Craniomaxillofacial Trauma & Reconstruction

5 pages, 384 KiB

Open AccessArticle

Subcranial Approach in Pediatric Craniofacial Surgery

by Jorge Ciechomski, Ruben Aufgang, Lucrecia Villanueva and Victoria Demarchi

Craniomaxillofac. Trauma Reconstr. 2010, 3(4), 231-235; https://doi.org/10.1055/s-0030-1268521 - 10 Nov 2010

Cited by 3 | Viewed by 61

We report our experience with the subcranial approach, developed at the Plastic Surgery Unit of Hospital “Ricardo Gutiérrez”, for the treatment of injuries in the frontoethmoidal orbital region in pediatric patients. The subcranial approach was described by Raveh et al for the treatment [...] Read more.

We report our experience with the subcranial approach, developed at the Plastic Surgery Unit of Hospital “Ricardo Gutiérrez”, for the treatment of injuries in the frontoethmoidal orbital region in pediatric patients. The subcranial approach was described by Raveh et al for the treatment of fractures in the frontoethmoidal area. The subcranial approach was used later for surgery of tumors and deformities of the frontoethmoidal region. We have used this approach in nine cases of nontraumatic injuries (one meningioma, one orbital bone fibrous dysplasia, one vascular malformation, five nasal dermoid cysts, and one fronto-orbital mucocele). One patient with vascular malformation died of a stroke 10 days after surgery. The patient with the meningioma had a recurrence. Another patient developed an infection that needed surgical resolution and hardware removal. A third patient suffered a mild infection that receded with medication. No other complications were registered. The surgical exposure obtained through this approach was always excellent and left no cosmetic defects. There was no evidence of facial growth disturbance in this group of patients, except in one patient who received radiotherapy after surgery. Operative time and hospitalization were lower in this group than in patients with conventional frontal craniotomy. Full article

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8 pages, 663 KiB

Open AccessArticle

Treatment of Palatal Fractures by Osteosynthesis with 2.0-mm Locking Plates as External Fixator

by Ricardo Cienfuegos, Eduardo Sierra, Benjamin Ortiz and Gerardo Fernández

Craniomaxillofac. Trauma Reconstr. 2010, 3(4), 223-230; https://doi.org/10.1055/s-0030-1268519 - 10 Nov 2010

Cited by 19 | Viewed by 96

Abstract

Treatment options for palatal fractures range from orthodontic braces, acrylic bars, and arch bars for maxillomandibular fixation to internal fixation, with plates and screws placed under the palate mucosa and periosteum, together with pyriform aperture or alveolar plating plus buttress reconstruction. Forty-five patients, [...] Read more.

Treatment options for palatal fractures range from orthodontic braces, acrylic bars, and arch bars for maxillomandibular fixation to internal fixation, with plates and screws placed under the palate mucosa and periosteum, together with pyriform aperture or alveolar plating plus buttress reconstruction. Forty-five patients, ages 4 to 56, were treated using medium- or high-profile locking plates placed over the palatal mucosa as an external fixator for palatal fractures, together with treatment for other associated facial fractures. In open fractures, plates were placed after approximating the edges of the mucosal wounds. Plates and screws for palate fixation were removed at 12 weeks, when computed tomography scans provided evidence of fracture healing. All palatal fractures healed by 12 weeks, with no cases of mucosal necrosis, bone exposure, fistulae, or infections. This approach achieves adequate stability, reduces the risk of bone and mucosal necrosis, and promotes healing of mucosal wounds in case of open fractures. Full article

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5 pages, 141 KiB

Open AccessArticle

Repair of Orbital Floor Fractures: Our Experience and New Technical Findings

by Pasquale Piombino, Giorgio Iaconetta, Roberto Ciccarelli, Antonio Romeo, Alessia Spinzia and Luigi Califano

Craniomaxillofac. Trauma Reconstr. 2010, 3(4), 217-221; https://doi.org/10.1055/s-0030-1268518 - 10 Nov 2010

Cited by 26 | Viewed by 83

Abstract

We report our experience with the repair of the orbital floor fractures and present new technical findings. We evaluated 30 subjects with pure blowout fractures treated at the Department of Maxillofacial Surgery of the Federico II University of Naples, Italy, between 2005 and [...] Read more.

We report our experience with the repair of the orbital floor fractures and present new technical findings. We evaluated 30 subjects with pure blowout fractures treated at the Department of Maxillofacial Surgery of the Federico II University of Naples, Italy, between 2005 and 2007. A preoperative examination by computed tomography scans provided classification of the orbital floor fractures into small and large fractures by measurement of the bone defect to choose the appropriate reconstructive implant materials, resorbable or nonresorbable. The clinical follow-up has been performed at 1 week, 1 month, 3 months, and 6 months. We observed a resolution of preoperative symptoms. The scar was not evident, and there was an absence of postoperative complications. We concluded that the use of resorbable materials for small orbital floor fractures and nonresorbable materials for large orbital floor fractures offers satisfactory results in both functional and aesthetic considerations. Furthermore, the new technical findings allow standardization of the surgical technique to be more accurate, also reducing the economic costs. Full article

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8 pages, 309 KiB

Open AccessArticle

Mydriasis during Orbital Floor Fracture Reconstruction: A Novel Diagnostic and Treatment Algorithm

by Matthew S. Yeo, Radwan Al-Mousa, Gangadhara Sundar and Thiam Chye Lim

Craniomaxillofac. Trauma Reconstr. 2010, 3(4), 209-216; https://doi.org/10.1055/s-0030-1268517 - 10 Nov 2010

Cited by 11 | Viewed by 76

Abstract

Orbital floor fractures are the most commonly encountered traumatic fractures in the facial skeleton. Mydriasis that is detected during orbital floor fracture reconstruction may cause significant distress to surgeons, as it may be associated with sinister events such as visual loss. It is [...] Read more.

Orbital floor fractures are the most commonly encountered traumatic fractures in the facial skeleton. Mydriasis that is detected during orbital floor fracture reconstruction may cause significant distress to surgeons, as it may be associated with sinister events such as visual loss. It is not an uncommon problem; previous studies have shown the incidence of mydriasis to be 2.1%. The combination of careful preoperative evaluation and planning, as well as specific intraoperative investigations when mydriasis is encountered, can be immensely valuable in allaying surgeons’ anxiety during orbital floor fracture reconstruction. In this review article, the authors discuss the common causes of mydriasis and present a novel systematic approach to its diagnostic evaluation devised by our unit that has been successfully implemented since 2008. Full article

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8 pages, 433 KiB

Open AccessArticle

Experience with the Use of Prebent Plates for the Reconstruction of Mandibular Defects

by Martin I. Salgueiro and Mark R. Stevens

Craniomaxillofac. Trauma Reconstr. 2010, 3(4), 201-208; https://doi.org/10.1055/s-0030-1268520 - 10 Nov 2010

Cited by 48 | Viewed by 97

Abstract

Bending of large titanium plates for mandibular reconstruction is a tedious task. This is usually done by trial and error over an intraoperatively bent template. By means of rapid prototype technology, accurate three-dimensional models can be obtained. Using these models, it is possible [...] Read more.

Bending of large titanium plates for mandibular reconstruction is a tedious task. This is usually done by trial and error over an intraoperatively bent template. By means of rapid prototype technology, accurate three-dimensional models can be obtained. Using these models, it is possible to design, obtain, and adapt custom hardware for individual surgical cases. Reductions of operating room time when using this technology have been reported from 17% to 60%, with an average of 20%. This translates to reduction of cost and risks, improving the overall surgical outcome. The purpose of this article is to establish the indications and contraindication for the use three-dimensional models and prebent plates. We present our experience with five cases in which prebent reconstruction plates were used for mandibular reconstruction. No significant complications occurred, and satisfactory results were achieved in all cases. We found that the models required to obtain the hardware are extremely accurate, have multiple reported applications, and represent a valuable surgical tool in the planning and execution of reconstructive surgery. Full article

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11 pages, 152 KiB

Open AccessArticle

Postoperative Care of the Facial Laceration

by Nicholas Medel, Neeraj Panchal and Edward Ellis

Craniomaxillofac. Trauma Reconstr. 2010, 3(4), 189-199; https://doi.org/10.1055/s-0030-1268516 - 10 Nov 2010

Cited by 10 | Viewed by 99

Abstract

The purpose of this investigation is to examine factors involved in the postoperative care of traumatic lacerations. An evidence-based comprehensive literature review was conducted. There are a limited number of scientifically proven studies that guide surgeons and emergency room physicians on postoperative care. [...] Read more.

The purpose of this investigation is to examine factors involved in the postoperative care of traumatic lacerations. An evidence-based comprehensive literature review was conducted. There are a limited number of scientifically proven studies that guide surgeons and emergency room physicians on postoperative care. Randomized controlled trials must be conducted to further standardize the postoperative protocol for simple facial lacerations. Full article

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3 pages, 147 KiB

Open AccessArticle

Isolated Bilateral Zygomatic Complex and Arch Fracture: A Rare Case Report

by Manikandhan Ramanathan and Mathew Pynumootil Cherian

Craniomaxillofac. Trauma Reconstr. 2010, 3(4), 185-187; https://doi.org/10.1055/s-0030-1268513 - 10 Nov 2010

Cited by 4 | Viewed by 89

Abstract

This is an unusual case of isolated bilateral zygomatic complex and arch fracture, which is extremely rare. The literature has no such report of a case. Full article

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8 pages, 280 KiB

Open AccessArticle

Teeth in the Line of Fracture: To Retain or Remove?

by Jimson Samson, Reena John and Shalini Jayakumar

Craniomaxillofac. Trauma Reconstr. 2010, 3(4), 177-184; https://doi.org/10.1055/s-0030-1268512 - 10 Nov 2010

Cited by 12 | Viewed by 99

Abstract

The purpose of this study was to analyze mandibular fracture site, relationship of the fracture line to the periodontium, vitality of teeth, displacement of the fracture segments and their implications, and determine whether to retain or remove the teeth in the fracture line. [...] Read more.

The purpose of this study was to analyze mandibular fracture site, relationship of the fracture line to the periodontium, vitality of teeth, displacement of the fracture segments and their implications, and determine whether to retain or remove the teeth in the fracture line. Fifty patients with 62 fractures were involved in this study. An electric pulp tester was used to measure the pulpal response. The degree of fracture displacement and the relationship of the fracture line to the periodontium were evaluated using panoramic radiographs. Fractures of the parasymphysis region constituted a majority of 60.87% in the gross displacement category. Four of 50 patients showed no response presurgically and minimal response postoperatively on pulp vitality testing. Patients with teeth in the fracture line showing no response on pulp vitality testing should be advised extraction to avoid further complications. Full article

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Craniomaxillofac. Trauma Reconstr., Volume 3, Issue 4 (December 2010) – 8 articles

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