Craniomaxillofacial Trauma & Reconstruction最新文献

{"title":"Effectiveness of a Structured Trauma Template in Improving Clinical Examination Accuracy in Maxillofacial Trauma: A Prospective Study.","authors":"Akhilesh K Pandey, Gigi Pg, Harshitha Rajanna, Abhishek Anil, Pravin Kumar, Ankita Chugh","doi":"10.1177/19433875241272435","DOIUrl":"10.1177/19433875241272435","url":null,"abstract":"<p><strong>Study design: </strong>Prospective pre-post study.</p><p><strong>Objective: </strong>Maxillofacial trauma presenting to the emergency department (ED) are often accompanied with complex concomitant injuries, thereby making thorough diagnosis and treatment plan quite an exacting task owing to the demanding conditions of the ED. The use of a structured maxillofacial trauma template helps in documenting the injuries comprehensively, aids in treatment planning, avoids medical negligence thereby improving the quality of care given to the patient. The study introduced a structured maxillofacial trauma template to improve the quality of the ED documentation.</p><p><strong>Methods: </strong>A total of 220 patients were evaluated for the quality of their ED documentation from September 2023 till February 2024. The group A included 110 patients where complete medical documentation was done routinely on a blank A4 sized paper, group B included 110 patients where the documentation was done using the structured oral and maxillofacial trauma template. The ED notes were thoroughly evaluated by the 2 independent authors for record completeness and documentation rate of history and examination findings.</p><p><strong>Results: </strong>The introduction of trauma template demonstrated a significant improvement of 18.95 % in record completeness. Significant improvement was seen in documentation rate among the covariates like place of injury, time of evaluation, primary care given, wound classification, dento-alveolar injury, ophthalmic evaluation, nerve injury evaluation, comorbidities with <i>P</i> = .001, and referral with <i>P</i> = .03. The ophthalmic evaluation showed significant improvement among covariates (loss of visual acuity, reflexes, diplopia, enophthalmos, subconjunctival haemorrhage, chemosis, periorbital oedema, periorbital ecchymosis, ocular dystopia) with <i>P</i> = .001, and extraocular muscle restriction with <i>P</i> = .004.</p><p><strong>Conclusions: </strong>The study demonstrated that the use of a structured oral and maxillofacial trauma template can significantly improve the quality of the ED documentation and contributes to better patient care in the ED.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP204-NP216"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking the Potential of Submental Intubation - Redefining Airway Management in Craniomaxillofacial Trauma Patients.","authors":"Amit Dharamvir Mahajan, Sharvari Prakash Daithankar, Pratesh Nitin Dholabhai, Aniruddh Pratap Singh, Aditya Rajesh Shah, Nirvani Pinkesh Shah","doi":"10.1177/19433875241278797","DOIUrl":"10.1177/19433875241278797","url":null,"abstract":"<p><strong>Study design: </strong>Submental intubation is and underutilized alternative to traditional techniques of intubation. Complications associated can indeed deter surgeons and anesthesiologist from performing it. Surgeons may opt for submental intubation if they believe that its advantages outweigh the potential risks of the procedure. Identifying the reasons of complications and implementing of proper strategies to address them can help mitigate risks.</p><p><strong>Objective: </strong>This study aims to compare and analyze the complications experienced during and after submental intubation to comment on its safety, efficacy. Revisiting literature, will help us to comment on diagnosis in trauma and associated perioperative and intraoperative complication with it. It will also help us deduce most preferred way of performing submental intubation and various methods to manage complications.</p><p><strong>Methods: </strong>Submental intubation in patients experiencing craniofacial trauma was reviewed retrospectively for 9 years from January 2015 to August 2023. Common diagnosis sites were analyzed for perioperative and postoperative complications.</p><p><strong>Results: </strong>It was found that there were no much complications faced perioperatively and also notes methods used for management of complications. Most commonly encountered postoperative complication was scar. Literature of past years was reviewed, during process we also came out with novel method for safe extubation for which we have got copyright from Government of India.</p><p><strong>Conclusions: </strong>Submental intubation is a safe and efficient intraoperative airway management technique for patients with craniomaxillofacial injuries when there is concurrent facial trauma. This study findings would underscore the safety and efficacy of SEI, making it a promising unparalleled method of airway management worth considering.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP230-NP241"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Characterization of Facial Lacerations in Emergency Departments in the United States.","authors":"Heather Peluso, Kevin Vega, Sthefano Araya, Lindsay Talemal, Civanni Moss, Jake Siegel, Adam Walchak","doi":"10.1177/19433875241257572","DOIUrl":"10.1177/19433875241257572","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;This is a retrospective study using the Nationwide Emergency Department Sample.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Facial laceration repairs are one of the most common procedures performed in the emergency department (ED). The goal of this study was to describe the patient's characteristics and healthcare cost associated with ED encounters for facial lacerations using the largest nationally representative database in the United States.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a retrospective study using the Nationwide Emergency Department Sample. The data was collected between January and December of 2019. Patients with either a primary or secondary diagnosis of facial laceration were included. The primary outcome was patient characteristics. The secondary outcomes were ED characteristics, number and type of procedures performed and total encounter charges. Diagnoses and procedures were identified using ICD-10 CM codes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 2,548,944 ED encounters for facial lacerations in the United States. Of those, laceration was the chief complaint in 75%. 80% of lacerations were unintentional, 8% were due to assaults, and &lt;1% due to suicidal attempts. The most common laceration location was the scalp (21%) followed by the lip (11%) and eyelid (11%). The mean patient age was 38 years. Most patients were adults (69%), male (62%), Caucasian (64%, African American 14%, Hispanic 14%, Other 4%, Asian 2%), from low income levels ($1-$45,999: 29%, $46,000- $58,999: 24%, $59,000-$78,999: 24%, $79,000 or more: 23%), with private insurance (32%, Medicaid 25%, Medicare 24%, self-pay 12%, other 6%). Most encounters were during summer (June, July, August) at large metropolitan areas with at least 1 million residents (52%, small metropolitan: 30%, micropolitan: 10%, other: 7%) at teaching hospitals (65%) located in the southern region of the United States (37%, Midwest: 23%, west: 21%, northeast: 19%). Almost half of the encounters were at non-trauma-designated hospitals (48%, Level 1 trauma center: 21%, Level 2 trauma center: 17%, Level 3 trauma center: 13%). The number of procedures during each encounter was: none: 4%, one: 17%, two: 23%, three: 11%, four: 11%, five or more: 28%. The most frequent laceration repair was a simple repair of superficial wounds of the face, ears, eyelids, nose, lips, and/or mucous membranes 2.5 cm or less, followed by simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities 2.5 cm or less. Most emergency department visits were billed as a Level 3 encounter, followed by Level 2 then Level 4. CT scan of the head was the most common imaging modality. Of all patients, &lt;1% were admitted to the hospital and 87% were discharged home. The average total emergency department charges were $5,733.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Facial laceration is a common complaint in the emergency department. It is costly, and disproportion","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP113-NP120"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Burden of Road Traffic Accidents on Facial Fractures: National Trends, Injury Patterns, and Disparities in 154,185 Patients.","authors":"Carol Y Wang, Daniel Y Kwon, Olachi Oleru, Nargiz Seyidova, Peter E Shamamian, Keisha E Montalmant, Alex Sarosi, Peter J Taub","doi":"10.1177/19433875241272440","DOIUrl":"10.1177/19433875241272440","url":null,"abstract":"<p><strong>Study design: </strong>National database study.</p><p><strong>Objective: </strong>Road traffic accidents (RTAs) are a common and challenging cause of facial fractures in the United States. The present study sought to utilize the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) to investigate national trends, injury patterns and disparities in facial fractures secondary to RTAs. To date, this is the first study to do so.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of patients with primary facial fractures secondary to RTAs using the 2018-2021 HCUP-NIS. Patients were classified into the RTA and non-RTA group. Demographics, injury patterns, and inpatient outcomes were compared.</p><p><strong>Results: </strong>In total, 154,185 primary facial fractures were identified, of which 17% (n = 26,115) were associated with RTAs. RTAs commonly involved cars (41%), followed by motorcycles (15%), pedestrians (11%), and bicyclists (10%). The RTA group was younger (34% vs 24% < 25 years, <i>P</i> < .01) and more frequently Hispanic (18% vs 15%, <i>P</i> < .01). The most common fracture types were mandibular (23%), frontal (14%), and orbital fractures (14%). The RTA group was 50% more likely to have multiple facial fractures (OR = 1.5, <i>P</i> < .01). The RTA group had a longer length of stay (5.3 vs 4.0 days, <i>P</i> < .01), admission charge ($127,932 vs $79,414, <i>P</i> < .01), and mortality rate (1.9% vs 1.4%, <i>P</i> < .01) than the non-RTA group.</p><p><strong>Conclusions: </strong>The present findings provide valuable insights, informing early involvement of craniofacial surgeons for the assessment of combination facial fractures and tailored treatment approaches for RTA patients.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP182-NP191"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunity Cost of Surgical Management of Craniomaxillofacial Trauma: A Longitudinal Study.","authors":"Khalil Issa, Nicholas A Frisco, Kayla W Kilpatrick, Maragatha Kuchibhatla, Dane M Barrett, David B Powers, Charles R Woodard","doi":"10.1177/19433875241292164","DOIUrl":"10.1177/19433875241292164","url":null,"abstract":"<p><strong>Study design: </strong>Single-institution retrospective financial analysis.</p><p><strong>Objective: </strong>Trauma care is consistently linked to inadequate reimbursement, posing a significant financial burden for large trauma centers. Data show that declining Medicare reimbursement rates have indirectly led to declining payment for all procedures covered by insurance. The goals of this study are to investigate the opportunity cost associated with contemporary surgical management of CMF trauma at our institution and to evaluate longitudinal financial trends.</p><p><strong>Methods: </strong>Patients with operative facial fractures between 2015 and 2022 at Duke University Medical Center were included and compared to patients undergoing general otolaryngology, plastic surgery and oral surgery operations in the same period. Procedural codes, payor type, charges billed, collections, relative value units (RVUs) and other financial data were obtained and analyzed among the 2 patient populations. Comparative analysis was performed to assess the financial trends in data reported previously from 2007-2015.</p><p><strong>Results: </strong>The collection rate at Duke University Medical Center for operatively managed CMF fractures remains significantly lower than non-CMF counterparts. Interestingly, the collection rate gap between CMF and non-CMF surgeries has narrowed when comparing to the data from 2007-2013. This is largely due to a decrease in collection rates for non-CMF procedures from 29.61% (2007-2013) to 26.57% (2015-2022) [<i>P</i> = 0.0001] and an increase in collection rates for CMF procedures from 17.25% (2007-2013) to 18.05% (2015-2022) [<i>P</i> = 0.0001].</p><p><strong>Conclusions: </strong>Despite a slight improvement of the gap in reimbursement rates for CMF and non-CMF surgeries over the last several years, trauma care continues to have a negative financial impact on health care institutions.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP290-NP297"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for Orbital Defect Assessment and Patient-Specific Implant Design: Introducing OA² (Orbital Assessment Algorithm).","authors":"Nils-Claudius Gellrich, Michael Grant, Damir Matic, Philippe Korn","doi":"10.1177/19433875241272436","DOIUrl":"10.1177/19433875241272436","url":null,"abstract":"<p><strong>Study design: </strong>This study presents a review of the evolutionary development in reconstructive orbital surgery over the past 3 decades. Additionally, it proposes the Orbital Assessment Algorithm (OA²) to enhance decision-making for intraorbital reconstruction of post-traumatic orbital deformities.</p><p><strong>Objective: </strong>The objective of this paper is to provide insights into modern post-traumatic orbital reconstruction from a surgeon's perspective, with a specific focus on adult patients. It aims to highlight the advancements in computer-aided design and manufacturing techniques, particularly in the field of reconstructive orbital surgery, and to introduce the OA² as a tool for improved decision-making in this context.</p><p><strong>Methods: </strong>The study conducts a comprehensive review of the evolution of reconstructive orbital surgery, focusing on the integration of 3D technology into surgical practices. It also outlines the development and rationale behind the proposed OA2, emphasizing its potential to enhance the accuracy and efficacy of intraorbital reconstruction procedures for post-traumatic deformities.</p><p><strong>Results: </strong>The review demonstrates the significant progress made in reconstructive orbital surgery, particularly in leveraging 3D technology for virtual modeling, navigation, and the design and manufacturing of patient-specific implants. The introduction of the OA² provides a structured approach to assessing and addressing post-traumatic orbital deformities, offering potential benefits in decision-making and surgical outcomes.</p><p><strong>Conclusions: </strong>In conclusion, this paper underscores the pivotal role of computer-aided design and manufacturing in advancing reconstructive orbital surgery. It highlights the importance of integrating innovative design concepts into implant manufacturing processes and emphasizes the potential of the OA² to guide surgeons in the management of post-traumatic orbital deformities, ultimately contributing to improved patient outcomes.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP298-NP318"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Factors Associated With the Development of Calvarial Osteoradionecrosis in Patients Treated for Cutaneous Malignancies.","authors":"Dumindu Weerakkody, Kevin Nguyen, Evania Lok, Richard Khor, Sweet P Ng, Ben Starvaggi, Morikatsu Wada, Henry Li, Sally Kiu-Huen Ng","doi":"10.1177/19433875241242940","DOIUrl":"10.1177/19433875241242940","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>Calvarial osteoradionecrosis (ORN) is a rare but devastating complication of radiotherapy. The aim of this study was to describe the cumulative incidence of Calvarial ORN in patients in patients treated for cutaneous malignancy of the scalp.</p><p><strong>Methods: </strong>Data was compiled from patient records of a large tertiary hospital Plastic Surgery department and radiotherapy records of an affiliated cancer Center. We included all patients that were treated for cutaneous malignancies of the scalp that received radiotherapy. Patient demographics, cancer stage, treatment modalities, intraoperative details, and patient outcome data were recorded. Patients with incomplete radiotherapy data were excluded.</p><p><strong>Results: </strong>We analyzed 105 radiotherapy treatments to the scalp administered to 84 patients and recorded 7 cases of calvarial ORN resulting in a gross incidence of 6.67% per radiotherapy treatment. The parietal bone was the most frequently targeted site of radiotherapy and accordingly the most common site of ORN (85.7%). Median time from radiotherapy dose to the development of ORN was 846 days. Higher number of radiotherapy fractionation (<i>P</i> = .038), cumulative radiotherapy dose (<i>P</i> = .035), prolonged radiotherapy duration (<i>P</i> = .022) and skin grafting (<i>P</i> = .003) were associated with the development of ORN.</p><p><strong>Conclusions: </strong>Our findings suggest radiotherapy variables, such as prolonged radiotherapy duration, increased cumulative dose and higher radiotherapy fractions were strongly associated with the development of ORN. In addition, skin grafting following surgical resection was associated with the development of ORN. Further studies with larger sample sizes are required to further explore this relationship.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP51-NP59"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving Forward: The Last Subscription Issue and the Dawn of Open Access.","authors":"","doi":"10.1177/19433875241296681","DOIUrl":"10.1177/19433875241296681","url":null,"abstract":"","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"269"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In- Versus Out-Fracture: A Novel Concept in Naso-Orbito-Ethmoid Injury.","authors":"Jesse Menville, Luke Soliman, Nidhi Shinde, Carole Spake, Stephanie Francalancia, Josue Marquez-Garcia, Nikhil Sobti, Vinay Rao, Albert S Woo","doi":"10.1177/19433875241280781","DOIUrl":"10.1177/19433875241280781","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objective: </strong>The Markowitz-Manson classification system categorizes nasoorbitoethmoid (NOE) fractures by severity of injury and remaining integrity of the medial canthal tendon. However, this system does not account for direction of bony displacement (in-fracture vs out-fracture), which can greatly affect symptomatology and management. We hypothesize that NOE fractures will present differently based upon their severity: Type I injuries are likely to present with medial nasal bone displacement (in-fracture), whereas Type III fractures will be more prone to lateral displacement (out-fracture).</p><p><strong>Methods: </strong>A retrospective review was performed for all patients with NOE fractures who were evaluated by the plastic surgery department at a level 1 trauma center over a 6-year period. Computed tomography data were evaluated to assess for directionality of fracture segment displacement. Frequencies of medial, lateral, and non-displacement across NOE types were compared by Chi-Squared Goodness of Fit and Fisher's Exact Tests.</p><p><strong>Results: </strong>111 patients met inclusion criteria. The patient population was 73.9% male and averaged 51.2 years old. When bilateral fractures were counted independently, there were 141 cases in total: 115 Type I, 20 Type II, and 6 Type III. Type I fractures were most commonly in-fractured (48.7%), while Type III injuries were consistently out-fractured (100%) (<i>p</i> < .001).</p><p><strong>Conclusions: </strong>While Type II and III NOE fractures have dominated clinical focus, this study highlights the prevalence of impaction within Type I fractures. These findings advocate for a more comprehensive approach to the evaluation of Type I NOE fractures and their potential risks, including traumatic hypotelorism and nasal airway obstruction.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP249-NP256"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does More Invasive Surgery Result in Higher Patient Satisfaction? A Long-Term Follow-Up of 136 Zygomaticomaxillary Complex Fractures.","authors":"Samin Rahbin, Ola Sunnergren, Ellen McBride, Hatef Darabi, Babak Alinasab","doi":"10.1177/19433875241286544","DOIUrl":"10.1177/19433875241286544","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective with follow-up.</p><p><strong>Objective: </strong>To evaluate the long-term satisfaction of surgically treated patients with zygomaticomaxillary complex (ZMC) fractures in relation to the use of internal fixation, number of fixation points, and orbital floor (OF) reconstruction. Secondary objectives were to describe the use of antibiotics and post-operative infections.</p><p><strong>Methods: </strong>Patients with unilateral ZMC fractures between 2007-2018 and treatment with either open reduction and internal fixation (ORIF) or closed reduction (CR) were identified from medical records and invited to follow-ups between 2018-2020. Patients were examined, photographed, and completed a questionnaire. A review panel of 3 experienced surgeons evaluated photographs and computed tomography (CT) scans pre- and post-surgery.</p><p><strong>Results: </strong>The study sample consisted of 136 patients (108 ORIF, 28 CR) with a median follow-up time of 76 months. Patient satisfaction of surgical outcome was high (97.8%), with no significant differences in relation to the use of internal fixation, number of fixation points, or OF reconstruction. Dissatisfaction was primarily related to hypoesthesia. On post-operative CT scans, malar asymmetry was more often predicted in patients with 1-point fixations. On questionnaires and photographs, malar asymmetry was more common in patients with 3-point fixations. Prophylactic antibiotics had no effect on the rate of post-operative infections.</p><p><strong>Conclusions: </strong>Patient satisfaction was not influenced by internal fixation, number of fixation points, or OF reconstruction. Selected ZMC fractures can be treated with less invasive approaches. Caution should be observed when predicting long-term malar asymmetry on post-operative CT scans. The findings of this study highlight the importance of a rational and ethical use of surgery.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP271-NP280"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}