scholarly journals Management of Frontal Bone Fracture in a Tertiary Neurosurgical Care Center—A Retrospective Study

2022 ◽  
Author(s):  
Rakshith Srinivasa ◽  
Sunil V. Furtado ◽  
Tanvy Sansgiri ◽  
Kuldeep Vala
Keyword(s):  
Retrospective Study ◽  
Ct Scan ◽  
Bone Fracture ◽  
Medical Records ◽  
Bone Fractures ◽  
Frontal Bone ◽  
Csf Leak ◽  
Csf Rhinorrhea ◽  
Fracture Management ◽  
Maxillofacial Fractures

Abstract Aim We present our experience in the management of frontal bone fractures using the previously described radiologic classification of frontal bone fractures. Methodology A retrospective study was conducted, which reviewed the medical records and computed tomographic (CT) scan images of patients with frontal bone fracture from January 2016 to February 2019. Patients with complete medical records and a follow-up of minimum 1 year were included in the study. Demographic details, mechanism of injury, associated intracranial injuries, maxillofacial fractures, management, and complications were analyzed. CT scan images were used to classify the frontal bone fractures using the novel classification given by Garg et al (2014). The indications for surgical treatment were inner table frontal sinus fracture with cerebrospinal fluid (CSF) leak, intracranial hematoma with significant mass effect requiring surgical evacuation, and outer table comminuted fracture that is either causing nasofrontal duct obstruction or for cosmetic purpose. Results A total of 55 patients were included in the study. Road traffic accidents as the commonest cause of frontal bone fractures. The most common fracture pattern was type 1 followed by type 5 and depth B followed by depth A. Four patients presented with CSF rhinorrhea. CSF rhinorrhea was more frequent with fracture extension to the skull base (depth B, C, D), which was statistically significant (p < 0.001). Conclusion Frontal bone fracture management has to be tailor-made for each patient based on the extent of the fracture, presence of CSF leak, and associated intracranial and maxillofacial injuries.

The Pattern of Maxillofacial Fractures in the Traumatic Brain Injury Patients in Songklanagarind Hospital: A Retrospective Study

2021 ◽  
Vol 104 (2) ◽  
pp. 185-190
Keyword(s):  
Traumatic Brain Injury ◽  
Retrospective Study ◽  
Brain Injury ◽  
Bone Fracture ◽  
Brain Injuries ◽  
Moderate Traumatic Brain Injury ◽  
Maxillofacial Fractures ◽  
Fall From Height ◽  
Frequent Site ◽  
The Mean

Background: Maxillofacial injuries are commonly associated with brain injuries, with the major etiological factors being traffic collision, violence, and fall from height. The incidence and etiology are important for the development of treatment and for the improvement of patient care in the future. Objective: To analyze the incidence of patterns of maxillofacial fractures with traumatic brain injuries and to measure the incidence of cause of injury, age, gender distribution, and length of stay in hospital. Materials and Methods: The present study was a retrospective study in Songklanagarind Hospital. The authors evaluated the patients that presented with a concomitant maxillofacial and traumatic brain injury in Songklanagarind Hospital between 2007 and 2016. The data were assessed using multiple logistic modeling and reported in term of percentage and corresponding 95% confidence intervals. Results: Eight hundred fifty-nine patients were studied, consisting of 73.3% male and 22.7% female. The mean age was 39.5 years. The severity of the traumatic brain injury was mild and 70.15% with associated alcohol consumption. The maxilla bone fracture was common in 49.9%. The patients with mild to moderate traumatic brain injury were related to the coronoid process of mandible and severe traumatic brain injury was related to Le Fort fracture type II and III. Conclusion: In the present study, the maxilla bone fracture was the most frequent site involved. In addition, there was an association between the severity of the head injury and the type of maxillofacial injury. Keywords: Traumatic brain injury, Maxillofacial fracture

scholarly journals A retrospective study to analyze treatment of post traumatic cerebro spinal fluid rhinorrhea and role of trans cranial pedicled pericranial repair in present day context

2022 ◽  
Vol 7 (4) ◽  
pp. 111-118
Author(s):  
Shashivadhanan ◽  
Abhishek Mishra
Keyword(s):  
Retrospective Study ◽  
Skull Base ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Spinal Fluid ◽  
Csf Leak ◽  
Care Hospital ◽  
Endoscopic Repair ◽  
Csf Rhinorrhea ◽  
Post Traumatic

: Skull base fractures are a major cause of morbidity and mortality in head injury. Anterior cranial Fossa (ACF) skull base fracture, leading to Cerebro Spinal Fluid (CSF) Rhinorrhea is one of the most commonly encountered presentation in ACF base fractures. The key to successful management of such cases lies in early diagnosis and surgical management before it leads to meningitis and avoidable mortality.To evaluate the cases of post traumatic CSF rhinorrhea and analyze the parameters utilized to guide the management strategies. An attempt was made to come up with guidelines for its management in a tertiary care hospital.This was a retrospective study in which all cases of traumatic CSF Rhinorrhea admitted to Tertiary care hospital were included. Patients were divided into three groups. First group was conservatively managed in which the rhinorrhea and serial imaging findings showed favourable response.In thesecond group patients were subjected to endoscopic repair by the ENT surgeon based on anatomical considerations. The third group included patients who were had failed the trial of conservative management and the site of leak did not favor endoscopic repair.The outcomes in all these groups were analyzed and conclusions drawn.A total of 54 patients were included in the study which was conducted between Jan 2014 to 2020. 24 were successfully managed conservatively,10 were managed with endoscopic repair and 20 were managed by bifrontal craniotomy and pedicled pericranial ACF Base repair. There was one case from the first group who developed CSF leak after one month necessitating ACF base repair. There was no recurrence reportedin the cases managed endoscopically, whereas one case subjected to craniotomy had recurrence requiring lumbar drain placement. With each transcranial surgery there was a refinement in the technique further minimizing complications. We have elaborated on the surgical nuances to ensurebetter outcomes. : Pedicledpericranial flap ACF base repair is an elegant approach which requires an understanding of the mechanism of CSF leak from skull base fractures. This procedure can easily be mastered and when performed correctly provides best results for cases where there are multiple ACF defects, those not accessible by endoscope and also in those cases where imaging is not able to localize the exact site of defect leading to CSF rhinorrhea. Anosmia is an in evitable complication of this procedure. However, the trade off between mortality resulting from meningitis versus anosmia makes it a viable and attractive treatment option.

scholarly journals PROPTOSE EM CÃES E GATOS: ANÁLISE RETROSPECTIVA DE 64 CASOS

2005 ◽  
Vol 10 (1) ◽  
Author(s):  
C.V.S. BRANDÃO ◽  
J.J.T. RANZANI ◽  
L.F.L.P. MARINHO ◽  
G.N. RODRIGUES ◽  
D.N. CREMONINI
Keyword(s):  
Retrospective Study ◽  
Corneal Epithelium ◽  
Medical Records ◽  
Bone Fractures ◽  
Etiologic Factor ◽  
Corneal Ulceration ◽  
Facial Bone ◽  
Favorable Prognosis ◽  
The Common ◽  
Worse Prognosis

Foi realizado um estudo retrospectivo envolvendo 45 cães e 19 gatos com proptose traumática do bulbo ocular. Foram estudados vários aspectos, tais como sexo, raça, idade, etiologia, tempo decorrente entre a lesão e admissão, seqüelas, além daqueles relacionados ao tratamento. O principal fator etiológico verificado entre cães foi a briga, enquanto na maioria dos gatos, a causa era desconhecida. Os cães adultos sem raça definida, seguidos pelo Pinscher, Poodle, Cocker Spaniel e Boxer foram os mais acometidos. As complicações mais comuns associadas à proptose foram ceratite ulcerativa, estrabismo, hifema, quemose, hiperemia, hemorragia de conjuntiva e periocular, ressecamento e opacidade da córnea, prolapso de terceira pálpebra, além de fratura nos ossos da face. Quinze cães e apenas 2 gatos avaliados foram submetidos ao reposicionamento do bulbo e tarsorrafia. Desses animais, somente 13 cães recuperaram a visão. Conclui-se que a precocidade na admissão dos cães influencia sobremaneira a obtenção de um prognóstico mais favorável, bem como na escolha do tratamento. Os gatos apresentam pior prognóstico em relação aos cães. Proptose in dogs and cats: retrospective analyses of 64 medical records Abstract A retrospective study of 45 dogs and 19 cats with traumatic proptosis was performed. Sex, breed-specific, age, etiologic factors, time between trauma and admission, sequels and treatment were obtained for these animals. The principal etiologic factor in dogs was fight and in cats was unknown. Mongrel dogs, Pinscher, Cocker and Boxer were the most affected breeds. The common complications were corneal ulceration, strabismus, hyphema, chemosis, hyperemia, conjunctive hemorrhage, defects in the corneal epithelium, third eyelid prolapsed and facial bone fractures. Fifteen dogs and only two cats suffered repositioning followed by tarsorrhaphy. From these animals, only thirteen dogs recovered the eye vision. In conclusion, the precocity in the admission was important for a more favorable prognosis as much as the treatment choice. The cats presented worse prognosis when compared to dogs.

Maxillofacial Bone Fractures in Children and Adolescents: Overview of 247 Cases in a Major Referral Hospital, Najran, Kingdom of Saudi Arabia

2020 ◽  
pp. 194338752095268
Author(s):  
John Spencer Daniels ◽  
Ibrahim Albakry ◽  
Ramat Oyebunmi Braimah ◽  
Mohammed Ismail Samara
Keyword(s):  
Retrospective Study ◽  
Children And Adolescents ◽  
Treatment Modality ◽  
Bone Fractures ◽  
Age Group ◽  
Facial Bone ◽  
Kingdom Of Saudi Arabia ◽  
Male Predominance ◽  
Fractures In Children ◽  
Maxillofacial Fractures

Study Design: A retrospective study investigating maxillofacial bone fractures in the pediatric and adolescent population. Objective: The aim of this study was to present our experience in the management of pediatric facial bone fractures. Methods: This was a retrospective study of maxillofacial bone fractures in children and adolescents between the ages <1 year and 19 years in a Saudi Arabian subpopulation. Data collected include demographics, etiology, pattern, and treatment of maxillofacial bone fractures. Data were analyzed using IBM SPSS Statistics for Windows Version 25 (IBM Corp.). Results were presented as simple frequencies and descriptive statistics. Results: Of the 1297 patients with maxillofacial bone fractures, 247 were cases involving children and adolescents giving a prevalence of 19.0% (247 patients, N = 1297). There were 233 males and 14 females with an M:F ratio of 16.6:1. The ages ranged from 9 months to 19 years with a mean ± SD of 14.4 ± 4.6. The age-group between 16 and 20 years had the highest frequency of patients (144 (58.4%)). In the 1- to 5-year group, falls accounted for most of the etiology (15 (6.1%)), while in the 16- to 20-year group, motor vehicular accident (MVA) was the main reason (120 (48.6%)). The majority of the fractures occurred in the mandible with 151(61.1%) cases. Open reduction and internal fixation (ORIF) were the main treatment modality in 171 (69.2%) patients. Conclusions: MVA was the main etiology of maxillofacial fractures in children and adolescents with male predominance, while the mandible had been the most frequently fractured bone. ORIF was the main treatment modality.

Incidence of bone fracture in Japanese patients receiving long-term hormone therapy for prostate cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16098-e16098
Author(s):  
Hiroji Uemura ◽  
Hideo Fusayasu ◽  
Shinji Ohtake ◽  
Narihiko Hayashi ◽  
Yumiko Yokomizo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Retrospective Study ◽  
Gnrh Agonist ◽  
Hormonal Therapy ◽  
Bone Fracture ◽  
Bone Fractures ◽  
Japanese Patients ◽  
University Hospital ◽  
Long Term Treatment

e16098 Background: For patients with advanced prostate cancer, long-term treatment of androgen deprivation has been conventionally performed. Among the adverse events such as hormonal therapy, bone fracture due to osteoporosis or metastatsis is one of indispensable events. We assessed the frequency of bone fractures in Japanese patients received hormonal therapy. Methods: Between 2000 and 2010, 1,108 Japanese patients were treated with hormonal therapy including GnRH agonist plus anti-androgens or GnRH agonist alone at Yokohama City University Hospital. Of those patients, 48 patients (4.3%) had bone fractures during their treatment. In this retrospective study, we examined the association of bone fracture with the long-term hormonal therapy by investigating the duration of hormonal therapy, fracture sites, and the occurrence of fracture in castration resistant prostate cancer (CRPC) patients. Results: The median age of the patients with fracture was 77 (60-85) years; the median duration from the start of hormonal therapy to fracture was 29.4 (5.4-110.4) months. Eight patients with CRPC had pathological fractures at bone metastases. With respect of fracture sites, 22 patients (46%) had spinal fractures and 10 patients (21%) had fracture of lower legs. Of 8 CRPC patients, 7 patients had spinal fracture after long-term hormonal therapy (median: 38.6 months, range: 15.7-99.1 months). Conclusions: Japanese patients with prostate cancer treated with hormonal therapy have lower risk for bone fracture compared with those in western countries and USA, and interestingly, it is recognized that vertebral body is vulnerable to fracture in Japanese, especially in CRPC patients treated for long-term hormonal therapy. Because bone fracture in patients with prostate cancer endanger their prognosis, the bone management how to prevent bone fracture is very important during hormonal therapy. For the purpose of it, more detailed analysis in this retrospective study should be required.

Excavating Meningoencephaloceles: A Newly Recognized Entity

2017 ◽  
Vol 31 (2) ◽  
pp. 127-134 ◽  
Author(s):  
Patricia A. Loftus ◽  
Sarah K. Wise ◽  
Pedram Daraei ◽  
Kristen Baugnon ◽  
John M. DelGaudio
Keyword(s):  
Ct Scan ◽  
Skull Base ◽  
Operating Room ◽  
Tertiary Care ◽  
Distinct Type ◽  
Csf Leak ◽  
Csf Rhinorrhea ◽  
Skull Base Defect ◽  
Skull Base Defects ◽  
Csf Leaks

Background Spontaneous cerebrospinal fluid (CSF) leaks are largely attributed to idiopathic intracranial hypertension and typically present as skull base defects with or without prolapse of intracranial contents. However, in our practice, we have encountered a distinct type of spontaneous CSF leak that presents in a different manner. Objective To discuss a newly-classified, difficult to treat, subset of spontaneous CSF leaks that present as excavation of the bone of the skull base in a tunnel- or canal-like fashion by a meningocele or meningoencephalocele instead of as a localized area of bony dehiscence. Methods A retrospective review was performed at a tertiary care rhinology practice to identify a subset of CSF leak patients with an excavating/canal-like skull base defect visualized radiographically on computed tomography (CT) scan or magnetic resonance imaging and/or endoscopically in the operating room. Results The cohort of patients consisted of 7 females and 1 male with an average age of 53.6 years and a self-reported race of 4:3:1 African-American: Caucasian-Indian. All patients presented with CSF rhinorrhea. The most common leak site was the cribriform and upper septum. Six of the 8 patients had multiple defects and/or progression of their skull base defects, and 5 patients required multiple and/or repeat repairs in the operating room. Seven of the 8 patients underwent a cisternogram because the excavating nature of the leaks made it difficult to identify the specific leak site on high-resolution CT scan alone. Conclusion In spontaneous CSF leaks that are difficult to identify or recur soon after a proper repair, an excavating pattern should be considered. Failure to recognize this type of leak and all of its tributaries, to fully unroof the excavated bone to completely resect the meningocele, and to visualize and close the site of origin will likely result in failure and recurrence of CSF leak.

scholarly journals Central nervous system hemorrhage in thrombocytopenic patients: computed tomographic findings in 21 cases

2007 ◽  
Vol 65 (2A) ◽  
pp. 268-272 ◽  
Author(s):  
Emerson L. Gasparetto ◽  
Paulo R. Benites Filho ◽  
Taísa Davaus ◽  
Arnolfo de Carvalho Neto
Keyword(s):  
Computed Tomography ◽  
Central Nervous System ◽  
Nervous System ◽  
Retrospective Study ◽  
Ct Scan ◽  
Medical Records ◽  
Midline Shift ◽  
Intraparenchymal Hemorrhage ◽  
Computed Tomographic ◽  
Parietal Lobes

OBJETIVE: To describe the CT scan findings of 21 thrombocytopenic patients with central nervous system (CNS) hemorrhage. METHOD: Retrospective study of the computed tomography (CT) of 21 platelet-depleted patients with CNS hemorrhage. One patient presented two episodes of hemorrhagic episode with different intervals. The clinical data were obtained by the review of the medical records. Two radiologists analyzed the films and reached the decisions by consensus. The following findings were studied: type of bleeding, number of lesions, topography, laterality, size and associated findings. RESULTS: Intraparenchymal hemorrhage (IPH) was the most common findings, found in 20 cases, being six of them associated with subarachnoid and intraventricular hemorrhages. The size of the lesions varied between 1.8 and 10.5 cm. The parietal lobes were more commonly affected (n=11, 50%), followed by the temporal (n=7, 31.8%), frontal (n=7, 31.8%) and occipital (n=2, 9.09%) lobes. In 15 cases (68.2%) there was a single area of hemorrhage and in the remaining cases there were multiple hemorrhages. Associated findings were found in 20 cases. The most prevalent were edema (n=17, 77.3%), hydrocephalus (10, 45.4%) and midline shift (n=9, 41%). CONCLUSION: The most frequent CT scan findings in thrombocytopenic patients with CNS hemorrhage are single IPH, located mostly in the parietal, temporal and frontal lobes, with varied sizes and associated with edema, hydrocephalus and midline shift.

scholarly journals Keen's Approach: A Dynamic Approach for Zygomatic Arch Fracture Management

2016 ◽  
Vol 06 (04) ◽  
pp. 92-94
Author(s):  
Muralee Mohan ◽  
Tripthi P. S. ◽  
Pratiksha Shetty ◽  
Akash Menon
Keyword(s):  
Bone Fractures ◽  
Head Injuries ◽  
Mouth Opening ◽  
Road Accident ◽  
Zygomatic Arch ◽  
Open Approach ◽  
Intraoral Approach ◽  
Aged Woman ◽  
Fracture Management ◽  
Maxillofacial Fractures

AbstractMaxillofacial fractures are often associated with blunt head injuries of which the outward projection of the Zygomatic Arch exposes it to frequent injury. Isolated Zygomatic arch fractures account for 10% of all Zygomatic bone fractures. Depressed Zygomatic arch fractures causes restricted mouth opening due to the partial or total obstruction of the movement of mandibular coronoid and condylar processes. Numerous techniques have been used to approach the site and reduce the fractured fragments, such as the Gillie's temporal approach, Keen's intraoral approach, anterior cheek skin incision and direct open approach.Below is a case report of an isolated Zygomatic arch fracture following a road accident in a middle aged woman that was surgically treated by open reduction through the Keen's intraoral approach. Successful reduction of the fractured segments and restoration of function was achieved with no scarring, minimal post-operative pain and satisfactory aesthetics.

scholarly journals Antibiotic use in nasal bone fracture: a single-center retrospective study

2021 ◽  
Vol 22 (6) ◽  
pp. 319-323
Author(s):  
Ji Hyuk Jung ◽  
Yeo Reum Jeon ◽  
Joon Ho Song ◽  
Seum Chung
Keyword(s):  
Retrospective Study ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Antibiotic Use ◽  
Careful Consideration ◽  
Antibiotic Usage ◽  
Nasal Packing ◽  
Related Complication

Background: Prophylactic antibiotics are used to prevent surgical wound infection; however, proper indications must be followed with careful consideration of the risks and benefits, especially in clean or clean-contaminated wounds. Nasal bone fractures are the most common type of facial bone fracture. The most common method for treating nasal bone fracture is closed reduction, which is performed inside the nasal cavity without an incision. The purpose of this study was to determine the need for antibiotic use in the closed reduction of nasal bone fractures.Methods: A retrospective study was conducted using data from the National Insurance Service Ilsan Hospital of the Republic of Korea between 2016 and 2018. The records of patients who underwent closed reduction of nasal bone fracture were reviewed and classified according to sex, age, comorbidities, perioperative antibiotic usage, postoperative complications, nasal packing, anesthesia type, surgeon’s specialty, and operation time.Results: Among the 373 patients studied, the antibiotic prescription rate was 67.3%. Just 0.8% of patients were prescribed preoperative antibiotics only, 44.0% were prescribed postoperative antibiotics only, and 22.5% were prescribed both preoperative and postoperative antibiotics. There were no cases that satisfied the definition of “surgical site infection.” Furthermore, 2.1% of infection-related complications (e.g., mucosal swelling, synechia, and anosmia) occurred only in the antibiotic usage group. The use of nasal packing, anesthesia type, and surgeon’s specialty did not show any difference in infection-related complication rates.Conclusion: According to the study findings, the routine use of perioperative antibiotics is not recommended in uncomplicated nasal bone fracture surgery.

scholarly journals LIMFOMA MALIGNA PADA MATA YANG DIRAWAT DI RUMAH SAKIT Dr. M. DJAMIL PADANG TAHUN 2003-2010

2011 ◽  
Vol 35 (1) ◽  
pp. 50
Author(s):  
Linda Wira Putri ◽  
Ardizal Rahman
Keyword(s):  
Retrospective Study ◽  
Ct Scan ◽  
Malignant Lymphoma ◽  
Medical Records ◽  
Ct Imaging ◽  
Common Type ◽  
Chief Complaint ◽  
Lymphoma Patient ◽  
Female Patients ◽  
Ocular Lymphoma

AbstrakMelaporkan kasus Limpoma pada Mata yang dirawat di RS. Dr. M. Djamil Padang.Studi retrospektif dari 17 rekam medik yang didiagnosa sebagai limfoma pada mata di Bagian Mata RSUP dr. M. Djamil antara 2003 – 2010.Terdapat 17 kasus limfoma pada mata di RSUP Dr. M. Djamil antara 2003 – 2010. Pasien laki-laki sebanyak 15 orang dan pasien perempuan 2 orang, dengan usia antara 4 bulan – 71 tahun. Keluhan utama paling sering (82,35%) adalah proptosis pada mata. Semua pasien diperiksa dengan CT scan dan pemeriksaan histopatologis. Tipe limfositik yang paling banyak ditemukan secara histopatologis (64,70%). Semua pasien dianjurkan untuk kemoterapi, tetapi hanya 10 pasien yang menjalani kemoterapi.Proptosis pada mata merupakan tanda yang paling sering dari limfoma maligna pada pasien yang berobat di RSUP Dr. M. Djamil. Tipe limfositik adalah tipe yang paling sering. Tidak semua pasien menjalani kemoterapi karena adanya masalah ekonomi.Kata kunci: Limfoma maligna, limfoma pada mata, proptosisAbstractReporting cases of hospitalized ocular lymphoma at Dr. M. Djamil Hospital from 2003 – 2010.Retrospective study of the medical records of 17 Ocular Lympomas diagnosed patients at the Ophthalmology Department of Dr. M. Djamil Hospital, between 2003 – 2010.There were 17 cases of Ocular Lymphoma at Dr. M. Djamil Hospital between 2003 – 2010. They are 15 male and 2 female patients, in range of age between 4 months to 71 years old. Most of them (82.35%) have chief complaint proptosed of the eye since months to years. All patients were examined using CT imaging and histopatologically. Lymphosityc type was the most type of hystopathological characterictic (64.70%) All patient were suggested to chemotherapy, but only 10 patients received chemotherapy.LAPORAN KASUS51Proptosed of the eye was the most commont sign of malignant lymphoma patient visited at Dr. M. Djamil Hospital. Lymphosityc type was the most common type. Not all patients could receive chemotherapy for they have economic problems.Key word : Malignant lymphoma,ocular lymphoma, proptosis

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