• Title/Summary/Keyword: oral and 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.

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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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.

Missing teeth after maxillofacial trauma: a case report and management protocol

  • Ramaraj, P.N.;Mahabaleshwara, C.H.;Rohit, Singh;Abhijith, George;Vijayalakshmi, G.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.6
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    • pp.422-427
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    • 2020
  • Management of maxillofacial trauma includes primary care, in which diagnosis and management of dentoalveolar injury play a vital role. Due to the impact sustained during a maxillofacial injury (whether direct or indirect), dentoalveolar injuries can occur, leading to fracture and displacement of teeth and associated alveolar bone into the surrounding soft tissues and associated structures, such as the maxillary sinus, nasal cavity, upper respiratory tract, tracheobronchial tree, or gastrointestinal tract. Undiagnosed displaced teeth may cause complications such as airway obstruction. This paper reports a case of displaced teeth in the nasal cavity and gastrointestinal tract and highlights the management protocol for displaced teeth secondary to maxillofacial trauma.

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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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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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.

A CLINICAL STUDY ON THE EMERGENCY PATIENTS OF ORAL AND MAXILLOFACIAL SURGERY VISITING SANG-GYE PAIK HOSPITAL EMERGENCY ROOM. (상계백병원 응급실에 내원한 구강악안면외과 응급환자에 대한 임상적 연구)

  • Baik, Jee-Seon;Yoon, Kyu-Ho;Park, Kwan-Soo;Cheong, Jeong-Kwon;Shin, Jae-Myung;Choi, Min-Hye;Kwon, Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.561-566
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    • 2008
  • This is a retrospective clinical study on 2,955 patients who had visited the Emergency Room of Sang-gye Paik Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 4 years from Aug. 2002 to Dec. 2006. The obtained results were as follows. The total number of patients was 2,955 and the ratio of male to female was 1.72:1. The age distribution peak was the 1st decade (30.8%), followed by the 3rd decade (14.3%) and the 4th decade (14.0%). Trauma (62.3%) was the most frequent cause in dental emergency patients, pulpitis (13.0%) and infection patients were next in order of frequency. In trauma patients group, facial bone injury, tooth injury, soft tissue injury were included and soft tissue injury group was most prevalent, followed by tooth injury group and facial bone group. In total patient, the ratio of admission was 3.5%. We obtained the results of the distribution of primary emergency care in the traumatic injury, causal distribution of the jaw fracture, distribution of related medical department in multiple associated injuries, distribution of emergency care in infection, causal distribution and control methods of oral bleeding, distribution of TMJ disorder. The trauma patient group was major in the dental patients who had visited the emergency room, but other various groups were included. So we should analyze the pattern and the variation of the dental emergent patient to provide the proper treatment.

THE CHANGES OF C-REACTIVE PROTEIN IN THE PATIENTS ASSOCIATED WITH MANDIBULAR FRACTURE (하악골 골절 환자에서의 C-Reactive Protein의 변화)

  • Gwak, Jong-Min;Kim, Chul-Hwan;Kim, Kyung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.35-41
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    • 2006
  • It is well known that concentration of C-reactive protein(CRP) in the serum increase as nonspecific reaction of the various tissue injury. The CRP, synthesized in the hepatocyte, is one of 'acute phase proteins' in the serum. The main signal patterns of this protein are regulated by synthesis of interleukin-I secreted from macrophage in the area of tissue injury. Many studies were performed for quantitative analysis for CRP according to various surgical operation, but the study for fracture patients associated with trauma, especially in mandible, are rare. The mandible fracture have intrinsic danger for infection in oral bacteria associated with open wound in oral cavity, and, are difficult for detection of tissue reaction between surgical swelling and infection by facial swelling. In this study, quantitative analysis for CRP associated tissue injury in mandibular fracture and surgical intervention was done, the results were as follows: 1. After initial mandibular trauma, the value of serum CRP diminished sequentially, most high value was presented in post-traumatic 2 days. 2. The CRP was diminished significantly 2 days after surgical intervention, and maintained normal value in 5 days after surgery. 3. The change of CRP are higher value in surgical intervention than initial trauma, it suggested that tissue injury from surgery was severe than trauma. 4. The high value of CRP was obtained in mandibular fracture combined soft tissue injury than no associated soft tissue injury. 5. In measurement of CRP according to surgical approach, highest serum value in patients of combined intra-oral and extra-oral approach was showed, and intra-oral approach, extra-oral approach, in sequential orders. 6. The CRP value are more higher in patient of 2 fracture site than only one fracture site. From the results obtained in this study, CRP has showed different values in mandibular fracture associated with severity of tissue injury and surgical intervention, and quantitative analysis of CRP value in serum can be applied to the clinical management of mandibular fracture.

Etiology and Patterns of Maxillofacial Fractures in 518 patients in Korea

  • Chung, Il-Hyuk;Lee, Eun-Kyung;Yoo, Chung-Kyu;Park, Chang-Joo;Song, Seung-Il;Hwang, Kyung-Gyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.1
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    • pp.83-89
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    • 2008
  • Purpose: Different patterns in the causes of maxillofacial injury are thought to correlate with socioeconomic status and regional environment. This study investigated maxillofacial fractures in order to analyze maxillofacial trauma characteristics and the relationship between the causes and injury patterns in Korea. Material and methods: A total of 518 patients with maxillofacial fractures who were treated at the Seoul National University Boramae Hospital between 1996 and 2004 were retrospectively analyzed. Data were obtained from the patients' medical records and radiographs. The male to female ratio in the patient group was 2.78:1, and the mean age was 32.3 years. Results: Midfacial fractures were the most common location of injury (46.1%). The most common etiologic factor was an activity associated with daily life (42.6%) including falls, stumbling, and collisions. The second most common cause was assault (32.4%), followed by traffic accidents (13.7%). In the case of midfacial fractures and mandibular fractures, assault was the most common etiologic factor, whereas in the case of alveolar bone fractures, activities associated with daily life were the most common cause. With regard to age groups, assault was the most common cause for patients between 10 and 39 years old and an activity associated with daily life was the most common cause in those under 10 years and over 40 years. Conclusions: This study concluded that activities associated with daily life and assault causes a large proportion of Korean maxillofacial injuries and that preventive measures should be implemented in order to minimize these risks.