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Endoscopically Assisted Marginal Mandibulectomy Using an Intraoral Approach Alone for Squamous Cell Carcinoma of the Posterior Mandibular Gingiva: A Technical Note. 内窥镜辅助下颌骨边缘切除术,单独使用口内入路治疗下颌后龈鳞状细胞癌:技术说明。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-06-01 DOI: 10.1177/19433875211015045
Atsushi Shudo

Study design: Technical note.

Objective: Marginal mandibulectomy is a surgical procedure for treatment of mandibular gingival tumors. The intraoral approach to the posterior region of the mandible for marginal mandibulectomy is difficult due to limited access and operating field visibility; the conventional surgical procedure may require some skin incisions. This report discusses the effectiveness of endoscopic assistance in marginal mandibulectomy.

Methods: This article describes endoscopically assisted marginal mandibulectomy using an intraoral approach alone for squamous cell carcinoma of the posterior mandibular gingiva.

Results: The advantages of this surgical method are twofold: (1) superior visibility to the lower edge of the mandible without any skin incision; and (2) safe surgical confirmation of important anatomy on the buccolingual side (e.g., mental foramen, lingual nerve, mandibular foramen, and neurovascular bundle). This minimally invasive approach without any skin incision, as well as the superior visibility of the operating field, are important advantages of endoscopically assisted marginal mandibulectomy that cannot be obtained by other surgical methods.

Conclusions: Endoscopically assisted marginal mandibulectomy using an intraoral approach alone may be useful because it avoids damage to facial skin and improves safety by employing an enlarged bright field.

研究设计:技术说明。目的:下颌边缘切除术是一种治疗下颌牙龈肿瘤的手术方法。下颌骨边缘切除术的口内入路是困难的,由于有限的通道和操作视野的能见度;传统的外科手术可能需要一些皮肤切口。本文讨论内窥镜辅助下颌骨边缘切除术的有效性。方法:这篇文章描述了内窥镜辅助下颌骨边缘切除术使用口腔内入路单独对下颌后龈鳞状细胞癌。结果:该术式具有双重优点:(1)下颌下缘可见性好,无皮肤切口;(2)对颊舌侧重要解剖结构的安全手术确认(如颏孔、舌神经、下颌孔和神经血管束)。这种无任何皮肤切口的微创入路,以及手术视野的优越可见性,是内镜辅助下颌骨缘切除术其他手术方式所无法获得的重要优势。结论:内窥镜辅助下颌骨缘切除术单独使用口内入路可能是有用的,因为它避免了对面部皮肤的损伤,并通过使用扩大的明亮视野提高了安全性。
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引用次数: 1
Children in Boxing and Martial Arts Should Be Better Guarded From Facial Injuries. 练习拳击和武术的孩子应该更好地保护面部免受伤害。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-06-01 DOI: 10.1177/19433875211016666
Rachael J Gotlieb, Thomas J Sorenson, Vedant Borad, Warren Schubert

Study design: Cross-sectional study.

Objective: Childhood participation in boxing and martial arts has increased over the past decade, and these activities are well-known causes of traumatic injury. We hypothesized that the face is frequently injured in the setting of pediatric boxing and martial arts trauma in the United States and that there are identifiable injury patterns.

Methods: We performed a cross-sectional study of consecutive pediatric patients in the National Electronic Injury Surveillance System (NEISS) from January 1, 2010 to December 31, 2019. Patients were included in our study if they were younger than 18 years of age and evaluated in the emergency department (ED) after boxing or martial arts trauma. Primary outcome was facial injury. Other variables of interest include age, sex, ED disposition, type and location of injury. Descriptive and univariate statistics of the primary outcome were computed with these variables.

Results: There were 4,978 total pediatric patients injured due to boxing and martial arts trauma reported by NEISS-participating EDs during the study period, and 264 patients experienced injury to the face (264/4978; 5.3%). Over 20% (n = 60) of reported facial injuries were fractures; the most fractured structure was the nose (42/60; 70), orbit (11/60; 18.3%), and mandible (6/60; 10%). Almost 20% (11/60%) of pediatric facial fractures due to boxing and martial arts trauma involved fighting a family member or friend, and a punch was the most common mode of fracture (42/58; 72.4%).

Conclusions: Facial injuries comprise about 5% of injuries after boxing and martial arts trauma and 22% of these facial injuries are fractures. If children choose to participate, parents, coaches, trainers, officials, and community leaders should make the greatest effort possible to minimize risk, including the mandatory use of head and face protective gear and elimination of training fighting, or "sparring."

研究设计:横断面研究。目的:在过去的十年中,儿童参与拳击和武术的人数有所增加,这些活动是众所周知的创伤性损伤的原因。我们假设在美国儿童拳击和武术创伤中,脸部经常受伤,并且有可识别的损伤模式。方法:我们对2010年1月1日至2019年12月31日在国家电子伤害监测系统(NEISS)中连续出现的儿科患者进行了横断面研究。如果患者年龄小于18岁,并在拳击或武术创伤后在急诊科(ED)进行评估,则纳入我们的研究。主要结局为面部损伤。其他感兴趣的变量包括年龄、性别、ED倾向、损伤类型和位置。用这些变量计算主要结局的描述性和单变量统计。结果:研究期间,参与neiss的急诊科共报告4,978例儿童因拳击和武术创伤而受伤,其中面部损伤264例(264/4978;5.3%)。超过20% (n = 60)的报告面部损伤为骨折;骨折最多的是鼻部(42/60;70),轨道(11/60;18.3%),下颌骨(6/60;10%)。近20%(11/60%)因拳击和武术创伤导致的儿童面部骨折涉及与家人或朋友打架,拳击是最常见的骨折方式(42/58;72.4%)。结论:面部损伤约占拳击和武术创伤后损伤的5%,其中22%为骨折。如果孩子选择参加,父母、教练、训练员、官员和社区领导人应该尽最大努力将风险降到最低,包括强制使用头部和面部防护装备,取消训练格斗或“陪练”。
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引用次数: 2
Incidence, Aetiology, and Associated Fracture Patterns of Infraorbital Nerve Injuries Following Zygomaticomaxillary Complex Fractures: A Retrospective Analysis of 272 Patients. 颧腋复合体骨折后眶下神经损伤的发生率、病因及相关骨折类型:272例回顾性分析。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-06-01 DOI: 10.1177/19433875211022569
Kathia Dubron, Maarten Verbist, Eman Shaheen, Titiaan Jacob Dormaar, Reinhilde Jacobs, Constantinus Politis

Study design: Retrospective study.

Objective: Zygomaticomaxillary complex (ZMC) fractures are common facial injuries with heterogeneity regarding aetiologies, fracture types, infraorbital nerve (ION) involvement, and treatment methods. The aim of this study was to identify associations between aetiologies, fracture types, and neurological complications. Additionally, treatment methods and recovery time were investigated.

Methods: Medical files of 272 patients with unilateral and bilateral ZMC fractures were reviewed, whose cases were managed from January 2014 to January 2019 at the Department of Oral and Maxillofacial Surgery, University hospitals Leuven, Belgium. History of ION sensory dysfunction and facial nerve motoric dysfunction were noted during follow-up.

Results: ION hypoaesthesia incidence was 37.3%, with the main causes being fall accidents, road traffic accidents, and interpersonal violence. Significant predictors of ION hypoaesthesia were Zingg type B fractures (P = 0.003), fracture line course through the infraorbital canal (P < .001), orbital floor fracture (P < 0.001), and ZMC dislocation or mobility (P = 0.001).

Conclusion: Of all ZMC fractures, 37.3% exhibited ION hypoaesthesia. Only ZMC Zingg type B fractures (74.0%) were significantly more associated with ION hypoaesthesia. ION hypoesthesia was more likely (OR = 2.707) when the fracture line course ran through the infraorbital canal, and was less dependent on the degree of displacement. Neuropathic pain symptoms developed after ZMC fractures in 2.2% patients, posing a treatment challenge. Neuropathic pain symptoms were slightly more common among women, and were associated only with type B or C fractures. No other parameters were found to predict the outcome of this post-traumatic neuropathic pain condition.

研究设计:回顾性研究。目的:颧腋复合体骨折是一种常见的面部损伤,在病因、骨折类型、眶下神经(ION)受累和治疗方法等方面存在异质性。本研究的目的是确定病因、骨折类型和神经系统并发症之间的关系。并对治疗方法和恢复时间进行了探讨。方法:回顾性分析2014年1月至2019年1月比利时鲁汶大学医院口腔颌面外科收治的272例单侧和双侧ZMC骨折患者的医疗资料。随访时记录离子感觉功能障碍和面神经运动功能障碍病史。结果:离子麻醉发生率为37.3%,主要原因为跌倒事故、道路交通事故和人际暴力。Zingg B型骨折(P = 0.003)、骨折线经眶下管(P < 0.001)、眶底骨折(P < 0.001)和ZMC脱位或活动(P = 0.001)是离子麻醉不良的显著预测因素。结论:在所有ZMC骨折中,37.3%表现为离子麻醉减退。只有zmczingg型B骨折(74.0%)明显与离子麻醉减退相关。当骨折线经过眶下管时,离子感觉减退的可能性更大(OR = 2.707),对移位程度的依赖性较小。2.2%的患者在ZMC骨折后出现神经性疼痛症状,这给治疗带来了挑战。神经性疼痛症状在女性中更为常见,且仅与B型或C型骨折相关。没有发现其他参数来预测这种创伤后神经性疼痛状况的结果。
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引用次数: 7
Facial Fractures Have Similar Outcomes When Managed by Either Otolaryngology or Plastic Surgery: Encounters From a Single Level I Trauma Center. 无论是耳鼻喉科还是整形外科,面部骨折都有相似的结果:来自单一一级创伤中心的遭遇。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-06-01 DOI: 10.1177/19433875211020615
Ashton Christian, Beatrice J Sun, Nima Khoshab, Areg Grigorian, Christina Y Cantwell, Sean A Melucci, Allison C Hu, Catherine M Kuza, Michael E Lekawa, Jeffry Nahmias

Study design: Retrospective cohort.

Objective: Traumatic facial fractures (FFs) often require specialty consultation with Plastic Surgery (PS) or Otolaryngology (ENT); however, referral patterns are often non-standardized and institution specific. Therefore, we sought to compare management patterns and outcomes between PS and ENT, hypothesizing no difference in operative rates, complications, or mortality.

Methods: We performed a retrospective analysis of patients with FFs at a single Level I trauma center from 2014 to 2017. Patients were compared by consulting service: PS vs. ENT. Chi-square and Mann-Whitney-U tests were performed.

Results: Of the 755 patients with FFs, 378 were consulted by PS and 377 by ENT. There was no difference in demographic data (P > 0.05). Patients managed by ENT received a longer mean course of antibiotics (9.4 vs 7.0 days, P = 0.008) and had a lower rate of open reduction internal fixation (ORIF) (9.8% vs. 15.3%, P = 0.017), compared to PS patients. No difference was observed in overall operative rate (15.1% vs. 19.8%), use of computed tomography (CT) imaging (99% vs. 99%), time to surgery (65 vs. 55 hours, P = 0.198), length of stay (LOS) (4 vs. 4 days), 30-day complication rate (10.6% vs. 7.1%), or mortality (4.5% vs. 2.6%) (all P > 0.05).

Conclusion: Our study demonstrated similar baseline characteristics, operative rates, complications, and mortality between FFs patients who had consultation by ENT and PS. This supports the practice of allowing both ENT and PS to care for trauma FFs patients, as there appears to be similar standardized care and outcomes. Future studies are needed to evaluate the generalizability of our findings.

研究设计:回顾性队列。目的:外伤性面部骨折(FFs)通常需要整形外科(PS)或耳鼻喉科(ENT)的专科会诊;然而,转诊模式往往是非标准化的,而且是针对特定机构的。因此,我们试图比较PS和耳鼻喉科的治疗模式和结果,假设在手术率、并发症或死亡率方面没有差异。方法:回顾性分析2014年至2017年在某一级创伤中心收治的ff患者。患者通过咨询服务进行比较:PS和耳鼻喉科。进行卡方检验和Mann-Whitney-U检验。结果:755例ff患者中,378例就诊于PS, 377例就诊于ENT。人口学数据差异无统计学意义(P > 0.05)。与PS患者相比,耳鼻喉科患者的平均抗生素疗程更长(9.4天vs 7.0天,P = 0.008),切开复位内固定(ORIF)率更低(9.8% vs 15.3%, P = 0.017)。总手术率(15.1% vs. 19.8%)、计算机断层扫描(CT)成像的使用(99% vs. 99%)、手术时间(65 vs. 55小时,P = 0.198)、住院时间(4 vs. 4天)、30天并发症发生率(10.6% vs. 7.1%)或死亡率(4.5% vs. 2.6%)均无差异(P > 0.05)。结论:我们的研究表明,耳鼻喉科和PS会诊的FFs患者的基线特征、手术率、并发症和死亡率相似。这支持了允许耳鼻喉科和PS同时治疗创伤FFs患者的做法,因为似乎有相似的标准化护理和结果。未来的研究需要评估我们的发现的普遍性。
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引用次数: 0
Implications of War and Healthcare. 战争和医疗保健的影响。
IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-06-01 Epub Date: 2022-05-12 DOI: 10.1177/19433875221096728
Rui Fernandes, Seenu Susarla, Sat Parmar
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引用次数: 0
An Alternative Approach Using Circummandibular Wiring for Treatment of Dentoalveolar Fractures in Children: A Case Report. 一种采用下颌周钢丝治疗儿童牙槽骨骨折的替代方法:1例报告。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-06-01 DOI: 10.1177/1943387521990283
José Henrique Santana Quinto, Andressa Bolognesi Bachesk, Lucas Costa Nogueira, Liogi Iwaki Filho
The prevalence of dentoalveolar injuries in children is approximately 25%, with falls from own height being one of the main etiologies. Diagnosis is based on the clinical evaluation associated with complementary imaging tests. The treatment of choice depends on the type of damage and structure affected. For alveolar process fractures, closed reduction and semi-rigid dental splinting for 4 to 6 weeks is generally satisfactory. However, some cases, such as severe segmental fractures, require open treatment to ensure adequate reduction and stabilization of the displaced alveolar segment, which is usually achieved by titanium miniplates and screws. Nevertheless, there are situations where this type of fixation is not possible, requiring alternative methods. Therefore, this article describes a surgical technique performed by open reduction, associating semi-rigid dental splint and circummandibular wiring in pediatric patient diagnosed with dentoalveolar fracture through clinical examination (with bone fracture displacement) and tomography. The technique promoted a good prognostic to the patient, proving to be a viable alternative for treating dentoalveolar fractures.
儿童牙槽损伤的患病率约为25%,从自身高度跌落是主要病因之一。诊断是基于临床评估和辅助影像学检查。处理的选择取决于损伤的类型和受影响的结构。对于牙槽突骨折,闭合复位和半刚性牙夹板治疗4 - 6周通常是满意的。然而,一些病例,如严重的节段性骨折,需要开放治疗,以确保移位的牙槽节段充分复位和稳定,这通常是通过微型钛板和螺钉实现的。然而,在某些情况下,这种固定是不可能的,需要其他方法。因此,本文描述了通过临床检查(骨折移位)和断层扫描诊断为牙槽骨骨折的儿童患者,采用开放复位,结合半刚性牙夹板和下颌周钢丝的手术技术。该技术促进了患者良好的预后,证明是治疗牙槽骨骨折的可行选择。
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引用次数: 0
The Liability of Performing Orthognathic Surgery. 执行正颌手术的责任。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-06-01 DOI: 10.1177/19433875211022530
Steven Halepas, Brendan Bryck, Kevin C Lee, Alia Koch

Study design: This is a retrospective case series using the Thomson Reuters Westlaw Edge database, an online subscription-based database of over 40,000 state and federal records.

Objective: There is growing academic interest in the medical malpractice literature. The primary objective of this study was to examine medical malpractice in orthognathic procedures in order to characterize factors that determine legal responsibility and help make the craniomaxillofacial (CMF) surgeon more comfortable when treating this patient population.

Methods: The database was queried for medical malpractice cases involving orthognathic surgery from 1985-2021. The characteristics of each lawsuit were identified, and descriptive statistics were reported.

Results: A total of 42 CMF malpractice cases were available for review, and total of 15 cases were included in the final sample. Verdict decisions and settlements occurred between 1991 and 2012. Of the 15 cases, the highest concentration of cases occurred in California (6) and Pennsylvania (2). 53% of cases were ruled in favor of the defendant, 7% of cases were settled, 27% of cases were ruled in favor of the plaintiff against the surgeon, and 13% were ruled in favor of the plaintiff against the hospital with the surgeon being found not liable. The minimum award of damages was $29,999 and the maximum was $550,000.

Conclusion: Litigation experience can be very time consuming and troublesome for medical practitioners. The risk of litigation and complications might be a prohibiting factor as to why CMF surgeons may not be preforming orthognathic surgery. The best defense against a malpractice case is to avoid one altogether. Learning from past mistakes is one way of ensuring that goal.

研究设计:这是一个使用汤森路透Westlaw Edge数据库的回顾性案例系列,该数据库是一个基于在线订阅的数据库,包含超过40,000个州和联邦记录。目的:学术界对医疗事故文献的兴趣日益浓厚。本研究的主要目的是检查正颌手术中的医疗事故,以确定确定法律责任的因素,并帮助颅颌面(CMF)外科医生在治疗这类患者时更舒适。方法:查询数据库1985-2021年涉及正颌手术的医疗事故案例。确定每个诉讼的特征,并报告描述性统计数据。结果:共收集到42例CMF医疗事故病例,最终纳入样本15例。判决和和解发生在1991年至2012年之间。在这15起案件中,最集中的案件发生在加利福尼亚州(6起)和宾夕法尼亚州(2起)。53%的案件被裁定有利于被告,7%的案件被和解,27%的案件被裁定有利于原告对外科医生不利,13%的案件被裁定有利于原告对医院不利,外科医生被判不负责任。最低赔偿金额为29,999元,最高赔偿金额为550,000元。结论:诉讼经验对医疗从业者来说是非常耗时和麻烦的。诉讼和并发症的风险可能是CMF外科医生不进行正颌手术的一个禁止因素。应对医疗事故的最好办法就是完全避免。从过去的错误中吸取教训是确保实现这一目标的一种方法。
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引用次数: 0
Slippery Slopes: Skiing-Related Facial Trauma in Adults. 滑坡:成人滑雪相关的面部创伤。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-06-01 DOI: 10.1177/19433875211020933
Alissa C Galgano, Jason E Cohn, Jordan J Licata, Sammy Othman, Fred J Stucker, Paige Bundrick

Study design: Retrospective, observational, cross-sectional study.

Objective: To determine the incidence of skiing-related facial trauma and to identify their patterns in terms of potential risk factors, mechanism of injury, anatomical location, and degree of severity.

Methods: Data was collected using the National Electronic Injury Surveillance System and included snow skiing-related incidents during the years 2009 to 2018. Specifically, injuries limited to the facial region including the head, face, eye(s), mouth, neck or ear(s) were reported. Patients with fractures were further classified by the study variables. Descriptive statistics were used to classify continuous variables while chi-square analysis was used to compare categorical variables.

Results: A total of 514 (n = 514) patients met the inclusion criteria within the study period. The majority of injuries were due to concussions (59%), followed by lacerations (18%), fractures (11%), contusions (11%) and dental injuries (1%). Of the fractures seen, the majority were nasal (30%) and cervical spine (30%), followed by midface (27%), mandible (9%) and skull (4%). In our population, head injuries were more common in females (80%) than in males (60%), whereas, mouth injuries were more common in males (8%) than females (1%) [χ2 = 30.2, p < 0.001].

Conclusions: Skiing-related craniofacial trauma remains a significant mechanism of injury. Our data illustrates a need to correlate these injuries to the use of personal protective equipment. Furthermore, this data calls for the strict implementation of such equipment and the development of safety protocols to further prevent deleterious injury.

研究设计:回顾性、观察性、横断面研究。目的:确定滑雪相关面部创伤的发生率,并从潜在危险因素、损伤机制、解剖位置和严重程度等方面确定其模式。方法:使用国家电子伤害监测系统收集数据,包括2009年至2018年期间与滑雪相关的事件。具体来说,损伤仅限于面部区域,包括头、脸、眼、口、颈或耳。根据研究变量进一步对骨折患者进行分类。用描述性统计对连续变量进行分类,用卡方分析对分类变量进行比较。结果:研究期间共有514例(n = 514)例患者符合纳入标准。大多数损伤是由于脑震荡(59%),其次是撕裂伤(18%),骨折(11%),挫伤(11%)和牙齿损伤(1%)。所见骨折中,以鼻骨折(30%)和颈椎骨折(30%)居多,其次是中脸骨折(27%)、下颌骨骨折(9%)和颅骨骨折(4%)。在我们的人群中,女性(80%)比男性(60%)更常见头部损伤,而男性(8%)比女性(1%)更常见口腔损伤[χ2 = 30.2, p < 0.001]。结论:与滑雪相关的颅面创伤仍然是一个重要的损伤机制。我们的数据表明,需要将这些伤害与个人防护装备的使用联系起来。此外,这些数据要求严格执行此类设备并制定安全协议,以进一步防止有害伤害。
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引用次数: 1
Epistaxis After Orthognathic Surgery: Literature Review and Three Case Studies. 正颌手术后鼻出血:文献回顾及三个个案研究。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-06-01 DOI: 10.1177/19433875211008086
Alisa Girard, Christopher D Lopez, Jonlin Chen, David Perrault, Nikhil Desai, Karl C Bruckman, Scott P Bartlett, Robin Yang

Study design: This is a literature review with 3 case studies.

Objective: Intraoperative and postoperative bleeding are the most common complications of orthognathic surgery and have the potential to become life-threatening. The rarity of severe postoperative epistaxis has resulted in limited characterization of these cases in the literature. The purpose of this study is to 1) differentiate various presentations of epistaxis following orthognathic surgery in the literature, 2) identify management approaches, and 3) to synthesize a treatment algorithm to guide future management of postoperative epistaxis.

Methods: A literature search of PubMed was conducted and 28 cases from 17 studies were assessed.

Results: Bleeding within the first week may indicate isolated epistaxis, often resolved with local tamponade. Half of cases were attributed to pseudoaneurysm rupture (n = 14), with epistaxis onset ranging from postoperative day 6 to week 9. Angiography was used in most cases (n = 17), often as the primary imaging modality (n = 11). Nasal endoscopy is a less invasive and effective alternative to angiography with embolization. Proximal vessel ligation was used in 3 cases but is not preferred because collaterals may reconstitute flow through the defect and cause rebleeding. Repeat maxillary down-fracture with surgical exploration was described in 4 cases.

Conclusions: As outlined in our management algorithm, nasal packing and tamponade should be followed by either local electrocautery or vascular imaging. Angiography with embolization is the preferred approach to diagnosis and management, whereas surgical intervention is reserved for cases of embolization failure or unavailability.

研究设计:这是一篇包含3个案例研究的文献综述。目的:术中和术后出血是正颌手术最常见的并发症,并有可能危及生命。严重术后鼻出血的罕见性导致文献中对这些病例的描述有限。本研究的目的是1)区分文献中正颌手术后鼻出血的各种表现,2)确定治疗方法,3)综合治疗算法以指导术后鼻出血的未来治疗。方法:检索PubMed文献,对17项研究的28例病例进行评价。结果:第一周内出血可能提示孤立性鼻出血,通常通过局部填塞解决。一半的病例归因于假性动脉瘤破裂(n = 14),鼻出血发作时间从术后第6天到第9周。大多数病例(n = 17)采用血管造影,通常作为主要成像方式(n = 11)。鼻内窥镜是一种微创和有效的替代血管造影与栓塞。3例采用近端血管结扎术,但不推荐使用,因为侧枝可能会重建血流并导致再出血。本文报道4例上颌重复下骨折伴手术探查。结论:根据我们的处理算法,鼻填塞和填塞后应进行局部电灼或血管成像。血管造影和栓塞是首选的诊断和治疗方法,而手术干预是保留在栓塞失败或无法获得的情况下。
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引用次数: 1
Mind the Gap: Covid-19 and Its Differential Effect on the Richer and Poorer Nations. 关注差距:Covid-19及其对富国和穷国的不同影响。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-03-01 DOI: 10.1177/19433875211067573
Rui Fernandes, Sat Parmar, Seenu Susarla
The gap in wealth between the richer and poorer nations was increasing prior to the Covid pandemic despite some of the extreme poverty rates declining. Evenwithin richer countries the gap between the rich and poor had been increasing. In the US, for example, over 2 million more households claim that they do not have enough to eat since the pandemic. In fact, one in five African American households says they are going hungry. The Covid-19 pandemic has hit hardest the poor countries and the poorer populations groups in richer countries. A BBC survey suggested a drop in income was reported by 69% of respondents in poorer countries, in comparison to 45% in richer ones. This is exacerbated by the potential for slower recovery in these countries often with poor access to vaccines. Vital income in many of these poorer countries has also been affected by the lack of tourism. Disruption of trade also affects the poorer countries the most. The Covid-19 pandemic has also highlighted the gaps in healthcare between the richer and poorer countries. Inequalities in health care can lead to differences in morbidity and mortality between the rich and poor. Richer countries have a moral obligation to support health care in the poor and this extends beyond universal vaccination against Covid-19. Strong healthcare systems are essential for a stable society and despite the economic crisis, investment in healthcare with improvement in sanitation and access to clean drinking water should be seen as paramount. As further waves of the pandemic strike Europe, the impact on the health of the poor in both rich and poor countries should be borne in mind.
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引用次数: 0
期刊
Craniomaxillofacial Trauma & Reconstruction
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