scholarly journals Penatalaksanaan emergensi pada trauma oromaksilofasial disertai fraktur basis kranii anterior

2017 ◽  
Vol 3 (2) ◽  
pp. 111 ◽  
Author(s):  
Agus Dwi Sastrawan ◽  
Endang Sjamsudin ◽  
Ahmad Faried

Emergency management of oromaxillofacial trauma with anterior cranial base fracture. Oromaxillofacial trauma with cranial base fracture is a case that is quite commonly found in the ER of Oral and Maxillofacial Surgery Department at Dr. Hasan Sadikin General Hospital Bandung. Emergency management aims to take any appropriate action, prevent complications, and consult to other departments involved. A man aged 28 years came with bleeding from the mouth due to a motorcycle accident approximately 6 hours before admission to the hospital. Physical examination showed facial asymmetry, bilateral periorbital edema and hematoma, rhinorrhea, and stitches in labiomental area. Intraoral examination showed maxillary, palatal, parasymphisis, dentoalveolar fractures, lacerated wound on the upper lip, lower lip, palate, gingival, difficulty in opening the mouth, and malocclusion of the teeth. Immediate and rapid surgical and maxillofacial surgical emergency was performed with minimal maxillary intervention, aiming to prevent persistent spontaneous cerebrospinal fluid leak, and prevent infection. The management of soft tissue and hard tissue injury is by reduction, fixation and immobilization of fractures, management of pain and administration of antibiotics. In conclusion, the emergency management of oromaxillofacial trauma with cranial base fracture is promptly and rapidly carried out with minimal intervention.ABSTRAKTrauma oromaksilofasial disertai fraktur basis kranii merupakan kasus yang cukup banyak ditemukan di Instalasi Gawat Darurat Bedah Mulut dan Maksilofasial RSUP Dr. Hasan Sadikin Bandung. Penatalaksanaan emergensi bertujuan untuk melakukan tindakan yang tepat, mencegah komplikasi, serta konsultasi kepada bagian lain yang terkait. Seorang laki- laki usia 28 tahun datang dengan keluhan perdarahan dari mulut akibat kecelakaan motor kurang lebih 6 jam sebelum masuk rumah sakit. Pemeriksaan fisik ditemukan wajah asimetris, edema dan hematoma pada regio periorbita bilateral, terdapat rhinorrhea, serta bekas jahitan pada regio labiomental. Pemeriksaan intra oral tampak fraktur pada daerah maksila, palatum, parasimfisis, fraktur dentoalveolar, vulnus laserasi pada bibir atas, bibir bawah, palatum, gingiva, kesulitan membuka mulut, dan maloklusi gigi geligi. Tindakan emergensi bedah mulut dan maksilofasial dilakukan segera dan cepat dengan minimal intervensi pada rahang atas bertujuan untuk mencegah kebocoran cairan serebro spinal persisten, dan mencegah terjadinya infeksi. Manajemen luka jaringan lunak dan jaringan keras, melakukan reduksi, fiksasi dan imobilisasi fraktur, manajemen nyeri serta pemberian antibiotik. Penatalaksanaan emergensi pada trauma oromaksilofasial disertai fraktur basis kranii dilakukan segera dan cepat dengan minimal intervensi.

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Lugaric ◽  
C Frezzini ◽  
A Patterson

Abstract Aim To determine the success rates of dental implants in complex patients treated in the Oral and Maxillofacial Surgery Department at Rotherham General Hospital (RGH). Method All patients who received dental implants in the period January 2010 – March 2017 at RGH were included in the audit. Standards 90% local standard Results 68 dental implants were placed in 22 patients: 15 patients head and neck reconstruction, 5 atrophic edentulous patients, 2 trauma. Conclusions Survival rates for dental implants in the literature is variable ranging from 91 -96% in native bone and mucosa and 46 - 98% in irradiated tissue.


2018 ◽  
Vol 16 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Carlos D Pinheiro-Neto ◽  
Maria Peris-Celda ◽  
Tyler Kenning

Abstract BACKGROUND The nasoseptal flap is the main pedicled flap used for endoscopic cranial base reconstruction. For large anterior cranial base defects, the anterior edge is a concern for the nasoseptal flap reach. OBJECTIVE To present a surgical technique that completely releases the vascular pedicle of the nasoseptal flap from the sphenopalatine artery (SPA) foramen improving considerably the reach of the flap. METHODS A patient with left anterior cranial base fracture involving the posterior table of the frontal sinus, who presented with cerebrospinal fluid leak and contused brain herniation to the ethmoid and frontal sinuses. Unilateral endoscopic endonasal anterior cranial base reconstruction was performed with left sided nasoseptal flap. The nasoseptal flap pedicle was dissected and completely released from the SPA foramen. The flap was left attached only to the internal maxillary artery (IMAX) vascular bundle. RESULTS The flap covered the entire left anterior cranial base, from the planum sphenoidale to the posterior table of the frontal sinus. There was complete obliteration of the cerebrospinal fluid fistula postoperatively with resolution of the radiographic pneumocephalus and the patient's rhinorrhea. CONCLUSION The complete release of the nasoseptal flap pedicle from the SPA foramen is feasible and remarkably improves the reach of the flap. It also increases the reconstructive area of the flap since the entire septal mucosa can be used for reconstruction and the pedicle length is based exclusively upon the SPA/IMAX.


2019 ◽  
Vol 12 (4) ◽  
pp. e229607 ◽  
Author(s):  
Amy Patrick ◽  
Keith Altman

Gingival pathology is a daily presentation, however a small number of systemic conditions can manifest similar to a common gingival condition and have fatal results. Dentist referred 56-year-old woman to Oral and Maxillofacial Surgery department with a 2-week medical history of gingival bleeding not responding to local measures. Biopsy showed eosinophilic infiltrate and vasculitis, and blood tests showed positive markers including cytoplasmic antineutrophil cytoplasmatic antibodies. Granulomatosis with polyangiitis is a rare disease affecting the respiratory tract, blood vessels and kidneys. Oral lesions are rarely the primary presenting feature. When left untreated, most cases are fatal within a year of diagnosis. The diagnosis can only be made when certain criteria are found, including granular oral lesions exhibiting an eosinophilic inflammatory infiltrate on biopsy. With 5% of cases showing intraoral lesions as the primary feature, it is essential that dentists have the knowledge of this rare disease to refer and not to treat as a common gingival condition.


2013 ◽  
Vol 59 (1) ◽  
pp. 40-43 ◽  
Author(s):  
Alina Iacob ◽  
Bálint Bögözi

Abstract Background: In the medical literature there are multiple reconstructive procedures for small and medium size defects of the lower lip, but only a few methods for larger defects involving the whole lower lip. Choosing the repairing procedure for larger lower lip defects must take into account two aspects: flap or flaps used should be local flaps, and suture lines should correspond to the natural facial creases or follow the functional lines of different facial aesthetic units. Finally, the flap or flaps should be large enough to restore the entire postexcisional defect. However, the more tissue is lost from the lower lip, the more challenging the reconstruction is from a functional and cosmetic point of view. Material and methods: During the last 2 years in the Oral and Maxillofacial Surgery Department of the County Emergency Clinical Hospital in Tîrgu Mureș, the unilateral Fujimori technique has been successfully used for the reconstruction of large lower lip defects in 4 patients with extended, neglected squamous cell carcinomas involving almost the whole lower lip tissue. These patients underwent complex surgical and oncological treatment. Surgery was performed in two stages: first, excision of the tumor and immediate lip reconstruction, and then removal of submandibular lymph nodes (level I), in the second stage. Results: The aesthetic and functional recovery of these patients was very good, with no need of other subsequent surgical corrections. Conclusions: The postoperative reconstruction of large defects of the lower lip is far from optimal, but it is very important to restore an adequate muscle function, the lip continence and a satisfactory facial appearance.


Author(s):  
Massimo Robiony ◽  
Elena Bocin ◽  
Salvatore Sembronio ◽  
Fabio Costa ◽  
Vittorio Bresadola ◽  
...  

The rise of the COVID-19 pandemic has posed new challenges for health care institutions. Restrictions imposed by local governments worldwide have compromised the mobility of patients and decreased the number of physicians in hospitals. Additional requirements in terms of medical staff security further limited the physical contact of doctors with their patients, thereby questioning the traditional methods of clinical examination. Our institution has developed an organization model to translate the essential clinical services into virtual consultation rooms using a telemedicine interface which is commonly available to patients. We provide examples of clinical activity for a maxillofacial surgery department based on teleconsultation. Our experience is summarized and an organization model is drafted in which outpatient consultation offices are translated into virtual room environments. Clinical examples are provided, demonstrating how each subspecialty of oral and maxillofacial surgery can benefit from virtual examinations. The concept of “telesemeiology” is introduced and a checklist is presented to guide clinicians to perform teleconsultations. This paper is intended to provide an organization model based on telemedicine for maxillofacial surgeons and aims to represent an aid for colleagues who are facing the pandemic in areas where lockdown limits the possibility of a physical examination.


2019 ◽  
Vol 8 (2) ◽  
pp. 25-31 ◽  
Author(s):  
ROWLAND AGBARA ◽  
BENJAMIN FOMETE ◽  
KELVIN OMEJE ◽  
POLYCARP ONYEBUCHI

Introduction: Sarcomas are a rare group of malignant tumors. This study highlights important findings in 91 cases of non-odontogenic sarcomas of the orofacial region. Materials and Methods: Patients who presented with orofacial sarcoma at the Oral and Maxillofacial Surgery Department of a regional University Teaching Hospital between January 1997 and June 2017 were retrospectively studied. Excluded were cases of Kaposi and odontogenic sarcomas. Data obtained were analyzed using the Statistical Package for Social Sciences (SPSS) version 16 (SPSS Inc., Chicago, IL, USA). Results from descriptive statistics were represented in the form of charts. Results: A total of 91 cases were reviewed and consisted of 51 (56.0%) males and 40 (44.0%) females, with a male to female ratio of 1.3:1. The mandible (n=47; 51.6%) and the maxilla (n=26; 28.6%) were the major sites involved. Osteogenic sarcoma (n=44; 48.4%) and rhabdomyosarcoma (n=16; 17.6%) occurred more frequently. A total of 41 (45.1%) patients had surgery and the common hard tissue procedures were mandibulectomy (n=26; 28.6%) and maxillectomy (n=10; 11.0%). Non-surgical oncological treatment was administered to 32 (35.2%) patients, and this was the only modality of treatment in 8 (8.8%) cases. The period of follow-up Arranged from 1-43 months and within this period; there were 7 (17.1%) recurrences with 1 case of pulmonary metastasis. Discussion: Most recurrences were noted less than one-year post-treatment. There is a tendency for patients to present late and compliance with follow up review is poor in this environment.


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