• Title/Summary/Keyword: Maxillofacial injury

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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
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    • v.42
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    • pp.39.1-39.5
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    • 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.

PENETRATING INJURY OF FACE AND NECK WITH THE VERTEBRAL ARTERY INJURY;A CASE REPORT (추골동맥 손상을 동반한 안면과 경부의 관통성 외상 치험예)

  • Song, Woo-Sik;Kim, In-Kwon;Lee, Sang-Hyun;Hwang, Yun-Jung;Ahn, Jung-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.5
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    • pp.447-451
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    • 2001
  • With the exception of gun shot wound, the incidence of penetrating injury of face and neck areas nonorganic foreign bodies is relative low. But the diagnostic evaluation and therapeutic management of penetrating facial wounds need careful decision, when the anatomic proximity of the major vessels and nerve is considered. Penetrating facial trauma with concomitant vascular injury present challenging problems, the immediate complication of this vascular injury are severe bleeding, hematoma formation, shock, obstruction of airway. The vascular injury is conformed by angiography. In this report, a industrial tool(long tack) fired by explosive air is penetrated into face and to neck. In angiograms penetrating injury of the vertebral artery is detected. We performed the embolization of the vertebral artery with coils and manual removal of the foreign body without any complication was followed.

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Risk of lingual nerve injuries in removal of mandibular third molars: a retrospective case-control study

  • Tojyo, Itaru;Nakanishi, Takashi;Shintani, Yukari;Okamoto, Kenjiro;Hiraishi, Yukihiro;Fujita, Shigeyuki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.40.1-40.7
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    • 2019
  • Background: Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic lingual nerve injuries in the removal of the mandibular third molar. Methods: A retrospective chart review was performed for patients who had undergone microsurgical repair of lingual nerve injuries. The following data were collected and analyzed: patient sex, age, nerve injury side, type of impaction (Winter's classification, Pell and Gregory's classification). Ratios for the respective lingual nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar. Results: The lingual nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic lingual nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual nerve injury was significantly higher in the patient versus the control groups in age. The lingual nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our lingual nerve injury group. The distoangular impaction rate in our lingual nerve injury group was significantly higher than the rate for the control groups. Conclusion: Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe lingual nerve injury in the removal of mandibular third molars.

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
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    • v.21 no.3
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    • pp.277-283
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    • 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.

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CLINICAL STUDY OF FACIAL NERVE INJURY AFTER TMJ SURGERY (악관절 수술후 안면신경 손상에 대한 임상적 연구)

  • Kim, Hyung-Gon;Park, Kwang-Ho;Lee, Eui-Wung;Kim, Joon-Bae;Joo, Jae-Dong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.447-457
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    • 1994
  • Authors have studied retrospectively the facial nerve injury after TMJ surgery through the preauricular approach routine. The study material used was 4 patients of all 113 patients who were diagnosed as internal derangement and have been operated from March 1989 to February 1991 in Youngdong severance hospital, and were induced postoperatived facial nerve injury. The patient group who had the postoperative injured facial nerve was recognized degree of injury using the diagnostic method, Electromyography(EMG) and Nerve conduction test(NCT) which are used widely at present and was treated as conservative care and we identified the recovery time as the same method. The results as follows : 1. The meticulous care and precious surgical technique are needed in both operation and postoperation. During the TMJ surgery, the excessive retraction of the flap and frequent use of nerve stimulator and electric surgical knife should be avoided as possible and postoperative hematoma and swelling should be minimized. 2. The 4 patients were experienced with the postoperative facial nerve injury of all 133 patients who had been operated the TMJ surgery through the routine preauricular approach on our hospital. And the incidence of postoperative facial nerve injury happened was about 0.3% and its incidence was relatively low comparing with any other previous reports. 3. EMG and NCT were considered as useful methods which can diagnose the nerve injury objectively and identified the effect of treatment and recovery time. 4. The faical nerve-injured patients who were induced postoperatively after TMJ surgery, were diagnosed as second-degree nere injury through the EMG and NCT. And the patient group was treated well as conservative physical therapy for about 2 to 4 months.

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Correlation between maxillofacial injury, use of mouth guards and stress in physical education majoring male students (스포츠전공 남학생의 구강악안면 외상과 보호구 착용 및 스트레스와의 관련성)

  • Jang, Jong-Hwa;Kim, Jee-Hee
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.2
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    • pp.89-97
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    • 2013
  • Purpose : The purpose of this study was to investigate the correlation between stress and maxillofacial injuries in male students. Methods : The subjects were 386 male students who were 18 years or more. Mean age was $20.99{\pm}2.80$ years. Data were collected using a self-reported questionnaire from March 7 to March 28, 2013. We surveyed maxillofacial injuries, mouth guards use and stress in male students majoring physical education. The data were analyzed by Cochran's Mantel-Haenszel, McNemar test and logistic multiple regression. Results : Those who had clenching habit and maxillofacial pain accounted for 48.7%. The pain was 3.23 folds higher in clenching habit than those who had not (OR=3.23, p <.001). The more stress they had, the more clenching habit (OR=2.13) and pain(OR=1.68) did they have. Within 2 years, those having maxillofacial injury accounted for 53.2% and 78.6% of them put on maxillofacial protection guard. In rule for mouth guard use, 39.9% had no maxillofacial injury. Maxillofacial injury was 2.41 folds higher in those who had no mouth guard usee (OR=2.41). Conclusion : Maxillofacial injury had a close correlation with mouth guard use and stress. Therefore, it is very important to establish the rule for mouth guard use in sports activities.

THE SURVEY ON ORAL HEALTH AND MAXILLOFACIAL TRAUMA INCIDENCE OF THE SPORTS PLAYERS IN KOREA (운동선수들의 구강 악 안면 영역에서의 스포츠 외상에 관한 설문조사)

  • Park, Neung-Seog;Woo, Yi-Hyung;Bak, Jin;Choi, Dae-Gyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.45 no.4
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    • pp.534-545
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    • 2007
  • Statement of problem: In spite of increasing sports injury, there was no collected data on the rate and type of dental injuries for athletes in Korea. Purpose: The purpose of this study was to investigate the occurrence of maxillofacial injuries and attitude of college sports player in Korea towards mouthguard. Material and methods: Total 617 athletes answered a series of questionnaire concerning their sports injury and using mouthguard. Results: 1. 81%(502) of athletes had, playing or training a sports, suffered an injury. Female athletes suffered an injury more than male athletes(p<0.05). Contact sports athletes were injured more than non contact sports athletes(p<0.05). 2. 335 athletes(54.8%) had suffered maxillofacial injuries while playing or training. 81.8% of athletes suffered an maxillofacial injury in contact sports(p<0.05). 3. Laceration of oral area, wrick in neck, fracture or avulsion on upper incisors, concussion, TMJ injury, fracture or avulsion on lower incisors, fracture or avulsion on lower molars were frequently injured area. 4. 67.2% of athletes answered that mouthguard could prevent sports injury especially high in contact sports(p<0.05). But only 39.1% of athletes required mouthguard while playing. 44.6% of athletes showed their intention of using mouthguard. Conclusion: This study shows that the incidence of maxillofacial injuries is very high while the actual use of mouthguard is very low. To prevent sports injury, a dentist must inform sports players and coaches of accurate information about mouthguard so that they can use it well. A dentist also has to provide them with better mouthguard on the basis of user's complaint.

OPTIC NERVE INJURY DUE TO FACIAL FRACTURES (안면골 골절로 인한 시신경 손상)

  • Yang, Young-Cheol;Ryu, Soo-Jang;Kim, Jong-Bae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.428-437
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    • 1994
  • Optic nerve injury serious enough to result in blindness had been reported to occur in 3% of facial fractures. When blindness is immediate and complete, the prognosis for even partial recovery is poor. Progressive or incomplete visual loss may be ameliorated either by large dosage of steroid or by emergency optic nerve decompression, depending on the mechanism of injury, the degree of trauma to the optic canal, and the period of time that elapses between injury and medical intervention. We often miss initial assessment of visual function in management of facial fracture patients due to loss of consciousness, periorbital swelling and emergency situations. Delayed treatment of injuried optic nerve cause permanent blindness due to irreversible change of optic nerve. But by treating posttraumatic optic nerve injuries aggressively, usable vision can preserved in a number of patients. The following report concerns three who suffered visual loss due to optic nerve injury with no improvement after steroid therapy and/or optic nerve decompression surgery.

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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
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    • v.45 no.5
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    • pp.233-240
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    • 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 THE EMERGENCY PATIENTS OF ORAL AND MAXILLOFACIAL SURGERY DURING RECENT 5 YEARS (최근 5년간 응급실을 내원한 구강악안면외과 환자에 대한 임상적 연구)

  • Kim, Jong-Ryoul;Chung, In-Kyo;Yang, Dong-Kyu;Park, Bong-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.2
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    • pp.155-162
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    • 2001
  • This is a clinical study on patients who had visitied the Emergency Room of Pusan National University Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 5 years, from 1992 to 1996. The results were as follow ; 1. The total number of patients was 2,680 and the ratio of male to female was 1.96:1, The highest monthly incidence was shown in September(12.1%) and October(10.5%) and the age distribution peaks was the third decade(24.3%), followed by the first(23.1%) and the fourth decade(17.2%). 2. Soft tissue injury group(29.1%) was the most prevalent, followed by tooth injury group(16.1%), facial bone injury group (16.0%), toothache group(11.2%), socket bleeding group(11.1%), infection group(9.8%) and TMJ dislocation group(5.9%). 3. The percentage of in-patients and out-patient were 21.6% and 78.4%, respectively. The frequent causes of admission were facial bone fracture(73.8%), infection(20.8%) and soft tissue injury(4.8%) in order. However, soft tissue injury was the most frequent cause in out-patient, followed by tooth injury(20.5%), toothache(14.3%), socket bleeding(14.2%) and TMJ dislocation(7.6%). 4. In the facial bone injury group, the mandibular fractures(70.6%) showed the highest incidence, followed by zygomatic bone and arch fractures(7.5%), maxillary bone fractures(4.0%) and nasal bone fractures(4.0%). 5. In the mandibular bone fracture, the most common location was symphysis(36.7%), followed by the mandibular angles(33.1%) and the condyles(21.8%). 6. The common causes of facial bone fractures were violence, fall and traffic accident in order. 7. The common causes of soft tissue injury were fall down, fight and traffic accident in order and the highest incidence was observed in infants before the age of 10 years(44.0%). 8. In the group of tooth injury, tooth luxation(38.5%) showed the highest incidence followed by tooth fracture(33.2%) and tooth loss(17.1%). The common causes of tooth injury were fall, fight and traffic accident in order. 9. In infected patients group, the ratio of in-patients to out-patients was 1 : 1.28, Buccal(24,7%) and infraorbital space abscess(23.3%) showed the highest incidence. 10. The pain caused by dental caries(39.0%) and pericoronitis(26.6%) showed high incidence in the toothache group. 11. The high incidence was observed during third(34.0%) and fourth (24.5%) decades in TMJ dislocation group. 12. In the group of socket bleeding patients, 92% was post-operative hemorrhage and 8% was accompanied with other systemic hemorrhagic diseases.

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