  
pp. 126-130 ◽  
Author(s):  
Ruchi Pathak Kaul ◽  
Sushma Sagar ◽  
Maneesh Singhal ◽  
Abhishek Kumar ◽  
Jiten Jaipuria ◽  
...  
Keyword(s):  
Trauma Center ◽  
The Body ◽  
Maxillofacial Trauma ◽  
Etiologic Factor ◽  
Mandibular Fractures ◽  
New Delhi ◽  
Maxillofacial Injuries ◽  
Concomitant Injuries ◽  
Female Ratio ◽  
Maxillofacial Fractures

There is an upward trend in facial injuries following changes in population pattern, increasing industrialization and urbanization, hence maxillofacial trauma is becoming a burden and a leading medical problem in emergency rooms worldwide. This study was performed to evaluate the pattern of maxillofacial fractures, associated injuries, and treatment used at Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi, India, between January 2007 and June 2010. The study provides basis for establishment of trauma as major etiology of maxillofacial injuries and planning for preventive strategies. A retrospective study of patients seen and treated at JPNATC, AIIMS, New Delhi, between January 2007 and June 2010 was performed. Data extracted from patient records included etiology, age, sex, types and sites of fractures, treatment modality, and concomitant injuries. There were 795 fractures of the maxillofacial skeleton and 86 concomitant injuries from 542 patients. Road traffic accident (RTA) (56.8%) was the most common etiologic factor, followed by falls (22.3%) and fights (18.5%). The age range was from 3 to 75 years (mean, 34.7 years) with a peak incidence in the third decade with a male-to-female ratio of 3.7:1. The most common location of maxillofacial fractures was the mandible 615 (77%) and middle third 180 (23%). With regard to mandibular fractures, the body (29.6%) was the most common site, followed by the angle (24.4%), ramus (19.5%), dentoalveolar (14.6%), symphysis (11.0%), condyle (0.8%) while in the middle third, the nasal bone (36.7%) was the most common, followed by zygomatic bone (27.8), Lefort II (14.4), Lefort I (7.8%), dentoalveolar (10.0%), and Lefort III (3.3%). Majority of the patients were treated by open reduction and internal fixation (70.6). Concomitant injuries were 84 (10.8%) with orthopedic injuries accounting for the majority (63.9%). Head injury was associated in 16.3% of cases. RTA was the major etiologic factor of maxillofacial injuries in our setting and the young adult males were the main victims. Henceforth, establishment of regionalized, efficient, and focused trauma centers in various parts of the country particularly for acute trauma should be emphasized. Also, the laws regarding the precautions such as seat belts, speed limits, and traffic rules must be observed strictly to reduce the incidence of RTA.

Is the Use of Intermaxillary Fixation Screws an Alternative to Erich Arch Bars for Maxillomandibular Fixation During Management of Maxillofacial Fractures? A Systematic Review and Meta-Analysis

2020 ◽  
pp. 194338752097141
Author(s):  
Anuj Jain ◽  
Anshul Rai
Keyword(s):  
Systematic Review ◽  
Oral Hygiene ◽  
Meta Analysis ◽  
Maxillofacial Trauma ◽  
Large Sample Size ◽  
Intermaxillary Fixation ◽  
Maxillomandibular Fixation ◽  
Arch Bar ◽  
Maxillofacial Fractures ◽  
Significant Difference

Study Design: Systematic review and meta-analysis. Objective: Maxillomandibular fixation (MMF) is a step of paramount importance during the management of maxillofacial trauma. Erich arch bars are being used for this purpose for decades but with advances in maxillofacial trauma management, intermaxillary fixation screws came into existence and are being used routinely. The present study was designed to identify if the intermaxillary fixation screws are really an alternative to Erich arch bars for management of maxillofacial trauma. Methodology: An exhaustive literature search was conducted in May 2020 on various electronic databases and studies comparing Erich arch bars and intermaxillary fixation screws were recruited for the analysis. Random-effects model with Mantel Haenszel statistics was used to analyze oral hygiene and duration of achieving MMF. Results: A total of 96 studies were identified, out of which 8 studies were included in the meta-analysis. There was no statistically significant difference in oral hygiene status of the patients in both the groups. Intermaxillary fixations screws required statistically significantly less time in achieving MMF. Needle stick injury was prominently seen with the use of Erich arch bar whereas other complications like mucosal coverage, root injury, screw loosening and screw fracture makes the use of intermaxillary fixation screws questionable. Conclusion: The present meta-analysis suggests that there is not enough evidence to recommend the use of intermaxillary fixation screws as an alternative to Erich arch bars. Further research with large sample size, high quality evidence and better methodology is recommended in this direction.

scholarly journals Retrospective study of sports-related maxillofacial fractures in a Brazilian trauma care center

2021 ◽  
Vol 20 ◽  
pp. e211615
Author(s):  
Julia Souza Ribeiro-dos-Santos ◽  
Vinícius Paes de Assis Santos ◽  
João Gualberto Cerqueira Luz
Keyword(s):  
Trauma Care ◽  
Care Center ◽  
Protective Equipment ◽  
Mandibular Fractures ◽  
Ratio Test ◽  
Adult Males ◽  
Fracture Characteristics ◽  
Fracture Location ◽  
Maxillofacial Fractures ◽  
Significant Difference

Aim: Maxillofacial fractures occur frequently in the general population, and sports-related fractures represent some of these cases. However, few studies have been carried out in Brazilian populations aimed at sports-related maxillofacial fractures. This study assessed the demographic and fracture characteristics of patients with sports-related maxillofacial fractures who were seen at a Brazilian trauma care center. Methods: Medical records of patients with a history of sports-related maxillofacial fractures treated between January 2018 and December 2019 were retrospectively evaluated. Personal data, fracture characteristics, sport type, treatment performed and need for hospitalization were collected. The data were subjected to statistical analyses with likelihood ratio test using the Statistical Package for Social Sciences (SPSS) 25.0 (p ≤ 0.050). Results: Forty cases (4.96% of the total) of facial fractures were included. The mean age was 24.9 (± 9.8) years, with a predominance of males (92.5%). The use of protective equipment was rare. The most frequently involved sport modality was soccer (47.5%), followed by cycling (27.5%). The most frequent fracture location was nose (45%), followed by mandible (25%) and zygomatic complex (17.5%). Soccer was responsible for most nose fractures (61.1%), while cycling caused the majority of mandibular fractures (60%). Conservative treatment predominated (60%). There was only a significant difference between fracture location and the need for hospitalization (p = 0.021). Conclusion: Patients with sportsrelated maxillofacial fractures were typically young adult males, the injury was more often located in the nose and mandible and related to soccer or cycling. The use of protective equipment must be reinforced.

Suicidal Ideation and Self-Determination in Institutionalized Elderly

Crisis ◽  
2001 ◽  
Vol 22 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Andrée Fortin ◽  
Sylvie Lapierre ◽  
Jacques Baillargeon ◽  
Réal Labelle ◽  
Micheline Dubé ◽  
...  
Keyword(s):  
Self Determination ◽  
Current Debate ◽  
Elderly Persons ◽  
Rational Suicide ◽  
Institutionalized Elderly ◽  
Significant Difference ◽  
Social Subscale ◽  
Civil Status ◽  
The Right ◽  
Taking Action

The right to self-determination is central to the current debate on rational suicide in old age. The goal of this exploratory study was to assess the presence of self-determination in suicidal institutionalized elderly persons. Eleven elderly persons with serious suicidal ideations were matched according to age, sex, and civil status with 11 nonsuicidal persons. The results indicated that suicidal persons did not differ from nonsuicidal persons in level of self-determination. There was, however, a significant difference between groups on the social subscale. Suicidal elderly persons did not seem to take others into account when making a decision or taking action. The results are discussed from a suicide-prevention perspective.

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