Craniomaxillofacial Trauma & Reconstruction

1 pages, 78 KiB

Open AccessEditorial

COVID-19 and the Craniomaxillofacial Surgical Community

by Srinivas M. Susarla, Sat Parmar and Rui Fernandes

Craniomaxillofac. Trauma Reconstr. 2020, 13(2), 83; https://doi.org/10.1177/1943387520921325 - 16 Apr 2020

Cited by 6 | Viewed by 41

The global outbreak of the novel coronavirus, SARS-CoV-2, or COVID-19, has dramatically transformed all aspects of our daily lives.[...] Full article

5 pages, 299 KiB

Open AccessCase Report

Rare Facial Cleft: Surgical Treatment and Middle-Term Follow-up During Charity Operation

by Andi Setiawan Budihardja, Bakhrul Lutfianto, Nataly Putri Liman, Hiensen Hiesmantjaja and Klaus-Dietrich Wolff

Craniomaxillofac. Trauma Reconstr. 2020, 13(2), 138-142; https://doi.org/10.1177/1943387520904210 - 25 Mar 2020

Cited by 5 | Viewed by 53

Abstract

Facial cleft is a rare and challenging craniofacial malformation. Treatment of rare facial cleft is complex, and the evaluation of its long-term results is challenging because of the low incidence. In this article, we would like to present middle-term follow-up of 6 patients [...] Read more.

Facial cleft is a rare and challenging craniofacial malformation. Treatment of rare facial cleft is complex, and the evaluation of its long-term results is challenging because of the low incidence. In this article, we would like to present middle-term follow-up of 6 patients with facial cleft Tessier number 4, number 5, and number 7 who were treated in our center during charity surgical mission. We will discuss surgical option, difficulties, and complication that may arise in this surgery. Full article

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8 pages, 524 KiB

Open AccessArticle

Skeletal Deformity in Patients With Unilateral Coronal Craniosynostosis: Perceptions of the General Public

by Emilie Robertson, Peter Kwan, Gorman Louie, Pierre Boulanger and Daniel Aalto

Craniomaxillofac. Trauma Reconstr. 2020, 13(2), 122-129; https://doi.org/10.1177/1943387520911873 - 25 Mar 2020

Cited by 2 | Viewed by 48

Abstract

Study Design: A two-alternative forced choice design was used to gather perceptual data regarding unicoronal synostosis (UCS). Objective: Cranial vault remodeling aims at improving the aesthetic appearance of infants with UCS by reshaping the forehead and reducing the potential for psychosocial discrimination. People’s [...] Read more.

Study Design: A two-alternative forced choice design was used to gather perceptual data regarding unicoronal synostosis (UCS). Objective: Cranial vault remodeling aims at improving the aesthetic appearance of infants with UCS by reshaping the forehead and reducing the potential for psychosocial discrimination. People’s perception of craniofacial deformity plays a role in the stigma of deformity. The purpose of this study is to examine the relationship between objective skull deformity in UCS patients and laypersons’ perception of skull normality. Methods: Forty layperson skull raters were recruited from the general public. Skull raters were asked to categorize 45 infant skull images as normal or abnormal. Twenty-one of the images were UCS skulls, and 24 were normal skulls. Skulls were displayed briefly on a computer to simulate a first impression scenario and generate a perceptual response. A χ² analysis and mixed-effects regression model were used to analyze the response data. Results: Members of the general public were good at distinguishing between skull groups, χ² (1) = 281.97, P < .001. In addition, skull raters’ responses were predicted by the severity of deformity in the UCS skulls (b = −0.10, z = −2.6, P = .010, CI: −0.18, −0.02). A skull with a deformity value of 2.8 mm (CI: 1.8, 4.1) was equally likely to be rated normal or abnormal. Conclusions: This is the first study to investigate the relationship between objective skull deformity in UCS and public perception. Laypersons were good at distinguishing the difference between normal and UCS skulls, and their perceptions of normality were predicted by the degree of skull deformity. Full article

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7 pages, 485 KiB

Open AccessArticle

Comparison of Maxillofacial Trauma Patterns in the Urban Versus Suburban Environment: A Pilot Study

by Jason E. Cohn, Jordan J. Licata, Sammy Othman, Tom Shokri and Seth Zwillenberg

Craniomaxillofac. Trauma Reconstr. 2020, 13(2), 115-121; https://doi.org/10.1177/1943387520910338 - 25 Mar 2020

Cited by 11 | Viewed by 40

Abstract

Introduction: Assault appears to be the most frequent cause of facial fractures in certain urban trauma centers, possibly due to the ease of acquiring weapons and increasingly aggressive behavior. The objectives of this study were to identify specific demographic, socioeconomic, maxillofacial fracture, and [...] Read more.

Introduction: Assault appears to be the most frequent cause of facial fractures in certain urban trauma centers, possibly due to the ease of acquiring weapons and increasingly aggressive behavior. The objectives of this study were to identify specific demographic, socioeconomic, maxillofacial fracture, and assault patterns in urban versus suburban communities. Methods: A retrospective chart review of patients who sustained maxillofacial fractures from August 2014 through August 2016 at one urban campus, Einstein Medical Center, Philadelphia, and two suburban campuses, Einstein Medical Center Montgomery and Elkins Park. The χ² testing was used to compare the categorical variables between the 2 groups. Results: A total of 259 maxillofacial trauma patients were identified, with 204 (79%) in the urban and 55 (21%) in the suburban environment. Patients in the urban population were more likely to be African American (70% vs 33%) and Hispanic (15% vs 6%) but less likely to be Caucasian (12% vs 55%, P < .0001). Urban patients were more likely to be single (70% vs 47%, P < .01), unemployed (64% vs 44%, P < .001), and receive Medicaid coverage (58% vs 26%, P < .001). Urban patients were more likely to be victims of assault (63% vs 44%), whereas suburban patients were more likely to sustain accidental injuries (16% vs 2%, P < .0001). Urban victims were more likely to be assaulted with an object (30% vs 12%) or gun (7% vs 0%, P = .05). Conclusion: Maxillofacial trauma patterns were shown to be significantly different in the urban versus suburban environment. Full article

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6 pages, 350 KiB

Open AccessArticle

Open Treatment of Mandibular Condyle by Direct Transparotid Approach: Our Experience

by Mohammed Salman Basha, Hussain AlAithan and Nyer Firdoose

Craniomaxillofac. Trauma Reconstr. 2020, 13(2), 109-114; https://doi.org/10.1177/1943387520903543 - 20 Mar 2020

Cited by 3 | Viewed by 39

Abstract

The fractures of the mandibular condyle are commonly encountered in maxillofacial surgical practice. The controversies to open or not to open are still ongoing. We have used both techniques, to successfully manage our patients. Open treatment of condyle fracture with or without dislocation [...] Read more.

The fractures of the mandibular condyle are commonly encountered in maxillofacial surgical practice. The controversies to open or not to open are still ongoing. We have used both techniques, to successfully manage our patients. Open treatment of condyle fracture with or without dislocation is technically challenging. We used a “Direct Transparotid” approach in treating 13 condyle fractures over a period of 4 years. The patients were evaluated for facial nerve injury, salivary fistula, scar, function, and occlusion over a period of 12 months. There were no major complications with acceptable scar, both intraoperatively and postoperatively. The script aims at presenting our experience of direct transparotid approach surgical technique. Full article

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3 pages, 230 KiB

Open AccessShort Note

Management of Zygomatic Arch Fractures by Intraoral Open Reduction and Transbuccal Fixation: A Technical Note

by Elavenil Panneerselvam, Sasikala Balasubramanian, Jaghandeep Kempraj, Vijitha Ravindira Babu and V. B. Krishna Kumar Raja

Craniomaxillofac. Trauma Reconstr. 2020, 13(2), 130-132; https://doi.org/10.1177/1943387520911866 - 17 Mar 2020

Cited by 5 | Viewed by 71

Abstract

Fractures of the zygomatic arch are common due to its anatomical prominence. The post-traumatic restoration of the arch form is important to maintain the midfacial symmetry and anteroposterior projection of the face. Open reduction and internal fixation (ORIF) of fractured arch is indicated [...] Read more.

Fractures of the zygomatic arch are common due to its anatomical prominence. The post-traumatic restoration of the arch form is important to maintain the midfacial symmetry and anteroposterior projection of the face. Open reduction and internal fixation (ORIF) of fractured arch is indicated in specific clinical presentations. The traditional methods of ORIF of zygomatic arch fractures require cutaneous incisions, which are associated with complications such as scarring and facial nerve injury. This article presents a simple technique of “intraoral reduction and transbuccal fixation” of the arch that negates the problems associated with the conventional approaches to ORIF. Full article

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4 pages, 172 KiB

Open AccessArticle

Does the Lag Time Between Injury and Treatment Affect Recovery of Infraorbital Nerve Disturbances in Zygomaticomaxillary Complex Fractures?

by Reza Tabrizi, Majid Neamati, Sara Rajabloo and Fatemeh Latifi

Craniomaxillofac. Trauma Reconstr. 2020, 13(2), 105-108; https://doi.org/10.1177/1943387520902896 - 17 Mar 2020

Cited by 3 | Viewed by 59

Abstract

Study Design: A cross-sectional study. Objective: Neurosensory disturbances (NSDs) of the infraorbital nerve (ION) are common following orbito-zygomaticomaxillary complex (ZMC) fractures. This study aimed to evaluate the effect of lag time between injury and treatment on recovery of NSDs of the ION following [...] Read more.

Study Design: A cross-sectional study. Objective: Neurosensory disturbances (NSDs) of the infraorbital nerve (ION) are common following orbito-zygomaticomaxillary complex (ZMC) fractures. This study aimed to evaluate the effect of lag time between injury and treatment on recovery of NSDs of the ION following open reduction internal fixation. Methods: Subjects who had ZMC fracture and paresthesia were studied. The lag time between injury and treatment was considered as the predictive factor. The level of NSDs according to the brush test and two-point discrimination (TPD) test and self-reported NSD were the outcomes of this study. Self-reported NSD was quantified using a visual analog scale. Results: Forty patients were studied. The lag time between injury and treatment had a significant correlation with the result of the TPD test and the self-reported level of NSD. In 73.6% of patients who had NSD following ZMC fracture, every 1-day delay in treatment increased the incidence of self-reported paresthesia by 0.44. Conclusions: It seems, a delay in treatment of ZMC fractures increased the risk of NSD. Full article

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6 pages, 256 KiB

Open AccessArticle

A Comparative Study Between Concentric Single-Needle Puncture Technique and Conventional 2-Needle Technique for Temporomandibular Joint Arthrocentesis Plus Corticosteroid Injections

by Amit Kumar, Amit Gupta, Rajarshi Ghosh, Rajeev Pandey and Sanjeev Kumar

Craniomaxillofac. Trauma Reconstr. 2020, 13(2), 99-104; https://doi.org/10.1177/1943387520911826 - 17 Mar 2020

Cited by 9 | Viewed by 59

Abstract

The purpose of the study was to compare 2 techniques of arthrocentesis, to find out the efficacy of one over the other at various parameters, and to contribute to the scarce literature of these 2 techniques. Forty patients reported with a chief complaint [...] Read more.

The purpose of the study was to compare 2 techniques of arthrocentesis, to find out the efficacy of one over the other at various parameters, and to contribute to the scarce literature of these 2 techniques. Forty patients reported with a chief complaint of pain in temporomandibular joint (TMJ), clicking in TMJ, and restricted mouth opening were included in this study. Twenty patients were divided into 2 groups, all reporting with temporomandibular disorders. Group A was treated with 2-needle technique of arthrocentesis, while group B underwent concentric needle technique of arthrocentesis under local anesthesia with Ringer’s lactate solution. The operating time was found to be less in concentric needle technique (mean: 25.36 minutes) compared to 2-needle technique (mean: 42.82 minutes), and the difference was found to be statistically significant. Concentric needle technique proved to be a better alternative for TMJ arthrocentesis as it has quite a lot of advantages over 2-needle technique. Full article

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5 pages, 398 KiB

Open AccessCase Report

Traumatic Facial Tattoo Injuries From Gunpowder and Ammunition: A Case Series

by Andrew C. Jenzer, Bradley P. Storrs, Zachary Daniels and Jeremy J. Hanlon

Craniomaxillofac. Trauma Reconstr. 2020, 13(2), 133-137; https://doi.org/10.1177/1943387520902893 - 16 Mar 2020

Cited by 4 | Viewed by 66

Abstract

Background and Overview: Gunpowder inclusion injuries are rare occurrences in the civilian sector but are more frequently encountered in the military setting. The authors report a case series of 3 active duty military service members treated by an Army hospital’s Oral & Maxillofacial [...] Read more.

Background and Overview: Gunpowder inclusion injuries are rare occurrences in the civilian sector but are more frequently encountered in the military setting. The authors report a case series of 3 active duty military service members treated by an Army hospital’s Oral & Maxillofacial Surgery service for the removal of embedded gunpowder particles so as to avoid traumatic tattooing. Case Description: Three otherwise healthy active duty military service members were treated for gunpowder inclusion injuries incurred while conducting live fire training exercises at a state-side military installation between 2018 and 2019. All 3 males presented with injuries of the same etiology: Their weapons malfunctioned, and while visually inspecting the action, a round exploded close to the face. This peppered the face with gunpowder particles that were both superficially and deeply embedded. Treatment focused on individual removal using fine forceps. The patients were followed up and healed quickly without any complications, specifically without traumatic tattooing from the gunpowder injuries. Conclusion and Practical Implications: Gunpowder inclusion injuries should be addressed quickly to remove the particles before epidermal healing occurs, thus avoiding the complication of traumatic tattooing. This surgical team recommends meticulous fine forceps removal as the treatment of choice for larger particles. Full article

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6 pages, 428 KiB

Open AccessArticle

The Prediction Capacity 3-D Software, on a 2-D Analysis, in Planning the Positioning of the Upper Lip After Maxillary Advancement

by Letícia Liana Chihara, Jéssica de Fátima Segantin, Paulo Esteves Pinto Faria, Eduardo Sant’Ana, Eduardo Dias-Ribeiro, Renato Luiz Maia Nogueira and Osny Ferreira-Júnior

Craniomaxillofac. Trauma Reconstr. 2020, 13(2), 93-98; https://doi.org/10.1177/1943387520906670 - 20 Feb 2020

Cited by 1 | Viewed by 49

Abstract

Purpose: The maxillary advancement using Le Fort I osteotomy directly affects in the positioning of the upper lip (UL) and the nasolabial angle (NLA), which plays an important role in facial expression and aesthetics, because of this, the aim of this study was [...] Read more.

Purpose: The maxillary advancement using Le Fort I osteotomy directly affects in the positioning of the upper lip (UL) and the nasolabial angle (NLA), which plays an important role in facial expression and aesthetics, because of this, the aim of this study was to evaluate the ability of Dolphin Imaging 11.8 software in predicting changes to the UL position and NLA in patients undergoing maxillary advancement. Materials and Methods: It was a retrospective cohort study. Predictive and final tracings using pre- and postoperative Cone Beam computed tomography (CBCT) of 24 patients undergoing maxillary advancement, regardless of mandibular movement, were compared. Whether the amount of advancement changes this predictability was also analyzed. The predictive and the 12- month postoperative data were evaluated using Dolphin Imaging 11.8 software and compared. Student t test was used to get the results. Results: The vertical analysis of the incisal tip and cementoenamel junction of the upper central incisor (UCI) and of the UL were statistically significant (P = .001 for all). The horizontal measurements of the same variables (P = .238, P = .516, P = .930, respectively) and the NLA (P = .060) showed no statistical significance. The amount of advancement did not interfere with the variables analyzed, except for the exposure (P = .009) and inclination of the UCI (P = .010). Conclusion: It was concluded that the amount of maxillary advancement does not interfere with the UL prediction; the prediction capacity of the software was good for the horizontal measurements, but had a significant error index for vertical measurements. Full article

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9 pages, 253 KiB

Open AccessArticle

Intraoperative Navigation and Cone Beam Computed Tomography for Restoring Orbital Dimensions: A Single-Center Experience

by Brecht De Cuyper, Johan Abeloos, Gwen Swennen and Lies Pottel

Craniomaxillofac. Trauma Reconstr. 2020, 13(2), 84-92; https://doi.org/10.1177/1943387520904869 - 18 Feb 2020

Cited by 5 | Viewed by 48

Abstract

Background: Correction of post-traumatic orbital defects remains a challenge for the maxillofacial surgeon. We examined the added value of combined intraoperative (IO) navigation and IO cone beam computed tomography (CBCT). Materials and Methods: A retrospective cohort study was performed in all consecutive patients [...] Read more.

Background: Correction of post-traumatic orbital defects remains a challenge for the maxillofacial surgeon. We examined the added value of combined intraoperative (IO) navigation and IO cone beam computed tomography (CBCT). Materials and Methods: A retrospective cohort study was performed in all consecutive patients requiring unilateral post-traumatic orbital surgery between January 2012 and December 2018. Patients were divided into 3 groups: IO navigation (NAV), IO-CBCT (CBCT), and IO navigation with IO-CBCT (NAV-CBCT). A detailed description of our workflow is provided. Volumetric comparison of the operated orbit to the contralateral orbit was made with Brainlab. Results: Of the 81 cases, 22 patients were included (12 males/10 females) with a mean age of 51 years. Three patients were assigned to NAV, 6 to CBCT, and 13 to NAV-CBCT. The reconstructed orbital volume did not significantly differ from the contralateral orbital volume within the 3 groups. The mean difference between the contralateral and the operated orbit was 3.05 cm³, 3.72 cm³, and 1.47 cm³ for NAV, CBCT, and NAV-CBCT, respectively, where only NAVCBCT showed a significant smaller volumetric difference in comparison to CBCT alone. Gender or age did not correlate with difference in orbital volume. Normal function and aesthetics was seen at 6 weeks postoperative in 0 of 3, 6 of 6, and 6 of 13 patients of the NAV, CBCT, and NAV-CBCT, respectively. Conclusion: Orbital defects can be treated effectively using IO navigation. Although our data could not demonstrate a significant added value of IO-CBCT in cases where IO navigation was used based on volumetric difference alone, the combination of IO-CBCT and IO navigation seems to give the best results considering both volumetric difference and postoperative function and aesthetics. Confirmation in a prospective, randomized trial with a larger sample size is required. Full article

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Craniomaxillofac. Trauma Reconstr., Volume 13, Issue 2 (June 2020) – 11 articles

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