Mid-facial soft tissue re-suspension following skeletal fixation after maxillofacial trauma—a prospective case series study

Oral and Maxillofacial Surgery - Open reduction and internal fixation (ORIF) is used for reduction and stabilization of facial fractures. Despite perfect anatomic skeletal reduction, subtle...     

Reasons for miniplate removal following maxillofacial trauma: a 4-year study.

INTRODUCTION: There is still no consensus on the need for routine removal of titanium miniplates in the maxillofacial skeleton. The purpose of this 4-year prospective study was to evaluate the reasons for removal of titanium miniplates ("2.0mm") following maxillofacial trauma. MATERIAL AND METHODS: Records of 280 patients were evaluated concerning the number of plates inserted, the site of plating, the number of patients in whom plates were removed, the site of removal and the reasons for which removal of plates was indicated. RESULTS: In the 280 patients with facial trauma, 599 miniplates were used during this period. Thirty-seven miniplates were removed from 27 of these patients. The main causes for removal were infection and exposure of the plate in the oral cavity, patients' request and/or the plates being palpable. The nasofrontal region, the area around the anterior wall of the antrum and the body of the mandible proved to be the commonest regions where plate removal was required. CONCLUSION: The number of miniplates removed was small but not insignificant. There is no evidence from this study to support advice for the routine removal of titanium miniplates from the maxillofacial skeleton.     

Avulsion of globe following maxillofacial trauma

Avulsion of the eye globe is a rare condition that is unexpected in maxillofacial trauma and results from severe trauma to the orbit and face. A search of the literature reveals very few reported cases. The present article reports a case of this singular, challenging condition and comments on several other related causes, pathophysiology mechanisms, risks, complications, and management.     

Psychological consequences of maxillofacial trauma: a preliminary study

AIMS: To identify the prevalence of post-traumatic psychological symptoms after maxillofacial trauma and prognostic factors related to poor outcome. METHODS: Thirty-nine patients were assessed within 10 days of injury and 24 again 4-6 weeks later using five standardised self-report measures on each occasion and a short structured interview at the time of initial contact. RESULTS: Specific post-traumatic psychological symptoms were present at initial assessment in 21 patients (54%), with 9 (41%) meeting diagnostic criteria for post-traumatic stress disorder at review 4-6 weeks later. Other psychiatric problems, such as anxiety and depression, were identified by the General Health Questionnaire and the Hospital Anxiety and Depression Scale. Characteristics associated with poorer outcome included: a previous history of psychological distress; fear of the unknown, and female sex. CONCLUSION: These findings highlight the adverse psychological effect of maxillofacial trauma both immediately after the event and 4-6 weeks after injury. Proper assessment of injured patients must include psychological aspects and further research is needed to identify the most appropriate response.     

Pediatric injuries in maxillofacial trauma: a 5 year study

Fractures of the facial skeleton in children are less frequent. This clinical retrospective study of 5 year was conducted on 95 patients aged less than 16 years who sustained maxillofacial injuries during the period 2003 to 2008. Age, sex, etiology incidence and type of fracture were studied. The ratio of boys to girls was 1.9:1. The 7–12 year age group was commonly involved and the highest incidence was at age of ten years. Falls were the most common cause of injury accounting for 41%, followed by road traffic accidents (30%). Sports related injuries, assault and child abuse were also the causes of injury in children. Dentoalveolar injuries were found to be highest incidence with 42.1% followed by mandibular fractures. The soft tissue injuries were associated the pediatric maxillofacial trauma were found to be 34.7% of all cases.     

Rugby-related adult maxillofacial trauma injuries: a NEISS database study

Oral and Maxillofacial Surgery - The primary objective of this study is to delineate the data on maxillofacial trauma in rugby utilizing the National Electronic Injury Surveillance System (NEISS)...     

Factors associated to post-operative nausea and vomiting following oral and maxillofacial surgery: a prospective study

Aim

This study aims to address and assess possible factors associated with nausea and vomiting (NV) following oral and maxillofacial surgery.

Material and methods

A prospective study was carried out in the period from December 2013 to January 2016 targeting all attended cases in that period. For statistical analysis, Pearson chi-square and Fisher tests were used to verify association and ANOVA and Student’s t tests to test for significant difference, p was defined as ≤0.05. The sample group consisted of 207 patients with an average age of 33.56 years (±13.23), and 70.5% of subjects were male.

Results

Calculations based on the predictive model showed that a female patient with prior history of nausea and vomiting who used opioids and had intra-oral surgical access would have a 96% chance of experiencing a nausea and vomiting episode.Other factors like age, being overweight, anesthesia, surgery duration, and duration of hospital stay also contribute so that these aspects must be paid careful attention prior to surgery to ensure a suitably orientated treatment that will avoid disturbances caused by post-operative nausea and vomiting.

Conclusion

The occurrence of post-operative nausea and vomiting after oral and maxillofacial surgery was found to be more higher incidence associated to female patients who used opioids, who had a prior history of NV, whose surgery involved intra-oral access, who were in the second or third decades of their lives, who have above average weight, and who have long anesthesia when undergoing surgery, resulting in a long hospital stays.

     

Quality of life impacts following childhood dento‐alveolar trauma

Abstract – Background: Dental injuries occur commonly in childhood and may necessitate demanding courses of treatment. The aim of this study was to investigate a variety of clinical and demographic factors that may influence the quality of life impacts experienced by children after a dental injury. Method: A total of 244 children who attended a UK dental hospital, for management of traumatised permanent incisors, were invited to participate in the study. Clinical, demographic and psychosocial variables were collected at baseline, and outcome variables were assessed again at a 6‐month follow up. Clinical variables included number of teeth injured; severity of the dental injury; visibility of the injury; time since injury; and number of dental appointments attended within the hospital. Psychosocial outcomes assessed included children’s oral health‐related quality of life (OHRQoL) and health‐related quality of life (HRQoL). Results: One hundred and eight children participated in the baseline study (44% response rate), and of this group of children, a total of 70 children completed follow‐up questionnaires (65% response rate). The results indicated that the most affected areas of children’s OHRQoL and HRQoL were functional limitations and school‐related activities, respectively. Of all the demographic and clinical variables, which were investigated within the current study, the only variable that significantly predicted OHRQoL and HRQoL for children was gender. Boys were found to report fewer impacts on their OHRQoL and HRQoL than girls. Interestingly, over two‐thirds of children reported fewer impacts at the 6‐month follow up. Conclusions: The results revealed that girls were more likely to report higher level of impacts on their OHRQoL and HRQoL than boys following traumatic injury to their permanent incisors. Clinical variables were not significant predictors of child quality of life outcomes following dento‐alveolar trauma at baseline or at the 6‐month follow up.     

Bilateral pulmonary aspiration of intact teeth following maxillofacial trauma

Tooth aspiration is one of the rare sequelae of dental trauma. When this does occur, the right bronchus is usually involved in adults due to the anatomical configuration. In this unusual case, two teeth were aspirated with one entering each lung. While the outcome from cases of aspiration of foreign bodies is usually favourable, this case serves to illustrate one of the possible unfavourable consequences.     

Bilateral pulmonary aspiration of intact teeth following maxillofacial trauma

Abstract— Tooth aspiration is one of the rare sequelae of dental trauma. When this does occur, the right bronchus is usually involved in adults due to the anatomical configuration. In this unusual case, two teeth were aspirated with one entering each lung. While the outcome from cases of aspiration of foreign bodies is usually favourable, this case serves to illustrate one of the possible unfavourable consequences.     

Quality of life assessment in temporomandibular joint ankylosis patients after interpositional arthroplasty: a prospective study

Temporomandibular joint (TMJ) ankylosis significantly impacts both physical and psychosocial patient wellbeing. A complete evaluation of treatment outcomes necessitates knowing the extent to which a patient’s quality of life (QoL) is impacted. This study was performed to evaluate the impact of TMJ ankylosis on QoL in 25 TMJ ankylosis patients treated by interpositional arthroplasty. The patients completed OHIP-14 and UWQoL questionnaires once before and then at 3 months after the surgery. There was a significant improvement in mean cumulative scores for both questionnaires. With the exception of functional limitation, all OHIP domains showed significant improvement. Preoperatively, the worst scores were found in the psychological distress domain, followed by the social handicap, physical pain and physical disability domains. More than half of the subjects (56%) reported having suicidal thoughts. Amongst the individual UWQoL domains, appearance, chewing, anxiety (P < 0.01), recreation and mood (P < 0.05) showed improved scores. Appearance and chewing were the top ranked priority domains before and after surgery. No significant change was found in speech, taste, sleep, or breathing. Psychosocial factors were found to play a much bigger role than previously thought. The physical, psychological, and social factors were intricately related and dynamically interacted with each other. Surgical treatment produced a definitive QoL improvement in the patients.     

Pattern of associated brain injury in maxillofacial trauma: a retrospective study from a high-volume centre

The incidence of head injury in maxillofacial trauma patients varies widely in the literature. A good understanding of the patterns of association between these injuries would aid in efficient multidisciplinary treatment. The aim of this study therefore was to understand the associations between head injury and facial trauma by retrospectively analysing the records of patients seen at a tertiary care trauma centre. Demographic data were also described. Records of 4350 facial trauma patients over a five-year period were reviewed. A total of 3564 (81.9%) patients were victims of motor vehicle accidents (MVA). Male patients predominated, comprising 3711 (85.3%), and 36.6% were in the third decade of life. Facial fractures were seen in 2120 (48.7%), the most common being zygomatic fractures (60%). At the time of trauma, 2383 (57.3%) patients were under the influence of alcohol, and 2821 (87.8%) victims of two-wheeler MVAs were not using their helmet. Of all patients, 29.75% sustained a traumatic brain injury (TBI). Midface fractures were strongly associated with TBI. Maxillofacial injury may be considered a risk factor for TBI, and as such should immediately be suspected and investigated in all patients. Prompt recognition and management can improve outcomes in these patients.     

老年患者颌面部创伤83例临床分析

目的：研究老年口腔颌面部创伤的临床治疗方法及效果。方法：对赤峰学院附属医院口腔科2008年8月至2013年8月期间收治的83例老年口腔颌面部创伤住院病人的病历资料进行统计和分析,并与同期的随机抽取的90例非老年组患者进行比较。结果：83例老年颌面创伤患者男女比例为2.9∶1。交通事故49.39%在致伤原因中居首位。下颌骨骨折发生率最高。在合并伤中,以颅脑损伤6例（42.86%）最多见。经过及时治疗,83例患者生命体征平稳,面部形态恢复满意,咀嚼功能良好,张口度≥3 cm,咬合关系恢复正常。结论：颌面部损伤治疗应以抢救生命,保护功能,恢复面容为原则,及时进行急救和固定处理。     

Oral myiasis in a maxillofacial trauma patient

Oral Myiasis is a rare disease that is mostly reported in developing countries. It is primarily caused by the invasion of the human body by fly larvae. The phenomenon is well-documented in the skin, especially among animals. This case report describes the presentation of Oral Myiasis caused by Musca Nebulo (common house fly), in a 28-year-old patient, with recent maxillofacial trauma. The patient was treated by manual removal of the larvae, after topical application of turpentine oil, followed by surgical debridement and oral therapy with Ivermectin.