Search

Introduction: The incidence of ocular injury associated with maxillofacial trauma remains poorly defined, with reported rates ranging from 0.8% to 92%. Our study aims to more accurately characterize ocular injuries associated with midface fractures., Methods: We performed a retrospective review of 1677 patients from 2015 to 2020 with midface fractures at a Level I trauma center. Isolated nasal bone and frontal process of the maxilla fractures were excluded. Demographic information, mechanism of injury, need for surgery, and ophthalmologic findings were documented. Statistical analysis was conducted using SPSS., Results: 773 patients between the ages of 15 and 92 were identified. Trauma most commonly resulted from assault (63.8%). The association between the mechanism of injury and ocular injury was statistically significant (p = 0.003), with 78.6% of gunshot wounds and 44.3% of assault patients having an ocular injury. The Ophthalmology service evaluated 62.6% of cases preoperatively. Minor ocular injury occurred in 36% of patients, including 46.1% of isolated orbital floor, and 28.2% of zygomaticomaxillary complex fractures. Major ocular injury occurred in 10.5% of patients., Conclusions: Over 10% of patients with midface fractures were found to have major ocular injuries. Ophthalmologic exams should be performed for all patients with midface fractures to guide clinical decision making and prevent further intraoperative ocular insults., Level of Evidence: Level 4. This study represents a retrospective cohort study analyzing ocular injuries detected in patients presenting to a Level I trauma center with maxillofacial fractures between 2015 and 2020 Laryngoscope, 133:1624-1629, 2023., (© 2022 The American Laryngological, Rhinological and Otological Society, Inc.)

Maxillofacial trauma may cause eye injury besides fractures of the facial skeleton. However, evulsion of the globe is a rare event, and there are only a few reports of true total enucleation of the globes in the literature. We report a 23-year-old man who was a victim of motorcycle accident, with enucleation of the globe, evulsion of the septal cartilage, and midfacial fractures. We reviewed and discussed the literature of traumatic evulsion of the globes in maxillofacial traumas.

Subcutaneous emphysema is the inadvertent introduction of air into tissues under the skin covering the chest wall or neck. The common causes of subcutaneous emphysema are rib fracture, parenchymal lung wound and esophageal trauma. Rarely, it occurs after oral and nasal surgery or maxillofacial trauma. We observed subcutaneous emphysema spread out from periorbital region to upper mediastinum in a patient presented to em e rgency department following minor maxillofacial trauma and admitted due to a simple fracture at his frontal maxillary wall. We present this present case to emphasize early initial management and close observation of minor facial traumas which can prevent further unexpected complications.

Still today, there is no classification of non-unions in maxillofacial traumatology. There is a broad spectrum of definitions that simultaneously describe the pathological conditions and functional implications determined by the anatomical location of the fractures and the time factor. In this article the authors describe a literature review about bone non-union classification. Weber, in 1973, introduced the term "pseudo-arthrosis" to describe an altered process of bone healing characterised by the presence of fibrous tissue interposed between the fracture segments, that was lined with cartilaginous tissue and joined by a capsule; Spiessl, in 1988, used the term "non-union" to define any alteration of the bone healing process after a time period of more than 6 months from the initial traumatic event; Rosen, in 1990, proposed a new classification of the modes of altered bone healing in fractures, distinguishing 5 categories: delayed consolidation, non-union, non-union vascular, non union avascular, pseudoarthrosis. The authors also talk about "poor bone positioning". This factor describes the incorrect anatomical position of the bone fragments despite perfectly normal healing according to Gruss. In this article they also discuss about the treatment of non-unions and the treatment of occlusal alterations caused by poor post-traumatic bone positioning.

We report 3 cases of unusual dental injuries following facial fractures. The first patient sustained intrusion of a maxillary incisor into the nasal cavity following a mandibular fracture. The tooth dislocated into the pharynx and was found lodged in the piriform fossa during surgery. The second patient sustained intrusion of molars into the maxillary sinus following maxillary and mandibular fractures. His treatment was delayed due to life-threatening hemorrhage. The third case involved ingestion of multiple avulsed teeth into the alimentary tract following severe maxillofacial fractures. Although the diagnosis was made more than a week after the injury, the patient did not suffer any complications as a result of the dental avulsion. The aim of this report is to emphasize the possibility of associated dental injuries in patients with facial fractures. The trauma surgeon should be cognizant of the importance of carrying out a thorough intraoral examination during the initial evaluation. Any missing tooth should be considered as possibly displaced into other tissue compartments, and must be routinely searched for with x-rays of the skull, cervical spine, chest, and abdomen. If full intrusion injury is suspected, further diagnostic investigation with facial computed tomography scanning may be worth while.

Myiasis is a disease commonly seen in animals, especially sheep and cattle. The condition is rare in man. A patient with a neglected fractured mandible with superimposed myiasis is reported.

A rare case of massive maxillofacial hemorrhage, which was controlled by transcatheter arterial embolization, is reported. A 23-year-old man with massive nasal and oral hemorrhage caused by maxillofacial fracture was admitted. Emergency angiography demonstrated extravasation of contrast material from the posterior superior alveolar artery, which was immediately embolized using gelatin sponge particles. This case shows that transcatheter arterial embolization is useful and effective for the treatment of massive hemorrhage resulting from severe maxillofacial injury.

Cervical spine fractures are a serious complication of maxillofacial trauma because of the high potential for mortality and neurologic morbidity. This study reviewed 563 patients with facial fractures treated by the Division of Oral and Maxillofacial Surgery at a level I trauma center and identified 11 concomitant cervical spine fractures (2.0%). These patients were almost exclusively male (91%), white (100%), between 20 and 35 years of age (64%), involved in a motor vehicle accident (91%), with a concomitant mandibular fracture (91%). The examination, diagnosis, and management of patients with cervical spine injuries are discussed.

This study investigated the occurrence of primary and secondary complications following conservative versus surgical intervention in the treatment of midface and lower jaw fractures. Follow-up studies were undertaken on 81 patients who had been admitted to the above clinic with such fractures during their adolescence. It was found that more complications developed after surgical intervention.

The retrospective examination of 70 patients who had suffered fractures in tooth-bearing segments of the maxilla and the mandible when they were between one and twelve years old revealed a high incidence of late pathologic changes (in 39 out of 70). Disorders in odontogeny, eruption of the teeth and occlusion were observed. Primary and secondary loss of teeth did also occur. Our results show the necessity to inform both the young patients and their parents about the high incidence of late changes after jaw fractures in childhood. An effective recall-system is required in order to diagnose and treat such changes as soon as possible.

A 5-year review of facial fractures and concomitant injuries at a level 1 trauma center is presented. The anatomic location of the facial fractures, age and sex of the patients, cause of injury, and associated systems injuries are presented. The majority of facial fractures were found in males; the most prevalent age range was 16 to 30 years. Mandible fractures outranked zygomatic and maxillary fractures (6:2:1). Assaults and motor vehicle accidents were the most frequent causes of facial fractures, and lacerations followed by neurologic and orthopedic injury were the most frequently encountered concomitant injuries. Motor vehicle accidents were the most frequent cause of associated injury.

Two cases are reported in which the treatment of pan-facial fractures via a bi-temporal flap approach was complicated by cessation of activity of the sinuatrial node (sinus arrest). The anatomical, physiological and anaesthetic implications of this potentially fatal complication are discussed.

Maxillofacial infections, either surgical or nonsurgical, are relatively infrequent, probably because of the excellent regional blood supply. Established infections are usually recognized early owing to the obvious signs of infection and the early symptoms. Fortunately, most infections respond to the penicillin group of antibiotics. However, spread of maxillofacial infections may be disastrous, not only locally and regionally but possibly even systemically. There is always a chance of a lethal complication from a maxillofacial infection.

Assessment and orthodontic treatment of malocclusions caused by traffic accidents were reported. Different methods were employed to reestablish the harmony of the occlusion with consequent good facial appearance. Appliances like the activator and direct bonding techniques were illustrated. Principles and techniques of orthodontics play an important role in the treatment of the malocclusions left untreated at the time of surgical operation for the facial trauma.