Craniomaxillofacial Trauma & Reconstruction最新文献

{"title":"Functional and Esthetic Outcomes of Either Surgically or Conservatively Treated Anterior Frontal Sinus Wall Fractures: A Long-Term Follow-Up.","authors":"Oscar Solmell, Ola Sunnergren, Abdul Rashid Qureshi, Babak Alinasab","doi":"10.1177/19433875241250225","DOIUrl":"10.1177/19433875241250225","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>Frontal sinus fractures (FSFs) can lead to a range of clinical challenges, including facial deformity, impaired facial sensation, cerebrospinal fluid (CSF) leakage, sinus drainage impairment, chronic sinus pain and mucocele formation. The optimal management approach, whether surgical or conservative, remains a topic of ongoing discussion. The aim of this study was to evaluate and compare the functional and esthetic outcomes of patients with surgically and conservatively treated FSFs.</p><p><strong>Methods: </strong>In this retrospective study, patients treated for FSFs at the Karolinska university hospital 2004 to 2020 were identified in hospital records and invited to participate in a long-term follow-up. Sequelae and satisfaction with the esthetic result were assessed trough questionnaires and physical examinations.</p><p><strong>Results: </strong>A total of 93 patients were included in the study, with 49 presenting isolated anterior wall fractures and 44 presenting combined anterior and posterior wall fractures. Surgical intervention was performed in 45 cases, while 48 were managed conservatively. Among patients with moderate anterior wall fractures (4-6 mm dislocation), 80% of surgically treated patients compared to 100% of conservatively treated patients expressed satisfaction with their cosmetic outcomes at follow-up (<i>P</i> = .03). In conservatively treated patients with a forehead impression, the anterior wall fracture dislocation ranged from 5.3 to 6.0 mm (<i>P</i> < .0001). Approximately 50% of surgically treated patients vs 15% of conservatively treated patients developed impaired forehead sensation at follow-up (<i>P</i> = .03). Thirty-six percent of surgically treated patients reported dissatisfaction with surgery-related scarring, particularly those who underwent surgery via laceration or bicoronal incision.</p><p><strong>Conclusions: </strong>This study suggests that anterior FSFs with a dislocation of 5 mm or less can be effectively managed conservatively with high patient satisfaction, low risk of long-term forehead sensation impairment and without potential development of forehead impression. Bicoronal incision or incision via a laceration may be associated with esthetic dissatisfaction and late sequelae such as alopecia.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP68-NP76"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649066","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":"Management of Le Fort I Fractures.","authors":"Jin-Yong Cho, Jaeyoung Ryu","doi":"10.1177/19433875241278796","DOIUrl":"10.1177/19433875241278796","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objective: </strong>This retrospective study aims to analyze the results of Le Fort I fracture treatment, with a focus on addressing malocclusion related to the fractures.</p><p><strong>Methods: </strong>The study included 43 patients diagnosed with Le Fort I fractures who underwent open reduction and internal fixation. Demographic data, causes of trauma, accompanying facial bone fractures, treatment methods, and complications were analyzed. Fisher's exact test was employed to assess the association between fractures and malocclusion.</p><p><strong>Results: </strong>Postoperative complications included occlusal disorder (6 cases), sensory disturbance (4 cases), and facial deformation (6 cases). Condylar fractures showed a statistically significant association with occlusal disorders (<i>P</i> = 0.044). Surgeon variability did not significantly impact occlusal outcomes (<i>P</i> = 0.25).</p><p><strong>Conclusions: </strong>Proper management of Le Fort I fractures requires a thorough understanding of surgical principles and consideration of concomitant fractures. Achieving anatomical reduction based on occlusion is crucial for successful outcomes, and additional Le Fort I osteotomy may be considered in challenging cases.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP225-NP229"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649148","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":"Pediatric Facial Fractures: A Multi-Institutional Level 1 Trauma Center Analysis of Incidence, Interventions, and Outcomes.","authors":"Madison Hinson, Avery Wright, Amelia Davidson, Samuel Kogan, Christopher Runyan","doi":"10.1177/19433875241272430","DOIUrl":"10.1177/19433875241272430","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Objective: </strong>The management of pediatric facial fractures presents distinctive considerations compared to adults. This study aims to provide a unique perspective on the correlations between the mechanism of injury, types of facial fractures, and fracture interventions and management utilized in 2 North Carolina Level 1 Trauma Centers to determine the optimal management options for this patient population.</p><p><strong>Methods: </strong>An IRB-approved retrospective chart review was performed of pediatric facial trauma patients ages <18 years old between January 2020 and December 2022 at Atrium Health Wake Forest Baptist Medical Center and Atrium Health Charlotte Medical Center. Data on patient demographics, mechanism of injury, facial fractures, interventions, and outcomes were collected.</p><p><strong>Results: </strong>Of 2,977 pediatric facial trauma patients, 582 patients sustained at least 1 facial fracture at the time of injury. Adolescents were significantly less likely to be transferred from outside institutions and to be admitted for further care (<i>P</i> = 0.002). Adolescents experienced higher levels of residual symptoms following initial discharge (<i>P</i> = 0.001) and were less likely to have a symptom resolution within 1 year (<i>P</i> < 0.0001). Neonates and infants were significantly more likely to receive conservative interventions and to sustain calvarium and skull base fractures (<i>P</i> < 0.0001).</p><p><strong>Conclusions: </strong>This study identifies differences in pediatric age groups related to transfers, admittance, fracture type, management, and outcomes. Our data suggests adolescent patients may experience a higher incidence of residual symptoms with lower levels of symptom resolution within 1 year. Further investigation into these differences may elicit optimized methods of fracture management in pediatric age groups and allow for effective, individualized care with improved long-term outcomes.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP192-NP203"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649220","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 Impact of Socioeconomic Status on Pediatric Facial Trauma.","authors":"Avery Wright, Madison Hinson, Amelia Davidson, Caitrin Curtis, Christopher Runyan","doi":"10.1177/19433875241280214","DOIUrl":"10.1177/19433875241280214","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Objective: </strong>Socioeconomic status (SES) greatly impacts one's health status and the type of trauma that a patient experiences due to increased risk of exposure and varying availability of resources to treat emergent conditions. There is a need for large-scale databases of pediatric facial trauma to identify discrepancies in occurrence and identify risk factors.</p><p><strong>Methods: </strong>This retrospective examination uses a multi-center database to evaluate pediatric facial trauma patients (n = 644) visiting Atrium Heath Wake Forest Baptist (AHWFB) hospital from 2020 to 2022. Data collected included demographic information, past medical and surgical history, trauma history, interventions, and long-term outcomes such as scarring, deformities, and sensory or motor deficits. The number of incidents for each zip code surrounding AHWFB was compared with SES data including unemployment rate, mean household income, and poverty level.</p><p><strong>Results: </strong>Thirty-five percent of patients sustained a high-energy injury, and 65% sustained a low-energy injury. Within the surrounding counties of AHWFB, there were more incidents of pediatric facial trauma in areas with greater rates of poverty (<i>P</i> = 0.006). Additionally, there were more incidents due to high-energy injuries in areas with lower income (<i>P</i> = 0.044) and more poverty (<i>P</i> = 0.002). Specifically, motor vehicle accidents were more common in areas with lower income (<i>P</i> = 0.017) and more poverty (<i>P</i> = 0.001).</p><p><strong>Conclusions: </strong>These findings in the central Piedmont region of North Carolina are consistent with previous research of SES's effect on health inequalities and serve as evidence of the need to take steps to prevent pediatric facial trauma in areas of low SES.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP242-NP248"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649226","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":"A Systematic Review of Local Flaps Utilized for External Auditory Canal Defects.","authors":"Anna Celeste Gibson, Olivia Speed, Jennings R Boyette, Robert Saadi","doi":"10.1177/19433875241262619","DOIUrl":"10.1177/19433875241262619","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review of the literature.</p><p><strong>Objective: </strong>The goal of this study is to review and summarize current literature on local flap reconstruction of external auditory canal (EAC) defects.</p><p><strong>Methods: </strong>PubMed and Ovid databases were queried utilizing search term combinations of \"external auditory canal,\" \"defects,\" \"flaps,\" \"local,\" and \"reconstruction.\" References in included articles were subject for review and inclusion. Articles published between 2013 and 2023 were included in the study.</p><p><strong>Results: </strong>A total of 108 articles were screened after duplicates were excluded. Of the 108 articles, 3 were not written or translated to English, 10 were not accessible for review on either database, and 71 were not applicable to our subject of interest. The remaining 24 articles were included in the systematic review. Due to the primary descriptive nature of the surgical techniques and variability of data collection, a formal meta-analysis was not possible.</p><p><strong>Conclusions: </strong>The EAC defect creates a difficult reconstructive dilemma. The armamentarium for repairing these defects can range from healing by secondary intention to free tissue transfer, however, local flap reconstruction proves to be a reliable and versatile option. This article reviews current local flap techniques for EAC defects and compares their advantages and disadvantages. Further, the authors provide a treatment algorithm and indications for choosing each flap in external auditory canal reconstruction.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP345-NP357"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649116","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":"Precision and Progress: Key Developments in Craniomaxillofacial Surgery.","authors":"","doi":"10.1177/19433875241286628","DOIUrl":"10.1177/19433875241286628","url":null,"abstract":"","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"17 3","pages":"179-180"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356143","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":"Erratum to \"Current Evidence for the Management of Edentulous Atrophic Mandible Fractures: A PRISMA-SWiM Guided Review\".","authors":"","doi":"10.1177/19433875221150350","DOIUrl":"https://doi.org/10.1177/19433875221150350","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/19433875221115585.].</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"17 2","pages":"176"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082386","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":"Corrigendum to \"The Impact of Payment Reform on Pediatric Craniofacial Fracture Care in Maryland\".","authors":"","doi":"10.1177/19433875231189076","DOIUrl":"https://doi.org/10.1177/19433875231189076","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/1943387520983634.].</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"17 2","pages":"174-175"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082383","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":"Resilience at the End of the Year: From Crisis to Innovation and the Future of Craniomaxillofacial Trauma and Reconstruction.","authors":"","doi":"10.1177/19433875231217130","DOIUrl":"10.1177/19433875231217130","url":null,"abstract":"","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"16 4","pages":"257"},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138478924","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":"Comparison of the Effective Radiation Dose in the Region of the Facial Skull Between Multidetector CT, Dental Conebeam CT and Intraoperative 3D C-Arms","authors":"Sebastian Pietzka, Anne Grieser, Karsten Winter, Alexander Schramm, Marc Metzger, Wiebke Semper-Hogg, Michael Grunert, Marcel Ebeling, Andreas Sakkas, Frank Wilde","doi":"10.1177/19433875231213906","DOIUrl":"https://doi.org/10.1177/19433875231213906","url":null,"abstract":"Study Design Experimental single-centre study of X-ray absorption using a phantom skull. Objective This experimental study aimed to compare the radiation doses of different 3D imaging devices used in maxillofacial surgery, including one Multidetector CT (MDCT), two Conebeam CT (CBCT) and four intraoperative 3D C-arms. Methods Thermoluminescent dosimeters (TLD) were used to determine the absorbed radiation in an Alderson-Rando phantom skull. The phantom skull was positioned in the before mentioned seven devices and a defined 3D facial skull image was acquired. Subsequently, the TLD’S were read out and the effective doses (ED) and the organ doses (OD) were calculated and compared. Results OD varied significantly between tissues as well as between the 3D X-ray devices. The OD of the 3D C-arms were significantly lower than those of all other devices. The OD of the CT, especially in the standard setting, was the highest. Only by special adjustments of the scan protocol regarding CMF requirements for traumatology, the MDCT could achieve almost equivalent doses as the two tested CBCT-scanners. The calculated effective doses were also lowest for the 3D C-arm devices (11.2 to 129.9 μSv). The ED of the MDCT were significant higher (284.52–844.97 μSv) than in all other devices. The ED of the CBCTs (173.7–184.9) were lower than for MDCT but still higher than those of the 3D C-arms. Conclusions Intraoperative imaging using 3D C-arm devices is an effective method to verify reduction results in maxillofacial surgery intraoperatively with significantly lower ED than postoperatively CBCT and MDCT imaging.","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"85 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135092422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}