• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.11
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• pp.588-592
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• 2018

Background and Objectives The incidence of facial bone fracture is increasing. The zygomatic bone, due to its anatomical prominence, is the second most common site of all facial bone fractures. In this study, we present the clinical experiences of zygomatic arch fracture in a tertiary hospital and introduce the Gillies approach for reduction and its outcome results. Subjects and Method We collected data from retrospective chart reviews of patients who underwent surgeries from 2010 to 2017 for zygomatic arch fractures at Chungbuk National University Hospital. Data were analyzed according to age, gender, cause of trauma, location of trauma, and clinical symptoms including trismus. All surgery was performed under general anesthesia and via the use of Gillies approach. The result of surgery was evaluated by postoperative facial computed tomography. Results Sixteen patients underwent surgery for zygomatic arch fracture. The patients had the average age of 41.3 years, a male predominance of 15:1 and physical assault as the most common cause of trauma. The time lag between injury and surgical reduction was 5.5 days. The surgical outcomes were assessed 'good' in 14 cases and 'moderate' in one case. Patients who had trismus preoperatively were resolved of it in all cases after operation. Postoperative complications were absent. Conclusion The Gillies approach proved to be a relatively easy, safe, and reliable method, and its surgical outcomes was satisfactory in our experiences.

• Journal of radiological science and technology
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• v.27 no.3
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• pp.13-18
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• 2004

In most patients with facial palsy after temporal bone injury, temporal bone High Resolution CT revealed direct or indirect facial nerve canal involvement, and in complete palsy severe degeneration groups, there were direct findings in most cases. Author believe that meticulous analysis and symptom correlation of the fracture patterns seen in facial canal injury in patients with traumatic facial nerve palsy is helpful for treatment planning and prognosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.2
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• pp.177-182
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• 2005

Malocclusion can be often found after improper reduction of facial bone fractures, especially by the plastic surgeon or other medical doctor. This causes lots of problem in esthetics, mastication, or facial symmetry. We present four cases which are related above problems. These were well treated by orthognathic surgery or orthodontic treatment.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.95-100
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• 2014

Purpose: Nasal bone fractures are the most common childhood facial bone fractures, with an incidence of about 39%. While taking a nasal bone x-ray is a common modality used in the emergency department, reports have expressed concerns with its low sensitivity and low specificity. Our study was aimed at comparing accuracy of physical and x-ray examination with that of facial bone computed tomography (CT). Methods: Electronic medical records (EMR) were retrospectively reviewed for patients under the age of 15 who visited our emergency department from January 2010 to December 2011with a chief complaint of nasal pain due to trauma and who had also undergone a nasal bone x-ray and facial bone CT. Patients who had not taken facial bone CT, who had been transferred, and who did not have EMR were excluded. We divided the patients into 2 groups, those who had nasal bone fractures and those without a fracture on their facial bone CT. We analyzed other parameters such as age, sex, and type of fracture to find statistical differences between the two groups. Results: A total of 209 patients were included. The patients with nasal bone fractures on their facial bone CT were older, and their traumas were more violent. Ten patients who had apparent nasal bone fractures on their facial bone CT had no definite signs of a fracture on their plain x-ray. Conclusion: Though facial bone CT is an effective modality in detecting nasal bone fractures, in evaluating younger patients suspected of having nasal bone fractures, prudent use of facial bone CT is needed to reduce unnecessary exposure to radiation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.6
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• pp.306-316
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• 2015

Objectives: The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods: A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results: The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion: This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.41-49
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• 1989

This is a retrospective study on facial bone fractures of Koreans. This study was based on a series of 110 patients who had been treated for facial bone fractures as in-patient at Guro Hospital, School of Medicine, Korea University for the period of September, 1984. to August, 1988. The results were obtained as follows : 1. 2nd decade(42.7%) was the highest age group in incidence, and age range was 2 years to 72 years, and the ration of Male/Female was 3.7 : 1. 2. Falling was most frequent cause of facial bone fractures(40.9%) 3. The frequent location of facial bone fractures were mandibule(67.1%), zygoma & zygomatic arch(11.7%), maxilla(10.9%), and others in order. 4. In mandibular fractures, one site fractures showed 30.1% and two site fractures showed 58.8% and triple site fractures showed 11.1%. The most frequent site of mandibular fracture was symphysis(32.7%) 5. The most frequent month of facial bone fracture was September.

• Archives of Craniofacial Surgery
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• v.9 no.1
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• pp.17-22
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• 2008

Purpose: For several decades, open reduction has been a controversial issue in mandibular condyle fracture. The authors have successfully used the open reduction and internal fixation with retromandibular approach and have found it to be satisfactory for mandibular condyle fracture. Methods: A total of 10 patients with mandibular condyle fracture underwent open surgical treatment using retromandibular approach. The incision for the retromandibular approach was carried below the ear lobe and the facial nerve branches were identified. Dissection was continued until the fracture site was exposed and internal fixation was performed with miniplate following intermaxillary fixation. The average period of joint immobilization was 1 weeks and the arch bars were removed in 3 weeks on average. The preoperative and postoperative panoramic view and three-dimensional computed tomography were compared. During the follow up period, we evaluated the presence of malocclusion, chin deviation, trismus, pain, click sound, facial nerve palsy, hypertrophic scar and skin fistula. Results: According to the radiographic findings, the fractured condyle was reducted satisfactorily in all patients without any symptoms of facial palsy. During the follow up period ranged form 6 to 12 months, all clinical symptoms were improved except in one case with chin deviation and malocclusion. Conclusion: Using open reduction and internal fixation of mandibular condyle fracture with retromandibular approach, all results were satisfactory with good functional outcomes and minimal complication. We concluded that the open surgical treatment should be considered as the first choice for mandibular condyle fracture management.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.36-40
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• 2012

Purpose: Statistical analysis of facial bone fractures has been performed in various papers. However, reports on risk factors for facial bone fractures are rare. In order to prevent facial bone fractures, it is important to determine the risk factors for their occurrence. This study seeks to perform a statistical analysis on and identify the risk factors associated with facial bone fractures. Methods: A retrospective study was performed to assess facial bone fractures in patients presenting from October 2009 to January 2011 through a chart review. The data collected included age, gender, etiology, and alcohol consumption. Data was analyzed using multinomial logistic regression analysis. The significance level was set at p<0.05 and SAS ver. 9.2 was used. Results: A total of 489 patients were analyzed. The patients' age ranged from 2 to 85 years (mean age, $31.8{\pm}15.4$ years). The ratio of men to women was 5.0:1. The predominant group was age below 19 years old (30.9%). The main causes of facial bone fractures were assaults (37.8%), falls (27.2%), and sport accidents (19.5%). On multinomial logistic regression analysis, age, especially in the teen group was associated with assaults (p<0.05) resulting in facial bone fractures. Alcohol consumption was significantly associated with assaults and falls (p<0.05) leading to facial bone fractures. Conclusion: Facial bone fracture is a challenging problem, because of its high incidence and financial cost. The findings of this study indicate that more effective policies aimed at reducing alcohol intake and teenage violence are needed.

• Archives of Craniofacial Surgery
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• v.14 no.2
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• pp.119-123
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• 2013

Except for special situations, it is generally agreed that best results in the treatment of facial fractures is expected if reduction is done within the first 2 or 3 weeks after injury. We reduced facial bone fractures at 4 to 7 weeks after trauma. A 44-year-old female patient underwent open reduction for her right zygomaticomaxillary complex fracture at 7 weeks after injury. A 59-year-old female patient underwent surgery for the right mandible body and left parasymphysis fractures at 4 weeks after injury. Using traditional approaches, granulation tissue and callus were removed from the fracture sites, and malunited fracture lines were separated by a small osteotome. We reduced the displaced fractured zygoma and mandible to their normal anatomical positions and fixed them using titanium plates. No complications such as asymmetry, malunion, malocclusion, or trismus were seen. Unfavorable asymmetric facial contours were corrected, and we obtained good occlusion with favorable bony alignment. The functional and aesthetic outcomes were satisfactory. Through removal the callus and limited osteotomy, a successful approach to the previously fractured line was possible, and an exact correction with symmetry was obtained. This method can be a good option for obtaining good mobility and clinical results in treating delayed facial bone fractures.

• Journal of Acupuncture Research
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• v.33 no.1
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• pp.95-101
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• 2016

Objectives : The aim of this report was to investigate the effects of Korean medical treatment on facial nerve paralysis with sensorineural hearing loss and tinnitus caused by traumatic temporal bone fracture. Methods : We treated a patient with acupuncture, herbal medicine and physiotherapy. The effect of these treatments was evaluated by House-Brackmann facial grading scale, Yanagihara's unweighted grading system and by Digital Infrared Thermographic Image. Results : After 21 days of Korean medical treatment, House-Brackmann facial grading scale changed from III to II and Yanagihara's unweighted grading score increased from 14 to 27. Digital Infrared Thermographic Image also improved. Conclusions : These results suggest that Korean medical treatments were effective in treating facial nerve paralysis with sensorineural hearing loss and tinnitus caused by traumatic temporal bone fracture. We hope that a more efficient application of this treatment will be the result of clinical data accumulated in future studies.