Background: Maxillofacial injury may vary from simple soft tissue lacerations to complex fractures of the orofacial region. Soft tissue injuries, whether isolated or in combination with other injuries, form part of th...Background: Maxillofacial injury may vary from simple soft tissue lacerations to complex fractures of the orofacial region. Soft tissue injuries, whether isolated or in combination with other injuries, form part of the frequent traumatic craniofacial injuries seen at the emergency department. The force of impact and the injury type is directly related to the severity of the injury sustained. This study aimed to analyze the etiological factors, prevalence, and management of oral and maxillofacial soft tissue injuries at the Komfo Anokye Teaching Hospital. Methods: This was a prospective study that involved children presenting with oral and maxillofacial injuries at the Accident and Emergency Department and the Oral and Maxillofacial Surgery unit of the Komfo Anokye Teaching Hospital in Kumasi between the period of April to October 2020 (6 months). Patient selection was by convenience sampling targeting all children with injuries who met the inclusion criteria. Inclusion criteria were children below the age of 18 years whose parents or caregivers consent to participation. Children with maxillofacial injuries as a result of burns were excluded from the study. Results: During the study period a total of 134 children were reviewed with oral and maxillofacial injuries at KATH. Of these, 107 (78.9%) were recorded cases of orofacial soft tissue injuries. There were 63 (58.9%) males and 44 (41.1%) females and the male-to-female ratio was 1.5:1. The age range of patients studied was 8 months – 17 years, with mean age ± SD being 9.5 ± 5.3 years. Road Traffic Crash (50.5%) was the most common etiology of which Motor cycle crash constituted 24.3% and Pedestrian knockdown was 19.6%. Falls (42.1%) were the next most common etiology. The lips (19.8%) and the forehead (18.5%) were the most frequently injured sites on the face whiles the tongue (3.3%) had the most injuries intraorally. Laceration (45.7%) was the most frequent injury reviewed, followed by abrasions (35.8%). Most of the soft tissue injuries underwent primary closure (56.3%). A complication rate of 21.2% was recorded in this study and hypertrophic scarring (11.3%) was the most observed.展开更多
BACKGROUND Penetrating arrow injuries of the head and neck are exceedingly rare in pediatric patients.This pathology has high morbidity and mortality because of the presence of vital organs,the airway,and large vessel...BACKGROUND Penetrating arrow injuries of the head and neck are exceedingly rare in pediatric patients.This pathology has high morbidity and mortality because of the presence of vital organs,the airway,and large vessels.Therefore,the treatment and removal of an arrow is a challenge that requires multidisciplinary management.CASE SUMMARY A 13-year-old boy was brought to the emergency room after an arrow injury to the frontal region.The arrowhead was lodged in the oropharynx.Imaging studies showed a lesion of the paranasal sinuses without compromising vital structures.The arrow was successfully removed by retrograde nasoendoscopy without complications,and the patient was discharged.CONCLUSION Although rare,maxillofacial arrow injuries have high morbidity and mortality and require multidisciplinary management to preserve function and aesthetics.展开更多
Gunshot injuries are rather serious but uncommon type of trauma in India. A 45-year-old male was presented with gunshot （pellets） embedded in the maxillofacial area for 22 years. There is no consensus in the literat...Gunshot injuries are rather serious but uncommon type of trauma in India. A 45-year-old male was presented with gunshot （pellets） embedded in the maxillofacial area for 22 years. There is no consensus in the literature whether to attempt their removal or leave them in situ. Our patient had no long-term sequela like infection, fistula formation, carcinogenesis or metal poisoning to date except for chill feeling on cold days. Management of this patient presented a dilemma in treatment in view of the effects of foreign bodies in the maxillofacial area.展开更多
Purpose： Maxillofacial injuries are frequently associated with multiple trauma and can determine func- tional and aesthetic bad outcomes.The severity ofmaxillofacial injuries may be considerable and can divert clinic...Purpose： Maxillofacial injuries are frequently associated with multiple trauma and can determine func- tional and aesthetic bad outcomes.The severity ofmaxillofacial injuries may be considerable and can divert clinicians＇ attention from other concomitant injuries which is less evident but potentially life-threatening. The aim of this study was to find out the concomitant injuries in patients referred to the Emergency Department （ED） of the University Hospital of Messina （North-East Sicily, Italy） for maxillofacial traumas. Methods： We retrospectively evaluated data of 240,833 patients admitted at the ED of the University Hospital of Messina from January 2008 to December 2015 because of maxillofacial injuries leading to hospitalization and surgical treatment. Patients who primarily received treatment care at different in- stitutions, pediatric trauma patients and adult patients who were transferred in accordance with pre- existing agreements in case of paucity of beds were excluded. Finally we included 447 （0.2%） patients over the 8 years. Data were evaluated with emphasis on epidemiology （age, gender, mechanism of trauma）, primary survey and abnormalities and pattern of trauma. Results： The most frequent cause of maxillofacial trauma was road accidents （319 patients, 71.4%）, among which motorcycle ones were prevalent. The maxillofacial injured who presented major lesions were 98 patients and minor lesions occurred in 349 patients： 443 （99.1%） patients underwent maxillofacial surgery, immediate or delayed depending on the severity of concomitant injuries （x^2 = 557.2, p 〈 0.0001）. Five concomitant neglected lesions were found to be associated with severe maxillofacial traumas （x^2 = 17.13, p 〈 0.0001 vs minor lesions）. All of the neglected lesions occurred in pauci- symptomatic patients who showed painless abdomen, no hemodynamic instability, no signs of hema- toma of anterior and posterior abdominal wall or other suspicious clinical signs and symptoms. Conclusion： Among the patients admitted firstly in other surgical wards different from the Maxillofacial Surgery Unit. diagnosis was more difficult, especially for blunt abdominal traumas, in which patients showed only vague and nonspecific symptoms concealing serious and life-threatening injuries. We recommend the routine use of whole body CT scan, when the maxillofacial injuries appear prevalent, mainly in patients affected by maxillofacial maior lesions.展开更多
Gunshot injuries are always known to cause severe morbidity and mortality when head and neck are involved. They vary in morbidity, which can occur in civilian surroundings. The wound largely depends on the type of wea...Gunshot injuries are always known to cause severe morbidity and mortality when head and neck are involved. They vary in morbidity, which can occur in civilian surroundings. The wound largely depends on the type of weapon, mass and velocity of the bullet, and the distance from where it has been shot. Close-range gunshot wounds in the head and neck region can result in devastating aesthetic and functional impairment. The complexity in facial skeletal anatomy cause multiple medical and surgical challenges to an operating surgeon, demanding elaborate soft and hard tissue reconstruction. Here we presented the successful management of three patients shot by short-range pistol with basic life support measures, wound management, reconstruction and rehabilitation.展开更多
Purpose:Trauma accounts for the leading cause of morbidity and mortality worldwide in the present day and may rightly be called the new pandemic. The prominent nature of the face exposes it to various traumatic injuri...Purpose:Trauma accounts for the leading cause of morbidity and mortality worldwide in the present day and may rightly be called the new pandemic. The prominent nature of the face exposes it to various traumatic injuries. A timely, prompt diagnosis along with employment of correct and quick treatment greatly improves the outcome for these patients. The aim of this retrospective study was to analyse the characteristics of maxillofacial injuries over a decade.Methods:The data were collected manually from the medical records of patients who reported to the tertiary centre from 1 January 2011 to 31 December 2019. All injured patients irrespective of age/gender with complete hospital records of clinical and radiographical diagnosis of maxillofacial injuries were included. The demographic data, etiology, site and type of injury, and seasonal variation were analyzed. Data were tabulated into 6 age groups (0 -7 years, 8 -18 years, 19 -35 years, 36 -40 years, 41 -59 years, and > 60 years). Five etiological factors, i.e. road traffic accidents, falls, assaults, sports-related, and occupational accidents, were further evaluated based on genders. Facial injuries were classified into 6 types: panfacial fractures, mandibular fractures (subcategorized), midface fractures (subcategorized), dentoalveolar fractures, dental injuries, and soft tissue injuries. The monthly and seasonal variation of the injuries was also charted. Data were expressed as frequency and percent.Results:A total of 10,703 maxillofacial injuries were included from the tertiary centre from the period of 2011 -2019, including 8637 males and 2066 females, with the highest occurrence in the 19 -35 years age group. Road traffic accident was the principal etiological factor of maxillofacial injuries in both genders (80.5%), followed by falls (9.6%), assaults (8.0%), occupational accidents (1.2%), and sporting injuries (0.7%). Midface fractures accounted for 52.5% (5623 fractures), followed by mandibular fractures (38.1%).Conclusion:The current study describes a change in the incidence of maxillofacial injuries along with variation in the demographic data. The implementation of safety gears and stricter traffic laws along with public awareness may aid in the reduction of maxillofacial injuries.展开更多
A variety of techniques and materials for the rehabilitation and reconstruction of traumatized maxillary ridges prior to dental implants placement have been described in literature. Autogenous bone grafting is conside...A variety of techniques and materials for the rehabilitation and reconstruction of traumatized maxillary ridges prior to dental implants placement have been described in literature. Autogenous bone grafting is considered ideal by many researchers and it still remains the most predictable and documented method. The aim of this report is to underline the effectiveness of using allogeneic bone graft for managing maxillofacial trauma. A case of a 30-year-old male with severely atrophic maxillary ridge as a conse- quence of complex craniofacial injury is presented here. Augmentation procedure in two stages was performed using allogeneic and autogenous bone grafts in different areas of the osseous defect. Four months after grafting, during the implants placement surgery, samples of both sectors were withdrawn and submitted to histological evaluation. On the examination of the specimens, treated by hematoxylin and eosin staining, the morphology of integrated allogeneic bone grafts was revealed to be similar to the autologous bone. Our clinical experience shows how the allogeneic bone graft presented normal bone tissue architecture and is highly vascularized, and it can be used for reconstruction of severe trauma of the maxilla.展开更多
Leopard attacks on humans are reported most often from the Indian subcontinent.The bite wounds are complex injuries infected with polymicrobial inoculum and may present as punctures,abrasions,lacerations or avulsions....Leopard attacks on humans are reported most often from the Indian subcontinent.The bite wounds are complex injuries infected with polymicrobial inoculum and may present as punctures,abrasions,lacerations or avulsions.The presentation and acceptable treatment of these injuries vary according to the wound.We hereby describe the clinical presentation and treatment of a male victim with leopard bite injuries on the head and neck region.As bite injuries are commonly found on and around the face,maxillofacial surgeons should be familiar with the therapy.Through thorough clinical and radiological examination,it is essential to prevent missing any hidden injuries,which can easily turn lethal.To benefit the rural population,more health facilities need to be established in remote areas.展开更多
文摘Background: Maxillofacial injury may vary from simple soft tissue lacerations to complex fractures of the orofacial region. Soft tissue injuries, whether isolated or in combination with other injuries, form part of the frequent traumatic craniofacial injuries seen at the emergency department. The force of impact and the injury type is directly related to the severity of the injury sustained. This study aimed to analyze the etiological factors, prevalence, and management of oral and maxillofacial soft tissue injuries at the Komfo Anokye Teaching Hospital. Methods: This was a prospective study that involved children presenting with oral and maxillofacial injuries at the Accident and Emergency Department and the Oral and Maxillofacial Surgery unit of the Komfo Anokye Teaching Hospital in Kumasi between the period of April to October 2020 (6 months). Patient selection was by convenience sampling targeting all children with injuries who met the inclusion criteria. Inclusion criteria were children below the age of 18 years whose parents or caregivers consent to participation. Children with maxillofacial injuries as a result of burns were excluded from the study. Results: During the study period a total of 134 children were reviewed with oral and maxillofacial injuries at KATH. Of these, 107 (78.9%) were recorded cases of orofacial soft tissue injuries. There were 63 (58.9%) males and 44 (41.1%) females and the male-to-female ratio was 1.5:1. The age range of patients studied was 8 months – 17 years, with mean age ± SD being 9.5 ± 5.3 years. Road Traffic Crash (50.5%) was the most common etiology of which Motor cycle crash constituted 24.3% and Pedestrian knockdown was 19.6%. Falls (42.1%) were the next most common etiology. The lips (19.8%) and the forehead (18.5%) were the most frequently injured sites on the face whiles the tongue (3.3%) had the most injuries intraorally. Laceration (45.7%) was the most frequent injury reviewed, followed by abrasions (35.8%). Most of the soft tissue injuries underwent primary closure (56.3%). A complication rate of 21.2% was recorded in this study and hypertrophic scarring (11.3%) was the most observed.
文摘BACKGROUND Penetrating arrow injuries of the head and neck are exceedingly rare in pediatric patients.This pathology has high morbidity and mortality because of the presence of vital organs,the airway,and large vessels.Therefore,the treatment and removal of an arrow is a challenge that requires multidisciplinary management.CASE SUMMARY A 13-year-old boy was brought to the emergency room after an arrow injury to the frontal region.The arrowhead was lodged in the oropharynx.Imaging studies showed a lesion of the paranasal sinuses without compromising vital structures.The arrow was successfully removed by retrograde nasoendoscopy without complications,and the patient was discharged.CONCLUSION Although rare,maxillofacial arrow injuries have high morbidity and mortality and require multidisciplinary management to preserve function and aesthetics.
文摘Gunshot injuries are rather serious but uncommon type of trauma in India. A 45-year-old male was presented with gunshot （pellets） embedded in the maxillofacial area for 22 years. There is no consensus in the literature whether to attempt their removal or leave them in situ. Our patient had no long-term sequela like infection, fistula formation, carcinogenesis or metal poisoning to date except for chill feeling on cold days. Management of this patient presented a dilemma in treatment in view of the effects of foreign bodies in the maxillofacial area.
文摘Purpose： Maxillofacial injuries are frequently associated with multiple trauma and can determine func- tional and aesthetic bad outcomes.The severity ofmaxillofacial injuries may be considerable and can divert clinicians＇ attention from other concomitant injuries which is less evident but potentially life-threatening. The aim of this study was to find out the concomitant injuries in patients referred to the Emergency Department （ED） of the University Hospital of Messina （North-East Sicily, Italy） for maxillofacial traumas. Methods： We retrospectively evaluated data of 240,833 patients admitted at the ED of the University Hospital of Messina from January 2008 to December 2015 because of maxillofacial injuries leading to hospitalization and surgical treatment. Patients who primarily received treatment care at different in- stitutions, pediatric trauma patients and adult patients who were transferred in accordance with pre- existing agreements in case of paucity of beds were excluded. Finally we included 447 （0.2%） patients over the 8 years. Data were evaluated with emphasis on epidemiology （age, gender, mechanism of trauma）, primary survey and abnormalities and pattern of trauma. Results： The most frequent cause of maxillofacial trauma was road accidents （319 patients, 71.4%）, among which motorcycle ones were prevalent. The maxillofacial injured who presented major lesions were 98 patients and minor lesions occurred in 349 patients： 443 （99.1%） patients underwent maxillofacial surgery, immediate or delayed depending on the severity of concomitant injuries （x^2 = 557.2, p 〈 0.0001）. Five concomitant neglected lesions were found to be associated with severe maxillofacial traumas （x^2 = 17.13, p 〈 0.0001 vs minor lesions）. All of the neglected lesions occurred in pauci- symptomatic patients who showed painless abdomen, no hemodynamic instability, no signs of hema- toma of anterior and posterior abdominal wall or other suspicious clinical signs and symptoms. Conclusion： Among the patients admitted firstly in other surgical wards different from the Maxillofacial Surgery Unit. diagnosis was more difficult, especially for blunt abdominal traumas, in which patients showed only vague and nonspecific symptoms concealing serious and life-threatening injuries. We recommend the routine use of whole body CT scan, when the maxillofacial injuries appear prevalent, mainly in patients affected by maxillofacial maior lesions.
文摘Gunshot injuries are always known to cause severe morbidity and mortality when head and neck are involved. They vary in morbidity, which can occur in civilian surroundings. The wound largely depends on the type of weapon, mass and velocity of the bullet, and the distance from where it has been shot. Close-range gunshot wounds in the head and neck region can result in devastating aesthetic and functional impairment. The complexity in facial skeletal anatomy cause multiple medical and surgical challenges to an operating surgeon, demanding elaborate soft and hard tissue reconstruction. Here we presented the successful management of three patients shot by short-range pistol with basic life support measures, wound management, reconstruction and rehabilitation.
文摘Purpose:Trauma accounts for the leading cause of morbidity and mortality worldwide in the present day and may rightly be called the new pandemic. The prominent nature of the face exposes it to various traumatic injuries. A timely, prompt diagnosis along with employment of correct and quick treatment greatly improves the outcome for these patients. The aim of this retrospective study was to analyse the characteristics of maxillofacial injuries over a decade.Methods:The data were collected manually from the medical records of patients who reported to the tertiary centre from 1 January 2011 to 31 December 2019. All injured patients irrespective of age/gender with complete hospital records of clinical and radiographical diagnosis of maxillofacial injuries were included. The demographic data, etiology, site and type of injury, and seasonal variation were analyzed. Data were tabulated into 6 age groups (0 -7 years, 8 -18 years, 19 -35 years, 36 -40 years, 41 -59 years, and > 60 years). Five etiological factors, i.e. road traffic accidents, falls, assaults, sports-related, and occupational accidents, were further evaluated based on genders. Facial injuries were classified into 6 types: panfacial fractures, mandibular fractures (subcategorized), midface fractures (subcategorized), dentoalveolar fractures, dental injuries, and soft tissue injuries. The monthly and seasonal variation of the injuries was also charted. Data were expressed as frequency and percent.Results:A total of 10,703 maxillofacial injuries were included from the tertiary centre from the period of 2011 -2019, including 8637 males and 2066 females, with the highest occurrence in the 19 -35 years age group. Road traffic accident was the principal etiological factor of maxillofacial injuries in both genders (80.5%), followed by falls (9.6%), assaults (8.0%), occupational accidents (1.2%), and sporting injuries (0.7%). Midface fractures accounted for 52.5% (5623 fractures), followed by mandibular fractures (38.1%).Conclusion:The current study describes a change in the incidence of maxillofacial injuries along with variation in the demographic data. The implementation of safety gears and stricter traffic laws along with public awareness may aid in the reduction of maxillofacial injuries.
文摘A variety of techniques and materials for the rehabilitation and reconstruction of traumatized maxillary ridges prior to dental implants placement have been described in literature. Autogenous bone grafting is considered ideal by many researchers and it still remains the most predictable and documented method. The aim of this report is to underline the effectiveness of using allogeneic bone graft for managing maxillofacial trauma. A case of a 30-year-old male with severely atrophic maxillary ridge as a conse- quence of complex craniofacial injury is presented here. Augmentation procedure in two stages was performed using allogeneic and autogenous bone grafts in different areas of the osseous defect. Four months after grafting, during the implants placement surgery, samples of both sectors were withdrawn and submitted to histological evaluation. On the examination of the specimens, treated by hematoxylin and eosin staining, the morphology of integrated allogeneic bone grafts was revealed to be similar to the autologous bone. Our clinical experience shows how the allogeneic bone graft presented normal bone tissue architecture and is highly vascularized, and it can be used for reconstruction of severe trauma of the maxilla.
文摘Leopard attacks on humans are reported most often from the Indian subcontinent.The bite wounds are complex injuries infected with polymicrobial inoculum and may present as punctures,abrasions,lacerations or avulsions.The presentation and acceptable treatment of these injuries vary according to the wound.We hereby describe the clinical presentation and treatment of a male victim with leopard bite injuries on the head and neck region.As bite injuries are commonly found on and around the face,maxillofacial surgeons should be familiar with the therapy.Through thorough clinical and radiological examination,it is essential to prevent missing any hidden injuries,which can easily turn lethal.To benefit the rural population,more health facilities need to be established in remote areas.
