• Title/Summary/Keyword: Multiple facial fracture

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Analysis of Pharmacopuncture Used in Facial Nerve Palsy Articles that Published in the Journal of Korean Medicine (한의학 학술지에 게재된 안면신경마비 증례 연구에서 사용된 약침에 관한 고찰)

  • Yoo, Hee-Jo;Kim, Gyung-Jun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.3
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    • pp.105-115
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    • 2019
  • Objectives : The purpose of this study is to analyze the trends of phamacopuncture used in facial nerve palsy related articles that have been published in the Korean medicine journal. Methods : 242 papers related to facial nerve palsy were retrieved from Oriental Medicine Advanced Searching Integrated System(OASIS) and Korean Traditional Knowledge Portal(KTKP). We selected 13 research papers treated with pharmacopuncture for facial nerve palsy. We analyzed for type of pharmacopuncture used, treatment point and clinical type. Results : 1. The number of searched articles is thirteen. 2. The most common clinical type of facial nerve palsy is Bell's palsy. Other types are accompanying tympanitis type, herpes zoster oticus, caused by traumatic temporal bone fracture type, Foville syndrome, Foville-Millard-Gubler syndrome and multiple cerebral neuritis. 3. In the case of pharmacopuncture, the most frequently used type is Hominis Placenta Pharmacopunture. The second is Hwangreonhaedok-tang and Hwangreon Pharmacopuncture. Other than that BV, Sinbaro, Jungsongouhyul Pharmacopuncture, Cornu Cervi Pantotrichum Pharmacopuncture and Ginseng pharmacopuncture are used. 4. The most frequently used part as a treatment point is ST4, ST6, TE17.

Frey Syndrome after Retromandibular Approach for Condyle Fracture Reduction (하악과두골절 수술 후 발생한 Frey Syndrome)

  • Lee, Jae-Min;Ki, Eun-Jung;Cheon, Hae-Myung;Choi, Moon-Gi
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.6
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    • pp.376-380
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    • 2013
  • Frey syndrome is a disease characterized by abnormal sweating, facial redness, and rare pain by stimulation of taste sense on the limited area dominated by the auriculotemporal nerve and great auricular nerve. Although the developmental mechanism and histopathologic cause of Frey syndrome are still being debated, the most reliable theory is based on injury of the parathympathetic nerve connected to the auriculotemporal nerve continuing to abnormal regeneration. The other theory is that the sweat glands develop an increased sensitivity after degeneration of sympathetic fibers. Therapy of Frey syndrome includes drugs, radiographic treatment, and surgical treatment; however, in most cases, treatment is not satisfactory. This is a case report on a 24-year-old male patient with Frey syndrome caused by the fracture reduction with retromandibular approach after multiple facial traumas and spontaneous healing without any special treatment.

DELAYED VISUAL LOSS BY INDIRECT TRAUMATIC OPTIC NEUROPATHY RELATED TO PANFACIAL FRACTURE: A CASE REPORT (범안면 골절과 연관된 간접적 외상성 시신경 병증에 의한 시력상실 증례)

  • Lee, Jong-Bok;Lee, Dae-Jeong;Choi, Moon-Ki;Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.1
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    • pp.81-85
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    • 2009
  • As panfacial fractures are involved multiple fracture, there are possibility of many pre-operative & postoperative complications. It is necessary to do exact pre-operative evaluation, appropriate operation and care, for preventing and treating these complications, especially related to optic nerve injury. The complication occurs rarely after periorbital facial bone fracture, and indirect injuries may occur as a result of impact shearing force transmitted into the optic nerve axons or to the nutrient vessels of the optic nerve. Also indirect injuries may occur after the force of impact because of vasospasm and swelling of the optic nerve within the confines of the nonexpansile optic canal. It is necessary to active evaluation and treatments involving decompression of the orbit surgically and high dose steroid therapy in relation to panfacial fracture. But sometimes this treatments are limited due to severe swelling of the face and related multiple bone fractures in the body. This case showed the delayed neuropathy, at last visual loss, in spite of megadose methylprednisolone administration. The purpose of this article is to present indirect traumatic optic neuropathy that is one of many complications in panfacial bone fracture.

Usefulness of indirect open reduction via a transconjunctival approach for the treatment of nasal bone fracture associated with orbital blowout fracture

  • Kim, Tae Ho;Kang, Seok Joo;Jeon, Seong Pin;Yun, Ji Young;Sun, Hook
    • Archives of Craniofacial Surgery
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    • v.19 no.2
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    • pp.102-107
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    • 2018
  • Background: Nasal fracture and orbital blowout fracture often occur concurrently in cases of midface blunt trauma. Generally, these multiple fractures treatment is surgery, and typically, the nasal bone and orbit are operated on separately. However, we have found that utilizing a transconjunctival approach in patients with concurrent nasal bone fracture and orbital blowout fracture is a useful method. Methods: The participants in the present study included 33 patients who visited the Plastic Surgery outpatient department between March 2014 and March 2017 and underwent surgery for nasal fracture and orbital blowout fracture. We assessed patients' and doctors' satisfaction with surgical outcomes after indirect open reduction via a transconjunctival approach for the treatment of nasal bone fracture with associated orbital blowout fracture. Results: According to the satisfaction scores, both patients and doctors were satisfied with transconjunctival approach. Conclusion: We presented here that our method enables simultaneous operation of nasal fracture accompanied by orbital blowout fracture, rather than treating the two fractures separately, and it allows precise reduction of the nasal fracture by direct visualization of the fracture site without any additional incisions or difficult surgical techniques. Also, by preventing the use of excessive force during reduction, this method can minimize damage to the nasal mucosa, thereby reducing the incidence of nasal bleeding.

Reduction of comminuted fractures of the anterior wall of the frontal sinus using threaded Kirschner wires and a small eyebrow incision

  • Lee, Da Woon;Kwak, Si Hyun;Choi, Hwan Jun;Kim, Jun Hyuk
    • Archives of Craniofacial Surgery
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    • v.23 no.5
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    • pp.220-227
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    • 2022
  • Background: Frontal sinus fractures are relatively rare. Their surgical management significantly differs depending on whether the posterior wall is invaded and the clinical features vary. A bicoronal incision or endoscopic approach can be used. However, the minimally invasive approach has been attracting attention, leading us to introduce a simple and effective surgical method using multiple-threaded Kirschner wires. Methods: All patients had isolated anterior wall fractures without nasofrontal duct impairment. The depth from the skin to the posterior wall was measured using computed tomography to prevent injury. The edge of the bone segment on the skin was marked, a threaded Kirschner wire was inserted into the center of the bone segment, and multiple Kirschner wires were gently reduced simultaneously. Results: Surgery was performed on 11 patients. Among them, seven patients required additional support for appropriate fracture reduction. Therefore, a periosteal elevator was used as an adjunct through a small sub-brow incision because the reduction was incomplete with the Kirschner wire alone. The reduction results were confirmed using facial bone computed tomography 1 to 3 days postoperatively. The follow-up period was 3 to 12 months. Conclusion: The patients had no complications and were satisfied with the surgical results. Here we demonstrated an easy and successful procedure to reduce a pure anterior wall frontal sinus fracture via non-invasive threaded Kirschner wire reduction.

A Case of Extensive Polyostotic Fibrous Dysplasia (광범위하게 진행된 다발성 섬유성이형성증)

  • Lee Byeong-Do;Hwang Eui-Hwan;Lee Sang-Rae
    • Imaging Science in Dentistry
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    • v.30 no.2
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    • pp.117-122
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    • 2000
  • Fibrous dysplasia is a benign disorder of bone consisting of intramedullary proliferation of fibrous tissue and irregularly distributed, poorly developed bone. The disease manifests itself in the monostotic form in which only one bone is involved and the polyostotic form in which multiple bones at different sites are affected. We reported a extensive case of polyostotic fibrous dysplasia with involvement of craniofacial bones, mandible, ribs and extremities. A 18-year-old man showed remarkable right facial swelling who had been treated on right femur 3 years ago with a bone graft for pathologic fracture and he recognized facial swelling 5 years ago. Extraoral radiograms and computed tomogram showed diffuse sclerosis with a ground glass appearance of the most cranial bones, facial bones. The right mandibular lesion showed very expansile lesion with mottled appearance. Bone scans showed mutifocal increased uptakes in craniofacial bones, right mandible, bilaterally in ribs, humerus, femur, tibia and characteristic varus deformity of right femur (shepherd's crook defomity). This case showed exceptionally bilateral, extensive nature of bone lesion and didn't show any features of skin pigmentation and endocrine disturbances.

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Classification of the Lateral Orbital Wall Fracture and Its Clinical Significance (안와 외벽 골절의 분류와 임상적 의의)

  • Cho, Pil Dong;Kim, Hyung Suk;Shin, Keuk Shun
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.553-559
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    • 2008
  • Purpose: The lateral orbital wall fractures have been previously classified by some authors. As there are some limitations in applying in their own classifications, we hope to present a refined classification system of the lateral orbital wall fracture and to identify the correlation between the specific type of the fracture and clinical diagnosis. Methods: The facial bone CT scans and medical records of 78 patients with the lateral orbital wall fractures were reviewed in a retrospective manner. The classification is based on the CT scan. In type I, the fracture and its segments are away from the lateral rectus muscle and in type II, they are next to or slightly pushing the muscle in axial CT scan. In type III, the fracture segments compress and displace the longitudinal axis of the muscle or the optic nerve in axial view of CT scan. Type IV fracture includes multiple fractures found around the orbital apex or optic canal in coronal view of CT scans of the type I and type II fractures. Results: The most common fracture pattern was type I(43.6%), followed by type IV(29.5%), type II(20.5%), and type III(6.4%). As diplopia and restriction of extraocular muscles were found in type I and II fractures, severe ophthalmic complications such as superior orbital fissure syndrome, orbital apex syndrome, and traumatic optic neuropathy were found in type III and IV fractures almost exclusively. Conclusion: We propose an easy classification system of the lateral orbital wall fracture which correlates closely with ophthalmic complications and may help to make further treatment plan. In Type III and IV fractures, severe ophthalmic complications may ensue in higher rates, so early diagnosis and treatment should be performed.

ORAL HEMORRHAGE CONTROL AS TREATMENT PRIORITY IN A MENTALLY RETARDED PATIENT WITH MULTIPLE TRAUMA (다발성 손상을 가진 정신지체 환자에서 치료 우선순위로 구강출혈의 조절)

  • Oh, Ji-Hyeon;Kim, Ji-Hun;Yoo, Jae-Ha
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.20-26
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    • 2016
  • Sympathetic reaction to grotesque facial injuries with oral bleeding can trigger confusion and generate inefficiency among emergency room personnel. Regardless of the extent of the injury, or of the sympathy elicated, the victim must be evaluated and treated as a whole patient with multiple trauma. There must be no confusion as to order of importance in the steps of evaluation : 1. airway 2. hemorrhage 3. shock 4. associated injuries 5. local injury 6. triage of facial injuries. The most dangerous aspect of oral hemorrhage is the possibility of its obstructing the upper airway. Swallowing large amounts of blood will usually cause gastric irritation and lead to vomiting, thus further complicating the management of the patient. Once a clear airway is assured and hemorrhage have been controlled, consideration is given to possible associated injuries before undertaking treatment of the facial injuries themselves. Status of the cardiopulmonary, gastrointestinal and neuromuscular systems all have a bearing on decisions concerning facial injury treatment. In this light, treatment priority becomes exceeding important. On the other hand, the importance of facial injuries should never be minimized, especially in a mentally retarded patient with oral hemorrhage. This is a case report about oral hemorrhage control as treatment priority in a mentally retarded patient.

Postoperative malocclusion after maxillofacial fracture management: a retrospective case study

  • Kim, Sang-Yun;Choi, Yong-Hoon;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.27.1-27.8
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    • 2018
  • Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.

Clinical Evaluation of Mandibular Condyle Fractures (하악 과두 골절 환자의 임상분석)

  • Lim, Hyoung-Sup;Kim, Su-Gwan;Oh, Ji-Su;Jeong, Mi-Ae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.1
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    • pp.53-57
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    • 2012
  • Purpose: This study considered the effects and proper treatments of mandibular condyle fractures by comparing clinical differences and complications according to analysis and treatment plan. Methods: From September 2007 to August 2010, patients who were diagnosed with condylar fracture and monitored for more than 3 months were selected. Cases were divided in a reductive manner and evaluated by type and period of intermaxillary fixation (IMF), status of occlusion and trismus according to the Spiessle/Schroll method. A total 50 patients were examined. Results: The number of the unilateral condyle fractures was 45 and 30 patients had multiple fractures. Type of fracture was categorized by the Spiessle/Schroll method. There were 21 patients with type I, 11 patients with type II, 3 patients with type 3, 10 patients with type V and 5 patients with type VI; there were no patients with a type IV fracture. 11 patients were operated on with open reduction. Among them, 9 patients were type II and 2 patients were type I. For type I patients, an intra-oral approach was conducted with an endoscope and trocar. For 3 of the type II patients, an retromandibular approach was conducted and for the rest of the type II patients, the same approach as type I was used. The periods of IMF were 2.36 weeks (mean) in open reduction group and 2.9 weeks (mean) in closed reduction group and the total mean period is 2.78 weeks. All patients had stable occlusion after removing the IMF. Trismus occurred in 1 patient for open reduction and 5 patients for closed reduction. Facial nerve palsy was observed in one patient postoperatively that resolved after 6 months. Conclusion: In this study, similar prognosis was shown after an open and closed reduction was conducted. Therefore, treatments need to be planned depending on the degree of condyle fracture and the amount of displacement. Additionally, the period of IMF could be shortened with open reduction.