• Title/Summary/Keyword: Maxillofacial injuries

Search Result 147, Processing Time 0.022 seconds

Management and prevention of third molar surgery-related trigeminal nerve injury: time for a rethink

  • Leung, Yiu Yan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.45 no.5
    • /
    • pp.233-240
    • /
    • 2019
  • Trigeminal nerve injury as a consequence of lower third molar surgery is a notorious complication and may affect the patient in long term. Inferior alveolar nerve (IAN) and lingual nerve (LN) injury result in different degree of neurosensory deficit and also other neurological symptoms. The long term effects may include persistent sensory loss, chronic pain and depression. It is crucial to understand the pathophysiology of the nerve injury from lower third molar surgery. Surgery remains the most promising treatment in moderate-to-severe nerve injuries. There are limitations in the current treatment methods and full recovery is not commonly achievable. It is better to prevent nerve injury than to treat with unpredictable results. Coronectomy has been proved to be effective in reducing IAN injury and carries minimal long-term morbidity. New technologies, like the roles of erythropoietin and stem cell therapy, are being investigated for neuroprotection and neural regeneration. Breakthroughs in basic and translational research are required to improve the clinical outcomes of the current treatment modalities of third molar surgery-related nerve injury.

A CLINICAL STUDY ON NASO-ORBITO-ETHMOIDAL FRACTURES (비-안와-사골 복합골절에 관한 임상적 연구)

  • Kim, Soo-Nam;Lee, Dong-Keun;Min, Seung-Ki;Oh, Sung-Hwan;Choi, Moon-Gi;Park, Hwa-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.21 no.3
    • /
    • pp.277-283
    • /
    • 1999
  • This study was aimed at furnishing the data of Naso-orbito-ethmoidal fractures and aiding treatmenting Naso-orbito-ethmoidal fractures A 5-year review of Naso-orbito-ethmoidal fractures and concomitant injuries is presented. The patients were treated in the Dept. of Oral and Maxillofacial Surgery of Wankwang University Hospital from Jan. 1, 1993 to Dec. 31, 1997. The results were as followes: Male predominated over female by a ratio of 4.6 : 1. The most common reasons is traffic accident(88.2%). The elapsed time from injury to operation is average 9.2 days, and the mean admission days were 79 days and removal of plates were average 217.3 days. The most associated facial bone fractures is Zygomatico-Maxillary complex fracture(20%). Associated injuries were neurologic injury(29.4%), orthopedic injury(23.5%), opthalmologic injury(17.6%), body injury(5.8%), neuropsychologic injury(5.8%) and otolaryngologic injury(5.8%) in this order. The most injured teeth were upper and lower incisors. The intubation methods for surgery were orotracheal(29.57%), submental(29.5%), and nasotracheal technique(41%). Most patients had complications, that were post-traumatic telecanthus, nasal depression, scar formation. This results suggest that early diagnosis and treatment is prerequisits to satisfactory result. Aggressive management of NOE fracture with direct or bicoronal exposure with aid of CT is now an accepted norm.

  • PDF

Scalp injury management by a maxillofacial surgeon in a low-resource hospital

  • Frimpong, Paul;Nguyen, Truc Thi Hoang;Nimatu, Edinam Salia;Amponsah, Emmanuel Kofi;Kim, Soung Min
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.42
    • /
    • pp.39.1-39.5
    • /
    • 2020
  • Background: Head or scalp injury is a life-threatening and typically accidental human injury. Most medical departments require immediate medical treatment and proper treatment with specialized medical personnel and facilities. However, in low-resource environments, such as the rural region of West Africa, the authors have treated emergency trauma patients and provided immediate treatment despite lack of resources. Case presentation: We reviewed three cases of scalp injury patients, with representative clinical information, and used these cases to outline feedback on scalp trauma treatment based on the specialty knowledge of general and emergency surgeon. Conclusions: Oral and maxillofacial surgeons are medical specialists that can immediately diagnose and treat these scalp injuries based on their medical knowledge and experience with the maxillofacial region.

THE CLINICAL STUDY OF THE MAXILLOFACIAL WAR INJURIES IN KOREAN (한국인 전상환자의 악안면결손에 대한 임상적연구)

  • Choi, Kyu-Hwan;Min, Seung-Ki;Um, In-Woong;Kim, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.14 no.4
    • /
    • pp.275-282
    • /
    • 1992
  • Maxillofacial war injures is specific representative of severe hard and soft tissue defect. This type of injuries were different from the trauma because it may be fatal. The purpose of this study was to evaluate the injury type base on the retrograde medical record in the 104 patients from Feb. 1991 to Aug. 1992 in Korea Veterans Hospital. The obtained results were as follows. 1. Among 104 cases, 51 cases(49.0%) were classified as mandibular defects only, and 53 cases (51.0%) were classified as maxillary with mandibular defect (combined). 2. The etiologic factors of injury were gunshot, artillery and grenade or shell: 33 cases, 14cases, and 10 cases respectively in Korea War, 19 cases, 5 cases, and 8 cases respectively in Vietnam War. 3. In 57 cases of mandibular partial defect, the angle area showed the highest frequencies, 18 cases(31.6%). 4. In 42 cases of mandibular segmental defect, the area between the 1st molar and the ascending ramus showed the highest frequencies. 17 cases(40.4%), and almost all cases were unilateral defect (40 cases, 95.0%) 5. Reconstruction method performed for segmental mandibular defect were wire or plate(15 cases, 35.7%) and soft tissue closure only(12 cases, 28.7%), respectively.

  • PDF

A COMPARATIVE STUDY OF THREE DIMENSIONAL RECONSTRUCTIVE IMAGES USING COMPUTED TOMOGRAMS OF FACIAL BONE INJURIES (안면골 외상환자의 전산화단층상을 이용한 삼차원재구성상의 비교연구)

  • Choi Eun-Suk;Koh Kwang-Joon
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
    • /
    • v.24 no.2
    • /
    • pp.413-423
    • /
    • 1994
  • The purpose of this study was to clarify the spatial relationship in presurgical examination and to aid surgical planning and postoperative evaluation of patients with facial bone injury. For this study, three-dimensional images of facial bone fracture were reconstructed by computed image analysis system and three-dimensional reconstructive program integrated in computed tomography. The obtained results were as follows: 1. Serial conventional computed tomograms were value in accurately depicting the facial bone injuries and three-dimensional reconstructive images demonstrated an overall look. 2. The degree of deterioration of spatial resolution was proportional to the thickness of the slice. 3. Facial bone fractures were the most distinctly demonstrated on inferoanterior views of three-dimensional reconstructive images. 4. Although three-dimensional reconstructive images made diagnosis of fracture lines, it was difficult to identify maxillary fractures. 5. The diagnosis of zygomatic fractures could be made equally well with computed image analysis system and three-dimensional reconstructive program integrated in computed tomography. 6. The diagnosis of mandibular fractures could be made equally well with computed image analysis system and three-dimensional reconstructive program integrated in computed tomography.

  • PDF

Acquired synechia of the tongue to the mouth floor

  • Sodnom-Ish, Buyanbileg;Nguyen, Truc Thi Hoang;Eo, Mi Young;Cho, Yun Ju;Kim, Soung Min;Lee, Jong Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.47 no.5
    • /
    • pp.394-397
    • /
    • 2021
  • Sodium hydroxide or caustic soda is a corrosive agent that can cause extensive damage to the oral mucosa, lips, and tongue when ingested either accidentally or intentionally. These injuries include microstomia, shallow vestibule, ankyloglossia, speech impairment, loss of teeth and impairment in facial expression. In the present article, we report a unique case of tongue adhesion to the mouth floor and its surgical management in a 66-year-old female patient, who had a history of caustic soda ingestion.

Facial fractures and associated injuries in high- versus low-energy trauma: all are not created equal

  • Hilaire, Cameron St.;Johnson, Arianne;Loseth, Caitlin;Alipour, Hamid;Faunce, Nick;Kaminski, Stephen;Sharma, Rohit
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.42
    • /
    • pp.22.1-22.6
    • /
    • 2020
  • Introduction: Facial fractures (FFs) occur after high- and low-energy trauma; differences in associated injuries and outcomes have not been well articulated. Objective: To compare the epidemiology, management, and outcomes of patients suffering FFs from high-energy and low-energy mechanisms. Methods: We conducted a 6-year retrospective local trauma registry analysis of adults aged 18-55 years old that suffered a FF treated at the Santa Barbara Cottage Hospital. Fracture patterns, concomitant injuries, procedures, and outcomes were compared between patients that suffered a high-energy mechanism (HEM: motor vehicle crash, bicycle crash, auto versus pedestrian, falls from height > 20 feet) and those that suffered a low-energy mechanism (LEM: assault, ground-level falls) of injury. Results: FFs occurred in 123 patients, 25 from an HEM and 98 from an LEM. Rates of Le Fort (HEM 12% vs. LEM 3%, P = 0.10), mandible (HEM 20% vs. LEM 38%, P = 0.11), midface (HEM 84% vs. LEM 67%, P = 0.14), and upper face (HEM 24% vs. LEM 13%, P = 0.217) fractures did not significantly differ between the HEM and LEM groups, nor did facial operative rates (HEM 28% vs. LEM 40%, P = 0.36). FFs after an HEM event were associated with increased Injury Severity Scores (HEM 16.8 vs. LEM 7.5, P <0.001), ICU admittance (HEM 60% vs. LEM 13.3%, P <0.001), intracranial hemorrhage (ICH) (HEM 52% vs. LEM 15%, P <0.001), cervical spine fractures (HEM 12% vs. LEM 0%, P = 0.008), truncal/lower extremity injuries (HEM 60% vs. LEM 6%, P <0.001), neurosurgical procedures for the management of ICH (HEM 54% vs. LEM 36%, P = 0.003), and decreased Glasgow Coma Score on arrival (HEM 11.7 vs. LEM 14.2, P <0.001). Conclusion: FFs after HEM events were associated with severe and multifocal injuries. FFs after LEM events were associated with ICH, concussions, and cervical spine fractures. Mechanism-based screening strategies will allow for the appropriate detection and management of injuries that occur concomitant to FFs. Type of study: Retrospective cohort study. Level of evidence: Level III.

Evaluation of safety and usefulness of submental intubation in panfacial trauma surgery

  • Singaram, Mohanavalli;Ganesan, Ilango;Kannan, Radhika;Kumar, Rajesh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.42 no.2
    • /
    • pp.99-104
    • /
    • 2016
  • Objectives: Submental intubation has been advocated as an alternative to classical tracheostomy for certain indicated panfacial trauma surgeries. Surgeons should have various options for airway management in maxillofacial trauma patients. Most maxillofacial injuries involve occlusal derangements, which might require intraoperative occlusal corrections; hence, orotracheal intubation is not ideal. Maxillofacial surgeons generally prefer nasotracheal intubation; however, in cases with concomitant skull base fracture or nasal bone fracture, nasotracheal intubation might not be suitable; in these situations, tracheostomy is typically performed. However, the possible complications of tracheostomy are well known. Due to trauma situations and to avoid the complications of tracheostomy, submental intubation would be an ideal alternative procedure in selected maxillofacial trauma surgery patients. This study aimed to evaluate the safety and usefulness of a submental intubation technique for panfacial trauma surgery. Moreover, we intended to share our experience of submental intubation and to recommend this simple, safe procedure for certain panfacial trauma surgeries. Materials and Methods: In five panfacial trauma patients, we performed submental intubation for airway management; the mean time required for the procedure was only eight minutes. Results: We were able to execute this procedure safely in a short time without any intraoperative or postoperative complications. Conclusion: Submental intubation is a safe and simple technique for airway management in indicated panfacial trauma surgery patients.

A CLINICAL STUDY ABOUT NATURE AND SEVERITY OF THE ZYGOMATIC BONE FRACTURES (관골 골절의 양상 및 정도에 관한 임상적 연구)

  • Ryu, Soo-Jang;Kim, Mi-Sook;Ro, Ki-Mun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.26 no.2
    • /
    • pp.211-218
    • /
    • 2000
  • This is a retrospective study on the nature and severity of zygomatic bone fractures. This study was based on a series of 358 patients with zygomatic bone fractures who treated as in-patient at Soonchunhyang Chonan Hospital during the period of Jan. 1993 through Dec. 1996. The results obtained are as follows : 1. The ratio of men to women was 4.41:1. The age frequency was highest in the second, third decade. The yearly distribution was the highest in 1993. The monthly distribution was highest in Feb. and Jun. 2. The most frequent cause was the traffic accident.(66.2%) 3. The most frequent type of fractures was the class I(undisplaced fx.).(25%) 4. The most frequent associated oral and maxillofacial injuries was soft tissue.(46.9%) 5. The most frequent associated systemic injuries was upper, lower extremity.(38%) 6. In A.I.S of oral and maxillofacial area, the mean score of A.I.S was $2.5{\sim}3$. In I.S.S, the highest mean score was in the ped TA.(19) 7. In respect of treatment, the most common method was open reduction with rigid fixation on fronto-zygomatic suture area.(47.8%) 8. The incidence of complication was 12% and the most common complication was malunion.(6.1%)

  • PDF

A study of introduction for Maxillofacial prosthesis in Dental Technology (치과기공의 악안면 보철분야 도입을 위한 이론적 고찰)

  • Lee, Hee-Kyung
    • Journal of Technologic Dentistry
    • /
    • v.29 no.2
    • /
    • pp.105-117
    • /
    • 2007
  • As a dental technician, the aim of the present study on maxillofacial prosthesis was to research its relation with dental technology and further development aspects by looking into its history, kinds, production materials and process. Dental technicians are to expect a great potential to work as maxillofacial prosthetist if having an interest in education of maxillofacial prosthesis field, and developing and operating the education process by expanding the range of dental technology. This article is to present overall history of maxillofacial prosthesis and some background information on the materials which have been used from the past. The maxillofacial field plays essential functions of mastication and speech, as well as performs appearance, which evokes good or bad feelings as an instant and instinctive response. The use of maxillofacial prostheses is not merely the replacement of a missing part of the face, resulted from injuries, but a rehabilitation process to help individuals come back to society. Rehabilitation includes both patient's physical and psychological recovery, such as self-esteem and selfconfidence. There has been a rapid development in application potentials of maxillofacial prosthesis technology which include implant, which can penetrate skin, and new materials. In order to produce maxillofacial prosthesis, general procedures of maxillofacial laboratory work should be understood first. Maxillofacial prosthesis and the dental prosthesis have many similarities in its academic perspective and originality. Maxillofacial prosthesis should be added into the curriculum for dental technology to achieve co-enhancement of the two fields.

  • PDF