scholarly journals Long-term evaluation of treatment protocols for isolated midfacial fractures in a German nation-wide craniomaxillofacial trauma center 2007–2017

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lars Bonitz ◽  
Vivienne Wruck ◽  
Elena Peretti ◽  
Dietmar Abel ◽  
Stefan Hassfeld ◽  
...  
Keyword(s):  
Complication Rate ◽  
Bone Fractures ◽  
Maxillofacial Surgery ◽  
Nasal Bone ◽  
Age Group ◽  
Prevention Measures ◽  
Average Hospital ◽  
Female Ratio ◽  
Midfacial Fractures ◽  
Orbital Floor Fractures

AbstractAn update on the trends in maxillofacial traumatology provides additional information on the actual and changing needs. This retrospective study aimed to review all patient records of patients treated for isolated midface fractures in the Department of Cranial- and Maxillofacial Surgery at the Dortmund General Hospital between 2007 and 2017. The patient radiographs and patient files were reviewed. The safety and efficacy of the applied methods were controlled by assessing complications based on the Clavien-Dindo classification system. The statistical analysis included descriptive methods including regression analysis and χ2-test. In eleven years, 3474 isolated midface fracture sites have been identified in 2868 patients. The yearly trend is slightly increasing, in elderly clearly worsening, in children and youth decreasing. The male-to-female ratio was 2.16:1 for the whole study population, in the age group 18–25 y.o. 6.95:1 while in elderly above 80 y.o. 1:2.51, the age group specific incidence reflects this result, too. The most common fractures were nasal bone fractures (1405), zygomatic fractures (832) and orbital floor fractures (700). The average hospital stay was 2.7 days, the most fractures were operated within 24 h. The complication rate was 2.02% (Clavien-Dindo class II–V). The incidence of midfacial fractures is increasing in the total population and especially in elderly, but decreasing in children. Development of injury prevention measures is needed in this population. The diagnostic and therapeutic procedures are appropriate, as there is a low complication rate and short inpatient stay observed.

1239 Postoperative Complication Rate of Facial Injury Repairs Treated by Maxillofacial On-Call Team: Surgical Audit

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Dhanjal ◽  
M Ghouri ◽  
S Crank
Keyword(s):  
Soft Tissue ◽  
Postoperative Complications ◽  
Postoperative Complication ◽  
Complication Rate ◽  
Maxillofacial Surgery ◽  
General Anaesthetic ◽  
Facial Injury ◽  
Postoperative Complication Rate ◽  
Female Ratio ◽  
Facial Injuries

Abstract Introduction A significant aspect of Oral and Maxillofacial Surgery workload relates to trauma, particularly soft-tissue injuries. Contingent on the aetiology of injury, facial wounds require debridement and rapid closure to reduce risk of infection and degree of scarring. The aim was to identify possible risks and frequency of postoperative complications, including problems identified by patients following treatment of facial injuries by the Maxillofacial on-call team. Method Data was retrospectively collected from patients who sustained soft-tissue facial injuries treated by the Maxillofacial team and provided with follow-up appointments from January to August 2020. Computerised clinical notes were accessed to determine patient demographics, mechanism and site of injury, location and time of repair, operator grade and postoperative complications (if any). Results 153 patients required debridement and suturing of a facial injury under local or general anaesthetic. Among these, the male to female ratio was 65:35. 47% of facial injuries resulted from mechanical fall. Lips were found to be the most common site (31%) of injury. Postoperative complication rate was 8% within the 8-month period, with reports of infection, wound dehiscence and haematoma requiring further treatment. 58% of complications resulted from treatment carried out between 5pm-5am with a sole operator (DCT/SHO). 83% of complications followed treatment carried out within the Emergency Department rather than Maxillofacial clinical setting. Conclusion Following facial injury repair, just less than 8% of patients experienced complications, which required corrective treatment. Although facial injuries require immediate care, careful planning and performing treatment in a specialised setup may improve perioperative care, thus clinical outcomes.

In the emergency department

2018 ◽  
Author(s):  
Luke Cascarini ◽  
Clare Schilling ◽  
Ben Gurney ◽  
Peter Brennan
Keyword(s):  
Soft Tissue ◽  
Bone Fractures ◽  
Maxillofacial Surgery ◽  
Soft Tissue Injuries ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Fractures ◽  
Soft Tissue Infections ◽  
Penetrating Injuries ◽  
Orbital Floor Fractures ◽  
Zygomatic Fractures

This chapter discusses oral and maxillofacial surgery in the A&E department, including, The paediatric OMFS patient, Overview of maxillofacial trauma, Mandibular fractures, Zygomatic fractures, Orbital floor fractures, Maxillary fractures, Nose, naso-ethmoidal, and frontal bone fractures, Face and scalp soft tissue injuries, Penetrating injuries to the neck, Intra-oral injuries, Dento-alveolar trauma, Dento-alveolar infections, Post-extraction complications, Head and neck soft tissue infections, Salivary gland diseases, and Miscellaneous conditions

scholarly journals Pattern of Angulations and Common Indications for Extraction of Impacted Mandibular Third Molar at KMU-Institute of Dental Sciences, Kohat

2019 ◽  
Vol 8 (2) ◽  
pp. 79-83
Author(s):  
Tariq Sardar ◽  
Gulrukh Sheikh ◽  
Saddique Aslam ◽  
Numan Muhammad Khan ◽  
Javed Akhtar Rana
Keyword(s):  
Maxillofacial Surgery ◽  
Third Molar ◽  
Age Group ◽  
Third Molars ◽  
Impacted Tooth ◽  
Female Ratio ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Background: The extraction of an impacted mandibular third molar (MTM), with associated pathologies or clinical manifestations is an important and one of the most frequent decisions in dentistry. The angle formed by the longitudinal axis of second and third molar is used to determine angulation of impacted MTM. The aim of this study was to identify the pattern of angulations of impacted mandibular third molar and common indications for extraction associated with these angulations.Material and Methods: This descriptive cross-sectional study was carried out at Department of Oral & Maxillofacial Surgery, Khyber Medical University Institute of Dental Sciences, Kohat, Khyber Pakhtunkhwa (KP) from November 2017 to July 2018. A total of 349 patients presenting with impacted mandibular third molars were included in this study. Name, age, gender, address, the angulation of the impacted tooth and the indication for extraction of the impacted tooth were recorded. Data comprising of qualitative and quantitative variables were analyzed using SPSS version 17.Results: Out of 349 patients, 206 were male and 143 females, with the male to female ratio of 1.4:1. The age range of the patients was from 18 years to 60 years with a mean age of 26 ± 6 years. The most common age group with impacted third molar was ≤ 25 years followed by 26 to 30 years’ age group. The most common angulation was mesioangular followed by vertical, horizontal and distoangular impacted mandibular third molar. Pericoronitis was the most common indication for extraction in all angulations except horizontal impaction where root resorption of the second molar was more common.Conclusion: Mesioangular is the most common angulation in impacted mandibular third molars. Pericoronitis is the main indication for all angulations of impacted mandibular third molars except horizontal angulation, occurring mostly in the third decade of life.

In the clinic

2018 ◽  
Author(s):  
Luke Cascarini ◽  
Clare Schilling ◽  
Ben Gurney ◽  
Peter Brennan
Keyword(s):  
Head And Neck ◽  
Bone Fractures ◽  
Maxillofacial Surgery ◽  
Soft Tissue Injuries ◽  
Oral And Maxillofacial Surgery ◽  
Oral Lesions ◽  
Skin Tumours ◽  
Orbital Floor Fractures ◽  
Mandible Fractures ◽  
Work Up

This chapter discusses oral and maxillofacial surgery in the clinic, including, Mandible fractures, Orbital floor fractures, Zygoma fractures, Maxillary fractures, Nose, naso-ethmoidal, and frontal bone fractures, Face and scalp soft tissue injuries, Dento-alveolar: assessment for extractions, Dento-alveolar: impacted teeth, Dento-alveolar: jaw pathologies, Temporomandibular joint problems, Oral and facial pain, Management of oral lesions, Management of neck lumps, Skin tumours, Work-up for major head and neck oncoplastic surgery, Reviewing head and neck cancer patients, Salivary gland diseases, Orthognathic patients, and Miscellaneous conditions in the clinic

scholarly journals ORBITAL FLOOR RECONSTRUCTION WITH TITANIUM MESH;

2014 ◽  
Vol 21 (03) ◽  
pp. 575-579
Author(s):  
Muhammad Usman Khalid ◽  
Arshad Mahmood Malik ◽  
Omer Sefvan Janjua
Keyword(s):  
Study Design ◽  
Complication Rate ◽  
Maxillofacial Surgery ◽  
Male Gender ◽  
Orbital Floor ◽  
Titanium Mesh ◽  
No Donor ◽  
Orbital Floor Fractures ◽  
Orbital Floor Reconstruction ◽  
Infraorbital Rim

Objective: To determine the outcome of orbital floor reconstruction with titaniummesh in terms of diplopia, enophthalmos, dystopia and infection etc. Study design: Descriptivecase series. Place & duration of study: Department of Oral & Maxillofacial Surgery, PunjabMedical College / Allied Hospital Faisalabad. One and Half year from 01-10-12 to 31-03-14.Material and Method: Twenty two patients clinically and radiographically having defect in theorbital floor due to trauma were included in the study. Titanium mesh was used to reconstruct theorbital floor through infraorbital rim incision and secured in place with 5mm micro screws. Thevariables to be analyzed were diplopia, enophthalmos, orbital dystopia and infection. Results: Inour study male gender predominates over female 20/22. Mean age of patients is 29.36 years ±5.21. Diplopia persisted in 2/10 (20%) patients. Enophthalmos persisted in 7/18 (38.8%) patients.dystopia persisted in ¼ (25%) patients. Infection didn’t develop in any of our patient (0%). Visualacuity was not affected in any of the patient (0%). Conclusions: Titanium mesh is a suitablematerial for reconstruction of orbital floor fractures with little complication rate and no donor sitemorbidity.

scholarly journals NASAL BONE FRACTUR

2009 ◽  
Vol 16 (02) ◽  
pp. 258-262
Author(s):  
EJAZ RAHIM ◽  
SUHAIL ASLAM ◽  
MUHAMMAD ALI
Keyword(s):  
Effective Treatment ◽  
Closed Reduction ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Bone Fractures ◽  
Age Groups ◽  
Nasal Bone ◽  
Functional Results ◽  
Female Ratio ◽  
Nasal Fractures

b j e c t i v e : To analyze modes of presentation, types of the nasal fractures and their management. Setting and Period:From 01 Apr 2006 to 31 Mar 2007 at Frontier Corps Hospital, Quetta. Patients and methods: This descriptive study consists of 50 patientsof both sexes and all age groups, managed for nasal bone fractures, presented in emergency as well as in outpatient department. Selectionof cases was non probability, convenient type. All patients were admitted in the hospital for evaluation and further management. Every caseof nasal fracture was properly evaluated, assessed and was managed accordingly. Diagnosis was based on proper history, thorough clinicalexamination and radiological confirmation. Results: From this study it was concluded that adults (80%) were affected more than children.Highest incidence was seen in the age group 18-30 years (46%). The male to female ratio was 3:1. The main aetiological factors in adultswere Sports injuries (30%), personal falls (24%), road traffic accidents (22%) and interpersonal assaults (20%) and in children personal falls(24%). Most of the patients (90%) presented within 2 weeks of the nasal trauma. Epistaxis (92%), nasal deformity (76%), pain andtenderness (72%) and nasal obstruction (70%) were main clinical features. Closed reduction under general anaesthesia (80%) was the mostcommon and effective treatment awarded and complications were minimal. Three cases who presented after 1 year of trauma were treatedby Septorhinoplasty (1), Septoplasty(1 )and SMR(1). 14%(7) patients were treated conservatively. Conclusion: Nasal bone fractures shouldnot be considered minor injuries until they have been thoroughly assessed. Closed reduction under GA is most effective treatment for thepatients presenting within 2 weeks of injury. Prognosis of un-complicated nasal fractures, in general, is good and they heal within 2-3 weekswith good cosmetic and functional results.

Complications of Midface Fractures

2017 ◽  
Vol 33 (06) ◽  
pp. 557-561
Author(s):  
Kirkland Lozada ◽  
Sameep Kadakia ◽  
Yadranko Ducic ◽  
Manoj Abraham
Keyword(s):  
Postoperative Complications ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Proper Function ◽  
Patient Specific ◽  
Le Fort ◽  
Proper Management ◽  
Fracture Patterns ◽  
Midface Fractures ◽  
Orbital Floor Fractures

AbstractThe midface relies on key vertical and horizontal buttresses for proper function and appearance. Trauma to the midface can lead to untoward complications involving critical structures of this area. Many reviews focus on operative management of midface fractures with little focus on complications of the injury and operative repair. We review the current literature on the most common initial and postoperative complications of midface trauma with a specific focus on zygomaticomaxillary complex (ZMC) and Le Fort fracture patterns. A thorough literature review was conducted using PubMed analyzing articles relevant to the subject matter. Various search terms were used to identify articles regarding midface fracture presentation, diagnosis, and management, as well as postoperative complications. Articles were examined by all authors and pertinent information was gleaned for the purpose of generating this review. Disruption of the midfacial buttress system can lead to a significant compromise in form and function. A wide variety of complications are seen in nasal bone fractures, orbital floor fractures, Le Fort, and ZMC fractures. Some fracture patterns can be managed conservatively without operative intervention; however, complications such as loss of facial width/projection, trismus, malocclusion, ocular entrapment, and significant enophthalmos should be managed with open repair. Timing and method of repair depend on patient-specific injury patterns and surgeon preference. Proper management depends on a detailed understanding of the anatomy and pathophysiology of each fracture pattern along with restoration of the patient's premorbid state. Complications of midface fractures result from disruption of the vertical and horizontal buttress support systems. Proper management and repair of midface complications requires a strong understanding of its anatomic basis and pathophysiology. Sequelae from these fractures can be serious and long lasting if not addresses appropriately. Astute diagnosis and timely management can prevent patients from suffering debilitating long-term sequelae.

Sonographic Evaluation of Nasal Bone Fractures

2000 ◽  
Vol 43 (1) ◽  
pp. 95
Author(s):  
Jung Eun Kim ◽  
Sun Wha Lee ◽  
Jung Kyoung Lee ◽  
Sun Hee Chung
Keyword(s):  
Bone Fractures ◽  
Nasal Bone ◽  
Sonographic Evaluation

Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. (Preprint)

2019 ◽  
Author(s):  
Waheed Atilade Adegbiji ◽  
Shuaib Kayode Aremu ◽  
AbdulAkeem Adebayo Aluko
Keyword(s):  
Foreign Body ◽  
Head And Neck ◽  
Clinical Features ◽  
University Teaching ◽  
Age Group ◽  
Geriatric Population ◽  
Female Ratio ◽  
Common Diagnosis ◽  
Foreign Body Impaction ◽  
Nose And Throat

BACKGROUND Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. OBJECTIVE This study aimed at determining prevalence, sociodemographic features, aetiology, clinical features, Complications and sources ofreferral of geriatric otorhinolaryngological, head and neck emergency in our center. METHODS This was a prospective hospital based study of geriatric otorhinolaryngology emergency in the Ear, Nose and Throat Department of Ekiti State University Teaching Hospital. The study was carried out between October 2016 and September 2018. Data were obtained by using pretested interviewers questionnaire.All data were collated and analyzed using SPSS version 18.0. The data were expressed by frequency table, percentage, bar charts and pie charts. RESULTS Geriatric otorhinolaryngology, head and neck emergency accounted for 5.3%. Major prevalence age group was 43.9% in the age group (60-64). There were 38.6% males with male to female ratio of 1:1.5. The main aetiology of geriatric otorhinolaryngology emergency was 29.5% trauma/road traffic accident/foreign body impaction and 25.8% tumour. Main anatomical distribution of geriatric otorhinolaryngology emergency were 38.6% throat diseases and 31.1% ear diseases. The most frequent clinical features were pain in 27.3%, hearing loss in 21.2%, tinnitus in 15.9%, bleeding in 14.4%, difficulty breathing in 12.9% and discharge in 11.4%. Common diagnosis in this study were 15.9% sinonasal tumour, 14.4% upper aerodigestive foreign body impaction, 10.6% earwax impaction and 19.8% otitis externa. Acute presentation (<13 weeks) occurred in 1 week in 74.2% and 2-13 weeks In 19.7%. Commonest time of presentation was daytime in 65.9%. Major sources of referral were 43.2% general practitioner and 31.1% casualty officers. Presentation of geriatric otorhinolaryngology emergency were mainly ear, nose and throat clinic in 59.8% with accident and emergency in 28.8%. Commonest associated comorbid illnesses among the geriatric patients were 18.2% hypertension, 14.4% arthritis and 9.8% diabetes mellitus. CONCLUSIONS Geriatric otorhinolaryngological emergency are common pathology with associated with comorbid illnesses. Detailed clinical assessment are mandatory for effective management outcome.

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