Craniomaxillofacial Trauma & Reconstruction

6 pages, 169 KiB

Open AccessArticle

Review of 793 Facial Fractures Treated from 2001 to 2008 in A Coruña University Hospital: Types and Etiology

by Maria Pombo, Ramón Luaces-Rey, Sonia Pértega, Jorge Arenaz, Jose Luis Crespo, Álvaro García-Rozado, Beatriz Patiño and Jose Luis López-Cedrún

Craniomaxillofac. Trauma Reconstr. 2010, 3(1), 49-54; https://doi.org/10.1055/s-0030-1249373 - 12 Mar 2010

Cited by 12 | Viewed by 59

Abstract

The purpose of this article is to analyze the incidence, demographic distribution, type, and etiology of all facial fractures treated by the Department of Oral and Maxillofacial Surgery in A Coruña University Hospital (Spain) from 2001 to 2008. A descriptive and analytic retrospective [...] Read more.

The purpose of this article is to analyze the incidence, demographic distribution, type, and etiology of all facial fractures treated by the Department of Oral and Maxillofacial Surgery in A Coruña University Hospital (Spain) from 2001 to 2008. A descriptive and analytic retrospective study evaluated 643 patients treated for facial fracture (excluding nasal and dento-alveolar) by the Department of Oral and Maxillofacial Surgery in A Coruña University Hospital from January 2001 to December 2008. Five parameters were studied: year of the injury, gender, age, fracture type, and etiology. Six hundred and forty-three patients with 793 fractures were included. Of these, 83.2% were males and 16.8% were females. The patients’ age ranged between 18 months and 89 years, with a mean of 37.6 and a median of 33. The major cause of injury was traffic accidents (27%), followed by assaults (20.5%), accidental traumas (20.1%), sports (11%), syncopes (7.8%), rural accidents (6.1%), industrial accidents (5.1%), and suicide attempts (0.3%). In 1.1% of the patients, it was impossible to verify the etiology. The etiology of facial fractures varies from one country to another, depending on the cultural, environmental, and socioeconomic factors. In our study, the most common cause was traffic accidents, closely followed by assaults. The number of fractures due to traffic accidents has decreased in the last 3 years. Rural accidents accounted for a significantly higher percentage of fractures than that observed in other series. The number of fractures receiving a surgical treatment from 2005 to 2008 has progressively decreased. Full article

► Show Figures

Figure 1

7 pages, 328 KiB

Open AccessArticle

Orbital Floor Fractures: A Retrospective Review of 45 Cases at a Tertiary Health Care Center

by Chun H. Rhim, Thomas Scholz, Ara Salibian and Gregory R. D. Evans

Craniomaxillofac. Trauma Reconstr. 2010, 3(1), 41-47; https://doi.org/10.1055/s-0030-1249374 - 11 Mar 2010

Cited by 14 | Viewed by 84

Abstract

The purpose of this retrospective study was to investigate treatment options for orbital floor fractures at a Level 1 Trauma Center in Southern California. A review of 45 cases of isolated orbital floor fractures treated at the University of California at Irvine between [...] Read more.

The purpose of this retrospective study was to investigate treatment options for orbital floor fractures at a Level 1 Trauma Center in Southern California. A review of 45 cases of isolated orbital floor fractures treated at the University of California at Irvine between February 2004 and April 2007 was done. Patients were retrospectively analyzed for gender, age, mechanism of injury, associated facial injuries, presenting symptoms, method of treatment, and postoperative complications. Thirty-six male patients and nine female patients were treated. Motor vehicle collision (26/45) was the most common cause of injury, and the mean age of the patients was 35.5 years (range: 15–81 years). Ecchymosis surrounding the orbital tissue was the most common presentation (38/45). Diplopia was present in 8 of 45 patients, with 1 patient requiring urgent decompression for retrobulbar hematoma. Forty-three patients underwent surgical repair; 40 underwent transconjunctival approach with lateral canthotomy; 17 underwent reconstruction with porous polyethylene Medpor (Porex Surgical, Inc., College Park, GA, USA); and 26 underwent reconstruction with a titanium mesh plate. Immediate postoperative complications included 12 patients with infraorbital numbness, 3 with diplopia, 1 with cellulitis, and 1 with ectropion with a subcilliary approach. Average timing of surgery of our study was 4.94 days (range, 1–20 days). Orbital floor fracture management has changed significantly over the past few decades with the introduction of new internal fixation methods and new materials for reconstructing orbital floor defects. Recommendations for surgical intervention on orbital floor fractures mostly depend on clinical examination and imaging studies. Consequences of inadequate repair of orbital floor fractures can lead to significant facial asymmetry and visual problems. Both porous polyethylene and titanium plates are effective tools for reconstructing the orbital floor. Our review demonstrates that orbital floor fractures can be repaired safely with minimal postoperative complications and confirms that transconjunctival approach to orbital floor is an effective way for exposure and prevention of ectropion that can be seen with other techniques. Full article

► Show Figures

Figure 1

8 pages, 512 KiB

Open AccessArticle

Principles of Implant-Based Reconstruction and Rehabilitation of Craniofacial Defects

by Brinda Thimmappa and Sabine C. Girod

Craniomaxillofac. Trauma Reconstr. 2010, 3(1), 33-40; https://doi.org/10.1055/s-0030-1249372 - 11 Mar 2010

Cited by 6 | Viewed by 50

Abstract

The final stages of reconstruction following craniofacial trauma or tumor resection often involve the fitting of prostheses. Development of osseointegrated implants for retention of prostheses has improved function and aesthetic outcome. Placement of osseointegrated implants requires coordinated care from multiple specialists and a [...] Read more.

The final stages of reconstruction following craniofacial trauma or tumor resection often involve the fitting of prostheses. Development of osseointegrated implants for retention of prostheses has improved function and aesthetic outcome. Placement of osseointegrated implants requires coordinated care from multiple specialists and a lifetime commitment of the patient. The workup and surgical treatment algorithms for placement of intraoral compared with extraoral implants are discussed. The quality and quantity of bone available are the most important factors influencing design and placement. The long-term retention of implants is influenced by implant site, local tissue bed preparation, and hygiene. Osseointegrated implants are a part of the complete rehabilitation of patients with craniomaxillofacial defects. Although final fitting and maintenance of prostheses is completed by prosthodontists and patients, successful placement and preservation of implants is affected largely by the plan set forth by the reconstructive surgeon. Full article

► Show Figures

Figure 1

8 pages, 651 KiB

Open AccessArticle

Pediatric Mandibular Resection and Reconstruction: Long-Term Results with Autogenous Rib Grafts

by André M. Eckardt, Enno-Ludwig Barth, Johannes Berten and Nils-Claudius Gellrich

Craniomaxillofac. Trauma Reconstr. 2010, 3(1), 25-32; https://doi.org/10.1055/s-0030-1249371 - 11 Mar 2010

Cited by 26 | Viewed by 60

Abstract

Reconstruction of mandibular defects following tumor resection in infants is a particular challenge. Although autogenous rib grafts have no relevance in the restoration of mandibular bone defects occurring after ablative tumor surgery due to limited bone stock and the availability of other donor [...] Read more.

Reconstruction of mandibular defects following tumor resection in infants is a particular challenge. Although autogenous rib grafts have no relevance in the restoration of mandibular bone defects occurring after ablative tumor surgery due to limited bone stock and the availability of other donor areas, they are a useful surgical alternative following tumor surgery in infants. We here report on a 2, 5, 8, and 15-year follow-up of four children who were diagnosed with benign tumors of the mandible with osseous destruction at the age of 4, 6, 15, and 18 months, respectively. Histologic diagnoses were melanotic neuroectodermal tumor (n = 2), hemangioendothelioma of the mandible (n = 1), and ameloblastoma (n = 1). Following continuity resection of the mandible, lateromandibular bone defects were restored using autogenous rib grafts. Both clinical and radiologic follow-up visits were performed for all children to assess growth of the facial skeleton and the mandible. One child was already further reconstructed using bone augmentation at the age of 15 years. Cephalometric measurements on panorex films and three-dimensional computed tomographic scans revealed a slight vertical growth excess and transversal growth inhibition of the reconstructed mandible compared with the nonoperated side. Although further growth of rib grafts is difficult to predict and occlusal disharmony may occur due to physiologic maxillary growth and growth of the unaffected mandible, we believe that autogenous rib grafts can be ideally used for the restoration of mandibular continuity defects in newborns and young children. Clinical follow-up visits on a yearly basis and orthodontic controls are useful for early orthodontic treatment of growth deficits. Further corrective surgery with bone augmentation or osseous distraction is required following completion of growth of the facial skeleton. Full article

► Show Figures

Figure 1

7 pages, 349 KiB

Open AccessArticle

Revisiting Orthodromic Temporalis Transfer in Treating Long-Standing Facial Paralysis

by Amir S. Elbarbary, Mostafa Hemeda and Adel H. Amr

Craniomaxillofac. Trauma Reconstr. 2010, 3(1), 17-23; https://doi.org/10.1055/s-0030-1249370 - 11 Mar 2010

Viewed by 50

Abstract

The treatment of long-standing facial paralysis through temporalis muscle transfer has stood the test of time. Herein, we present a modification in temporalis muscle transfer for lower facial reanimation. Instead of the traditional stripping of the temporalis muscle from its origin, its insertion [...] Read more.

The treatment of long-standing facial paralysis through temporalis muscle transfer has stood the test of time. Herein, we present a modification in temporalis muscle transfer for lower facial reanimation. Instead of the traditional stripping of the temporalis muscle from its origin, its insertion is stripped from the coronoid process through an intraoral approach. The detached fibers were then sutured to a fascia lata graft, which was passed and secured to the orbicularis oris to reanimate the corner of the mouth. The procedure is less extensive and provides a direct “orthodromic” line of pull with good muscular excursion and power. This simple procedure has been applied to 12 consecutive cases with long-standing complete facial paralysis presenting to the Plastic and Reconstructive Surgery Clinic at the Ain-Shams University Hospital over the past 2 years. In addition to symmetry at rest, this easy procedure allowed for good movement of the corner of the mouth with restoration of a balanced smile. Full article

► Show Figures

Figure 1

8 pages, 306 KiB

Open AccessArticle

Traumatic Superior Orbital Fissure Syndrome: Current Management

by Chien-Tzung Chen and Yu-Ray Chen

Craniomaxillofac. Trauma Reconstr. 2010, 3(1), 9-16; https://doi.org/10.1055/s-0030-1249369 - 11 Mar 2010

Cited by 32 | Viewed by 122

Abstract

Traumatic superior orbital fissure syndrome is an uncommon complication of craniomaxillofacial trauma with an incidence of less than 1%. The syndrome is characterized by ophthalmoplegia, ptosis, proptosis of eye, dilation and fixation of the pupil, and anesthesia of the upper eyelid and forehead. [...] Read more.

Traumatic superior orbital fissure syndrome is an uncommon complication of craniomaxillofacial trauma with an incidence of less than 1%. The syndrome is characterized by ophthalmoplegia, ptosis, proptosis of eye, dilation and fixation of the pupil, and anesthesia of the upper eyelid and forehead. This article describes a detailed anatomy of the superior orbital fissure as it related to pathophysiology and clinical findings. Etiology and diagnosis are established after detailed physical and radiographic examination. On the basis of our clinical experience in the management of superior orbital fissure syndrome and from the data reported previously in the literature, an algorithm for treatment of traumatic superior orbital fissure syndrome including use of steroid, surgical decompression of superior orbital fissure, and reduction of concomitant facial fracture is presented and its rationale discussed. Full article

► Show Figures

Figure 1

7 pages, 389 KiB

Open AccessArticle

A New Classification Based on the Kaban's Modification for Surgical Management of Craniofacial Microsomia

by Jose Rolando Prada Madrid, Giovanni Montealegre and Viviana Gomez

Craniomaxillofac. Trauma Reconstr. 2010, 3(1), 1-7; https://doi.org/10.1055/s-0030-1249368 - 11 Mar 2010

Cited by 14 | Viewed by 61

Abstract

In medicine, classifications are designed to describe accurately and reliably all anatomic and structural components, establish a prognosis, and guide a given treatment. Classifications should be useful in a universal way to facilitate communication between health professionals and to formulate management protocols. In [...] Read more.

In medicine, classifications are designed to describe accurately and reliably all anatomic and structural components, establish a prognosis, and guide a given treatment. Classifications should be useful in a universal way to facilitate communication between health professionals and to formulate management protocols. In many situations and particularly with craniofacial microsomia, there have been many different classifications that do not achieve this goal. In fact, when there are so many classifications, one can conclude that there is not a clear one that accomplishes all these ends and defines a treatment protocol. It is our intent to present a new classification based on the Pruzansky's classification, later modified by Kaban, to determine treatment protocols based on the degree of osseous deficiency present in the body, ramus, and temporomandibular joint. Different mandibular defects are presented in two patients with craniofacial microsomia type III and IV according to our classification with the corresponding management proposed for each type and adequate functional results. Full article

► Show Figures

Figure 1

Journal Menu

Journal Browser

Craniomaxillofac. Trauma Reconstr., Volume 3, Issue 1 (March 2010) – 7 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI