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Unlocking the Potential of Submental Intubation - Redefining Airway Management in Craniomaxillofacial Trauma Patients. 释放颏下插管的潜能--重新定义颅颌面创伤患者的气道管理。
IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-27 DOI: 10.1177/19433875241278797
Amit Dharamvir Mahajan, Sharvari Prakash Daithankar, Pratesh Nitin Dholabhai, Aniruddh Pratap Singh, Aditya Rajesh Shah, Nirvani Pinkesh Shah

Study design: Submental intubation is and underutilized alternative to traditional techniques of intubation. Complications associated can indeed deter surgeons and anesthesiologist from performing it. Surgeons may opt for submental intubation if they believe that its advantages outweigh the potential risks of the procedure. Identifying the reasons of complications and implementing of proper strategies to address them can help mitigate risks.

Objective: This study aims to compare and analyze the complications experienced during and after submental intubation to comment on its safety, efficacy. Revisiting literature, will help us to comment on diagnosis in trauma and associated perioperative and intraoperative complication with it. It will also help us deduce most preferred way of performing submental intubation and various methods to manage complications.

Methods: Submental intubation in patients experiencing craniofacial trauma was reviewed retrospectively for 9 years from January 2015 to August 2023. Common diagnosis sites were analyzed for perioperative and postoperative complications.

Results: It was found that there were no much complications faced perioperatively and also notes methods used for management of complications. Most commonly encountered postoperative complication was scar. Literature of past years was reviewed, during process we also came out with novel method for safe extubation for which we have got copyright from Government of India.

Conclusions: Submental intubation is a safe and efficient intraoperative airway management technique for patients with craniomaxillofacial injuries when there is concurrent facial trauma. This study findings would underscore the safety and efficacy of SEI, making it a promising unparalleled method of airway management worth considering.

研究设计:门下插管是传统插管技术的一种替代方法,但未得到充分利用。相关并发症确实会阻碍外科医生和麻醉师进行插管。如果外科医生认为门下插管的优势大于手术的潜在风险,他们可能会选择门下插管。找出并发症的原因并采取适当的应对策略有助于降低风险:本研究旨在比较和分析门下插管术中和术后出现的并发症,对其安全性和有效性进行评论。重温文献将有助于我们对创伤诊断以及与之相关的围手术期和术中并发症进行评论。它还将帮助我们推断出最可取的门下腔插管方式以及处理并发症的各种方法:方法:回顾性分析了自 2015 年 1 月至 2023 年 8 月的 9 年间颅颌面外伤患者的颏下插管情况。对常见诊断部位的围手术期和术后并发症进行分析:结果发现,围手术期并发症不多,并发症处理方法也有说明。最常见的术后并发症是疤痕。对过去几年的文献进行了回顾,在此过程中,我们还提出了安全拔管的新方法,并获得了印度政府的版权:结论:对于颅颌面受伤的患者来说,如果同时伴有面部创伤,门下插管是一种安全有效的术中气道管理技术。这项研究结果将强调 SEI 的安全性和有效性,使其成为一种值得考虑的有前途的气道管理方法。
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引用次数: 0
Management of Le Fort I Fractures. 勒堡 I 型骨折的处理
IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-23 DOI: 10.1177/19433875241278796
Jin-Yong Cho, Jaeyoung Ryu

Study design: A retrospective study.

Objective: This retrospective study aims to analyze the results of Le Fort I fracture treatment, with a focus on addressing malocclusion related to the fractures.

Methods: The study included 43 patients diagnosed with Le Fort I fractures who underwent open reduction and internal fixation. Demographic data, causes of trauma, accompanying facial bone fractures, treatment methods, and complications were analyzed. Fisher's exact test was employed to assess the association between fractures and malocclusion.

Results: Postoperative complications included occlusal disorder (6 cases), sensory disturbance (4 cases), and facial deformation (6 cases). Condylar fractures showed a statistically significant association with occlusal disorders (P = 0.044). Surgeon variability did not significantly impact occlusal outcomes (P = 0.25).

Conclusions: Proper management of Le Fort I fractures requires a thorough understanding of surgical principles and consideration of concomitant fractures. Achieving anatomical reduction based on occlusion is crucial for successful outcomes, and additional Le Fort I osteotomy may be considered in challenging cases.

研究设计回顾性研究:本回顾性研究旨在分析 Le Fort I 型骨折的治疗效果,重点是解决与骨折相关的咬合不正问题:研究纳入了43名确诊为Le Fort I型骨折并接受切开复位内固定术的患者。研究分析了人口统计学数据、外伤原因、伴随的面部骨骼骨折、治疗方法和并发症。采用费雪精确检验评估骨折与咬合不正之间的关系:结果:术后并发症包括咬合紊乱(6 例)、感觉障碍(4 例)和面部变形(6 例)。髁突骨折与咬合紊乱的关系具有统计学意义(P = 0.044)。外科医生的差异对咬合结果没有明显影响(P = 0.25):结论:正确处理 Le Fort I 型骨折需要充分了解手术原则并考虑并发骨折。根据咬合情况实现解剖复位是取得成功结果的关键,对于具有挑战性的病例,可考虑进行额外的Le Fort I截骨术。
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引用次数: 0
Orbital Trauma Epidemiologic Characteristics by Life Stage. 按生命阶段划分的眼眶创伤流行病学特征
IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-17 DOI: 10.1177/19433875241275102
Aayma Irfan, Nihal Punjabi, Aishwarya Suresh, Ian Waldrop, Jared C Inman, Nicholas W Sheets

Study design: Retrospective database review.

Objective: This study aims to characterize and compare the epidemiological factors of orbital trauma between life stages by utilizing the National Electronic Injury Surveillance System (NEISS), a nationally representative database.

Methods: The NEISS was queried for orbital injuries from 2013 to 2022. Demographic data, injury type, injury location, and product related to injury were compared across life stages defined as 0-5 years (young children), 6-17 years (adolescents), 18-64 years (working adults), and >65 years (elderly adults).

Results: 7846 orbital injuries were reported in the NEISS from 2013-2022. Incidence increased in all age groups over the study period but was highest in elderly adults. There was a bimodal distribution in the frequency of orbital trauma, with peaks occurring at age<20 and around age 80. Adolescents were most likely to be injured by sports-related products while young children and elderly adults were more likely to be injured by household products. Orbital fractures were the most common type of injury across all age groups (40.6%), with the highest rate observed in working adults. Elderly adults were more likely to be admitted to the hospital compared to working adults (RR 1.62 [1.49-1.77]).

Conclusions: The rate of orbital trauma is increasing over time, especially in elderly adults, highlighting the need for increased and improved preventative and education measures. The age-specific epidemiological factors identified in this study may help improve detection and management of injuries and guide public health initiatives.

研究设计回顾性数据库回顾:本研究旨在利用具有全国代表性的数据库 "全国电子伤害监测系统(NEISS)"来描述和比较不同生命阶段眼眶创伤的流行病学因素:方法:从 2013 年到 2022 年,在 NEISS 中查询眼眶损伤情况。比较了不同生命阶段(0-5 岁(幼儿)、6-17 岁(青少年)、18-64 岁(工作成人)和大于 65 岁(老年成人))的人口统计学数据、损伤类型、损伤位置以及与损伤相关的产品:2013-2022年间,NEISS共报告了7846例眼眶损伤。在研究期间,所有年龄组的发病率均有所上升,但老年人的发病率最高。眼眶外伤的频率呈双峰分布,高峰出现在年龄段:随着时间的推移,眼眶外伤的发生率正在上升,尤其是在老年人中,这凸显了加强和改进预防和教育措施的必要性。本研究中确定的特定年龄流行病学因素可能有助于改善损伤的检测和管理,并为公共卫生措施提供指导。
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引用次数: 0
Effectiveness of a Structured Trauma Template in Improving Clinical Examination Accuracy in Maxillofacial Trauma: A Prospective Study. 结构化创伤模板在提高颌面创伤临床检查准确性方面的效果:一项前瞻性研究。
IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-06 DOI: 10.1177/19433875241272435
Akhilesh K Pandey, Gigi Pg, Harshitha Rajanna, Abhishek Anil, Pravin Kumar, Ankita Chugh

Study design: Prospective pre-post study.

Objective: Maxillofacial trauma presenting to the emergency department (ED) are often accompanied with complex concomitant injuries, thereby making thorough diagnosis and treatment plan quite an exacting task owing to the demanding conditions of the ED. The use of a structured maxillofacial trauma template helps in documenting the injuries comprehensively, aids in treatment planning, avoids medical negligence thereby improving the quality of care given to the patient. The study introduced a structured maxillofacial trauma template to improve the quality of the ED documentation.

Methods: A total of 220 patients were evaluated for the quality of their ED documentation from September 2023 till February 2024. The group A included 110 patients where complete medical documentation was done routinely on a blank A4 sized paper, group B included 110 patients where the documentation was done using the structured oral and maxillofacial trauma template. The ED notes were thoroughly evaluated by the 2 independent authors for record completeness and documentation rate of history and examination findings.

Results: The introduction of trauma template demonstrated a significant improvement of 18.95 % in record completeness. Significant improvement was seen in documentation rate among the covariates like place of injury, time of evaluation, primary care given, wound classification, dento-alveolar injury, ophthalmic evaluation, nerve injury evaluation, comorbidities with P = .001, and referral with P = .03. The ophthalmic evaluation showed significant improvement among covariates (loss of visual acuity, reflexes, diplopia, enophthalmos, subconjunctival haemorrhage, chemosis, periorbital oedema, periorbital ecchymosis, ocular dystopia) with P = .001, and extraocular muscle restriction with P = .004.

Conclusions: The study demonstrated that the use of a structured oral and maxillofacial trauma template can significantly improve the quality of the ED documentation and contributes to better patient care in the ED.

研究设计前瞻性前后研究:急诊科(ED)收治的颌面部外伤患者往往伴有复杂的并发症,因此,由于急诊科条件苛刻,彻底诊断和治疗计划是一项相当艰巨的任务。使用结构化颌面外伤模板有助于全面记录损伤情况,帮助制定治疗计划,避免医疗疏忽,从而提高对患者的护理质量。该研究引入了结构化颌面外伤模板,以提高急诊室文件记录的质量:从 2023 年 9 月到 2024 年 2 月,共对 220 名患者的急诊室文件质量进行了评估。方法:从 2023 年 9 月到 2024 年 2 月,共对 220 名患者的急诊室记录质量进行了评估。A 组包括 110 名患者,他们的完整医疗记录都是在空白的 A4 纸上按常规完成的;B 组包括 110 名患者,他们的记录都是使用结构化的口腔颌面外伤模板完成的。两位独立作者对急诊室记录的完整性以及病史和检查结果的记录率进行了全面评估:结果:采用创伤模板后,记录完整性显著提高了 18.95%。在受伤地点、评估时间、初级护理、伤口分类、牙槽损伤、眼科评估、神经损伤评估、合并症(P = .001)和转诊(P = .03)等协变量中,记录率均有显著提高。眼科评估显示,协变量(视力丧失、反射、复视、眼球突出、结膜下出血、化脓、眶周水肿、眶周瘀斑、眼球震颤)显著改善,P = 0.001;眼外肌受限显著改善,P = 0.004:该研究表明,使用结构化的口腔颌面外伤模板可显著提高急诊室文件记录的质量,有助于改善急诊室对患者的护理。
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引用次数: 0
Pediatric Facial Fractures: A Multi-Institutional Level 1 Trauma Center Analysis of Incidence, Interventions, and Outcomes. 小儿面部骨折:多机构一级创伤中心对发病率、干预措施和结果的分析。
IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-05 DOI: 10.1177/19433875241272430
Madison Hinson, Avery Wright, Amelia Davidson, Samuel Kogan, Christopher Runyan

Study design: Retrospective chart review.

Objective: The management of pediatric facial fractures presents distinctive considerations compared to adults. This study aims to provide a unique perspective on the correlations between the mechanism of injury, types of facial fractures, and fracture interventions and management utilized in 2 North Carolina Level 1 Trauma Centers to determine the optimal management options for this patient population.

Methods: An IRB-approved retrospective chart review was performed of pediatric facial trauma patients ages <18 years old between January 2020 and December 2022 at Atrium Health Wake Forest Baptist Medical Center and Atrium Health Charlotte Medical Center. Data on patient demographics, mechanism of injury, facial fractures, interventions, and outcomes were collected.

Results: Of 2,977 pediatric facial trauma patients, 582 patients sustained at least 1 facial fracture at the time of injury. Adolescents were significantly less likely to be transferred from outside institutions and to be admitted for further care (P = 0.002). Adolescents experienced higher levels of residual symptoms following initial discharge (P = 0.001) and were less likely to have a symptom resolution within 1 year (P < 0.0001). Neonates and infants were significantly more likely to receive conservative interventions and to sustain calvarium and skull base fractures (P < 0.0001).

Conclusions: This study identifies differences in pediatric age groups related to transfers, admittance, fracture type, management, and outcomes. Our data suggests adolescent patients may experience a higher incidence of residual symptoms with lower levels of symptom resolution within 1 year. Further investigation into these differences may elicit optimized methods of fracture management in pediatric age groups and allow for effective, individualized care with improved long-term outcomes.

研究设计回顾性病历审查:与成人相比,小儿面部骨折的治疗需要考虑不同的因素。本研究旨在提供一个独特的视角,分析北卡罗来纳州两家一级创伤中心的损伤机制、面部骨折类型、骨折干预措施和处理方法之间的相关性,以确定这一患者群体的最佳处理方案:方法:对经 IRB 批准的小儿面部创伤患者的年龄进行回顾性病历审查:在 2,977 名小儿面部创伤患者中,有 582 名患者在受伤时至少有一处面部骨折。青少年从外部机构转院和入院接受进一步治疗的几率明显较低(P = 0.002)。青少年在初次出院后出现残留症状的几率更高(P = 0.001),且在一年内症状缓解的几率更低(P < 0.0001)。新生儿和婴儿接受保守治疗以及颅骨和颅底骨折的几率明显更高(P < 0.0001):本研究确定了儿科年龄组在转院、入院、骨折类型、处理和预后方面的差异。我们的数据表明,青少年患者可能会出现较高的残留症状,且在一年内症状缓解的程度较低。对这些差异的进一步调查可能会优化儿科年龄组的骨折管理方法,从而提供有效的个性化护理,改善长期疗效。
{"title":"Pediatric Facial Fractures: A Multi-Institutional Level 1 Trauma Center Analysis of Incidence, Interventions, and Outcomes.","authors":"Madison Hinson, Avery Wright, Amelia Davidson, Samuel Kogan, Christopher Runyan","doi":"10.1177/19433875241272430","DOIUrl":"10.1177/19433875241272430","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Objective: </strong>The management of pediatric facial fractures presents distinctive considerations compared to adults. This study aims to provide a unique perspective on the correlations between the mechanism of injury, types of facial fractures, and fracture interventions and management utilized in 2 North Carolina Level 1 Trauma Centers to determine the optimal management options for this patient population.</p><p><strong>Methods: </strong>An IRB-approved retrospective chart review was performed of pediatric facial trauma patients ages <18 years old between January 2020 and December 2022 at Atrium Health Wake Forest Baptist Medical Center and Atrium Health Charlotte Medical Center. Data on patient demographics, mechanism of injury, facial fractures, interventions, and outcomes were collected.</p><p><strong>Results: </strong>Of 2,977 pediatric facial trauma patients, 582 patients sustained at least 1 facial fracture at the time of injury. Adolescents were significantly less likely to be transferred from outside institutions and to be admitted for further care (<i>P</i> = 0.002). Adolescents experienced higher levels of residual symptoms following initial discharge (<i>P</i> = 0.001) and were less likely to have a symptom resolution within 1 year (<i>P</i> < 0.0001). Neonates and infants were significantly more likely to receive conservative interventions and to sustain calvarium and skull base fractures (<i>P</i> < 0.0001).</p><p><strong>Conclusions: </strong>This study identifies differences in pediatric age groups related to transfers, admittance, fracture type, management, and outcomes. Our data suggests adolescent patients may experience a higher incidence of residual symptoms with lower levels of symptom resolution within 1 year. Further investigation into these differences may elicit optimized methods of fracture management in pediatric age groups and allow for effective, individualized care with improved long-term outcomes.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"19433875241272430"},"PeriodicalIF":0.8,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcome Evaluation of Three-Dimensionally Printed Patient-Specific Surgical Plates for Mandibular Reconstruction. 用于下颌骨重建的三维打印患者专用手术板的效果评估。
IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-03 DOI: 10.1177/19433875241272441
Wen-Bo Zhang, Chao-Fei Wang, Yao Yu, Shuo Liu, Lei-Hao Hu, Hui Yuh Soh, Jie Zhang, Xin Peng

Study design: Prospective and retrospective studies.

Objective: The aim of this study was to evaluate the clinical effects and accuracy of three-dimensionally (3D)-printed patient-specific surgical plates used for mandibular defect reconstruction.

Methods: This study included patients who underwent mandibular defect reconstruction with vascularized autogenous bone grafts between January 2012 and August 2021. They were divided into experimental (fixation with 3D-printed surgical plates) and control (fixation with conventional surgical plates) groups. Flap survival rate, postoperative complications and patient self-evaluated facial appearance were compared. Mandibular reconstruction accuracy evaluation included postoperative position deviation of the whole mandible, transplanted bone graft, lower mandibular border, mandibular condyle, and mandibular angle on the reconstructed side compared to baseline.

Results: This study included 20 patients (14 males, six females; age, 39.45 ± 11.69 years), ten each in the experimental and control groups. The mean follow-up was 16 ± 22.05 (range, 6-99) months. All procedures were successful, no plate-related complications (breakage, loosening, or exposure of the surgical plates) were reported, and all patients were satisfied. The groups were statistically similar in th e position deviation of the whole mandible, transplanted bone graft, mandibular condyle, and mandibular angle, but the position and morphology of the lower mandibular border on the reconstructed side in the experimental group were better than those in the control group (P = 0.016).

Conclusions: 3D-printed patient-specific surgical plates could be applied in mandibular reconstruction safely and effectively, simplifying the surgical procedure, shortening the preoperative preparation times, achieving satisfactory outcomes, and improving the clinical effects and accuracy of individualized mandibular reconstruction.

研究设计前瞻性和回顾性研究:本研究旨在评估用于下颌骨缺损重建的三维(3D)打印患者特异性手术板的临床效果和准确性:本研究纳入了2012年1月至2021年8月期间使用血管化自体骨移植进行下颌骨缺损重建的患者。他们被分为实验组(使用 3D 打印手术板固定)和对照组(使用传统手术板固定)。比较了皮瓣存活率、术后并发症和患者自我评估的面部外观。下颌骨重建准确性评估包括术后整个下颌骨、移植骨、下颌骨下缘、下颌骨髁状突和重建侧下颌角与基线相比的位置偏差:本研究包括 20 名患者(14 名男性,6 名女性;年龄为 39.45 ± 11.69 岁),实验组和对照组各 10 名。平均随访时间为 16 ± 22.05(6-99)个月。所有手术均获得成功,未报告与钢板相关的并发症(钢板断裂、松动或外露),所有患者均表示满意。两组在整个下颌骨、移植骨、下颌骨髁状突和下颌角的位置偏差方面具有统计学相似性,但实验组重建侧下颌骨下缘的位置和形态优于对照组(P = 0.016):结论:3D打印患者特异性手术板可安全有效地应用于下颌骨重建,简化了手术过程,缩短了术前准备时间,取得了满意的效果,提高了下颌骨个性化重建的临床效果和准确性。
{"title":"Outcome Evaluation of Three-Dimensionally Printed Patient-Specific Surgical Plates for Mandibular Reconstruction.","authors":"Wen-Bo Zhang, Chao-Fei Wang, Yao Yu, Shuo Liu, Lei-Hao Hu, Hui Yuh Soh, Jie Zhang, Xin Peng","doi":"10.1177/19433875241272441","DOIUrl":"10.1177/19433875241272441","url":null,"abstract":"<p><strong>Study design: </strong>Prospective and retrospective studies.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the clinical effects and accuracy of three-dimensionally (3D)-printed patient-specific surgical plates used for mandibular defect reconstruction.</p><p><strong>Methods: </strong>This study included patients who underwent mandibular defect reconstruction with vascularized autogenous bone grafts between January 2012 and August 2021. They were divided into experimental (fixation with 3D-printed surgical plates) and control (fixation with conventional surgical plates) groups. Flap survival rate, postoperative complications and patient self-evaluated facial appearance were compared. Mandibular reconstruction accuracy evaluation included postoperative position deviation of the whole mandible, transplanted bone graft, lower mandibular border, mandibular condyle, and mandibular angle on the reconstructed side compared to baseline.</p><p><strong>Results: </strong>This study included 20 patients (14 males, six females; age, 39.45 ± 11.69 years), ten each in the experimental and control groups. The mean follow-up was 16 ± 22.05 (range, 6-99) months. All procedures were successful, no plate-related complications (breakage, loosening, or exposure of the surgical plates) were reported, and all patients were satisfied. The groups were statistically similar in th e position deviation of the whole mandible, transplanted bone graft, mandibular condyle, and mandibular angle, but the position and morphology of the lower mandibular border on the reconstructed side in the experimental group were better than those in the control group (<i>P</i> = 0.016).</p><p><strong>Conclusions: </strong>3D-printed patient-specific surgical plates could be applied in mandibular reconstruction safely and effectively, simplifying the surgical procedure, shortening the preoperative preparation times, achieving satisfactory outcomes, and improving the clinical effects and accuracy of individualized mandibular reconstruction.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"19433875241272441"},"PeriodicalIF":0.8,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Burden of Road Traffic Accidents on Facial Fractures: National Trends, Injury Patterns, and Disparities in 154,185 Patients. 道路交通事故对面部骨折造成的负担:154 185 名患者的全国趋势、伤害模式和差异。
IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-02 DOI: 10.1177/19433875241272440
Carol Y Wang, Daniel Y Kwon, Olachi Oleru, Nargiz Seyidova, Peter E Shamamian, Keisha E Montalmant, Alex Sarosi, Peter J Taub

Study design: National database study.

Objective: Road traffic accidents (RTAs) are a common and challenging cause of facial fractures in the United States. The present study sought to utilize the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) to investigate national trends, injury patterns and disparities in facial fractures secondary to RTAs. To date, this is the first study to do so.

Methods: A retrospective analysis was conducted of patients with primary facial fractures secondary to RTAs using the 2018-2021 HCUP-NIS. Patients were classified into the RTA and non-RTA group. Demographics, injury patterns, and inpatient outcomes were compared.

Results: In total, 154,185 primary facial fractures were identified, of which 17% (n = 26,115) were associated with RTAs. RTAs commonly involved cars (41%), followed by motorcycles (15%), pedestrians (11%), and bicyclists (10%). The RTA group was younger (34% vs 24% < 25 years, P < .01) and more frequently Hispanic (18% vs 15%, P < .01). The most common fracture types were mandibular (23%), frontal (14%), and orbital fractures (14%). The RTA group was 50% more likely to have multiple facial fractures (OR = 1.5, P < .01). The RTA group had a longer length of stay (5.3 vs 4.0 days, P < .01), admission charge ($127,932 vs $79,414, P < .01), and mortality rate (1.9% vs 1.4%, P < .01) than the non-RTA group.

Conclusions: The present findings provide valuable insights, informing early involvement of craniofacial surgeons for the assessment of combination facial fractures and tailored treatment approaches for RTA patients.

研究设计全国数据库研究:在美国,道路交通事故(RTA)是导致面部骨折的一个常见且具有挑战性的原因。本研究试图利用医疗成本与利用项目全国住院病人样本(HCUP-NIS)来调查继发于道路交通事故的面部骨折的全国趋势、伤害模式和差异。迄今为止,这是第一项此类研究:使用 2018-2021 年 HCUP-NIS 对继发于 RTA 的原发性面部骨折患者进行了回顾性分析。患者被分为 RTA 组和非 RTA 组。对人口统计学、损伤模式和住院结果进行了比较:共发现 154 185 例原发性面部骨折,其中 17% (n = 26 115)与 RTA 相关。快速交通事故通常涉及汽车(41%),其次是摩托车(15%)、行人(11%)和骑自行车者(10%)。RTA 组的年龄更小(34% 对 24% 小于 25 岁,P < .01),更多是西班牙裔(18% 对 15%,P < .01)。最常见的骨折类型是下颌骨骨折(23%)、额骨骨折(14%)和眼眶骨折(14%)。RTA 组发生多发性面部骨折的可能性高出 50%(OR = 1.5,P < .01)。RTA组的住院时间(5.3天 vs 4.0天,P < .01)、入院费用(127,932美元 vs 79,414美元,P < .01)和死亡率(1.9% vs 1.4%,P < .01)均长于非RTA组:本研究结果提供了宝贵的见解,有助于颅颌面外科医生及早参与面部合并骨折的评估,并为 RTA 患者提供量身定制的治疗方法。
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引用次数: 0
Analyzing Epidemiology and Hospital Course Outcomes of LeFort Fractures in the Largest National Pediatric Trauma Database. 在最大的全国儿科创伤数据库中分析 LeFort 骨折的流行病学和住院治疗结果。
IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-21 DOI: 10.1177/19433875241262616
Sofia Perez Otero, Michael F Cassidy, Kerry A Morrison, Hilliard T Brydges, John Muller, Roberto L Flores, Daniel J Ceradini

Study design: Retrospective observational study.

Objective: This study analyzes the epidemiology of pediatric Le Fort fractures and assesses the incidence of concomitant injuries and acute-level hospital course using the largest, national pediatric trauma database to date.

Methods: Pediatric midface and Le Fort fractures from 2016-2019 were identified in the National Trauma Data Bank. Descriptive analyses of Le Fort compared to non-Le Fort midface fractures were performed. Multivariable regression assessed whether Le Fort fractures were risk factors for ICU admission, intracranial injury, cervical spine (C-spine) fracture, tracheostomy, and mortality.

Results: A total of 1489 patients with Le Fort fractures were identified. There were 520 Le Fort I, 632 Le Fort II, and 609 Le Fort III fractures. Fracture incidence increased with age. Le Fort fractures showed higher rates of concomitant intracranial injury (P < 0.001), ICU admission (P < 0.001), C-spine fracture (P < 0.001), and tracheostomy (P < 0.001). Incidence of all the above increased with higher-grade Le Fort fractures. Le Fort III fractures had higher rates of mortality than non-Le Fort midface fractures (7.6% vs 3.2%). Multivariable regression showed that all Le Fort patterns were independent risk factors for tracheostomy and ICU admission, but only Le Fort I for C-spine fractures.

Conclusions: The incidence of Le Fort fractures appears to increase with age. Higher category Le Fort fractures are associated with greater morbidity.

研究设计回顾性观察研究:本研究利用迄今为止最大的全国性儿科创伤数据库,分析了小儿Le Fort骨折的流行病学,并评估了伴随损伤的发生率和急性住院治疗过程:在国家创伤数据库中确定了2016-2019年的小儿中面部和Le Fort骨折。对Le Fort与非Le Fort中面部骨折进行了描述性分析。多变量回归评估了Le Fort骨折是否是入住ICU、颅内损伤、颈椎(C-spine)骨折、气管切开术和死亡率的风险因素:共确定了 1489 名 Le Fort 骨折患者。结果:共发现 1489 例 Le Fort 骨折患者,其中 Le Fort I 型骨折 520 例,Le Fort II 型骨折 632 例,Le Fort III 型骨折 609 例。骨折发生率随年龄增长而增加。Le Fort骨折患者合并颅内损伤(P < 0.001)、入住重症监护室(P < 0.001)、C型脊柱骨折(P < 0.001)和气管切开术(P < 0.001)的比例较高。随着Le Fort骨折等级的升高,上述情况的发生率也随之升高。Le Fort III骨折的死亡率高于非Le Fort中面骨折(7.6% vs 3.2%)。多变量回归显示,所有Le Fort模式都是气管切开术和入住重症监护室的独立风险因素,但只有Le Fort I是C型脊柱骨折的独立风险因素:结论:Le Fort骨折的发生率似乎随着年龄的增长而增加。结论:Le Fort骨折的发生率似乎随着年龄的增长而增加。
{"title":"Analyzing Epidemiology and Hospital Course Outcomes of LeFort Fractures in the Largest National Pediatric Trauma Database.","authors":"Sofia Perez Otero, Michael F Cassidy, Kerry A Morrison, Hilliard T Brydges, John Muller, Roberto L Flores, Daniel J Ceradini","doi":"10.1177/19433875241262616","DOIUrl":"10.1177/19433875241262616","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Objective: </strong>This study analyzes the epidemiology of pediatric Le Fort fractures and assesses the incidence of concomitant injuries and acute-level hospital course using the largest, national pediatric trauma database to date.</p><p><strong>Methods: </strong>Pediatric midface and Le Fort fractures from 2016-2019 were identified in the National Trauma Data Bank. Descriptive analyses of Le Fort compared to non-Le Fort midface fractures were performed. Multivariable regression assessed whether Le Fort fractures were risk factors for ICU admission, intracranial injury, cervical spine (C-spine) fracture, tracheostomy, and mortality.</p><p><strong>Results: </strong>A total of 1489 patients with Le Fort fractures were identified. There were 520 Le Fort I, 632 Le Fort II, and 609 Le Fort III fractures. Fracture incidence increased with age. Le Fort fractures showed higher rates of concomitant intracranial injury (<i>P</i> < 0.001), ICU admission (<i>P</i> < 0.001), C-spine fracture (<i>P</i> < 0.001), and tracheostomy (<i>P</i> < 0.001). Incidence of all the above increased with higher-grade Le Fort fractures. Le Fort III fractures had higher rates of mortality than non-Le Fort midface fractures (7.6% vs 3.2%). Multivariable regression showed that all Le Fort patterns were independent risk factors for tracheostomy and ICU admission, but only Le Fort I for C-spine fractures.</p><p><strong>Conclusions: </strong>The incidence of Le Fort fractures appears to increase with age. Higher category Le Fort fractures are associated with greater morbidity.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"19433875241262616"},"PeriodicalIF":0.8,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Systematic Review of Local Flaps Utilized for External Auditory Canal Defects. 对用于治疗外耳道缺损的局部皮瓣进行系统回顾。
IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-20 DOI: 10.1177/19433875241262619
Anna Celeste Gibson, Olivia Speed, Jennings R Boyette, Robert Saadi

Study design: Systematic review of the literature.

Objective: The goal of this study is to review and summarize current literature on local flap reconstruction of external auditory canal (EAC) defects.

Methods: PubMed and Ovid databases were queried utilizing search term combinations of "external auditory canal," "defects," "flaps," "local," and "reconstruction." References in included articles were subject for review and inclusion. Articles published between 2013 and 2023 were included in the study.

Results: A total of 108 articles were screened after duplicates were excluded. Of the 108 articles, 3 were not written or translated to English, 10 were not accessible for review on either database, and 71 were not applicable to our subject of interest. The remaining 24 articles were included in the systematic review. Due to the primary descriptive nature of the surgical techniques and variability of data collection, a formal meta-analysis was not possible.

Conclusions: The EAC defect creates a difficult reconstructive dilemma. The armamentarium for repairing these defects can range from healing by secondary intention to free tissue transfer, however, local flap reconstruction proves to be a reliable and versatile option. This article reviews current local flap techniques for EAC defects and compares their advantages and disadvantages. Further, the authors provide a treatment algorithm and indications for choosing each flap in external auditory canal reconstruction.

研究设计系统性文献综述:本研究旨在回顾和总结目前有关外耳道(EAC)缺损局部皮瓣重建的文献:方法:使用 "外耳道"、"缺损"、"皮瓣"、"局部 "和 "重建 "等检索词组合查询 PubMed 和 Ovid 数据库。对收录文章中的参考文献进行审阅和收录。研究纳入了 2013 年至 2023 年间发表的文章:在排除重复文章后,共筛选出 108 篇文章。在这108篇文章中,有3篇文章没有撰写或翻译成英文,有10篇文章在两个数据库中都无法查阅,有71篇文章与我们感兴趣的主题不相关。其余 24 篇文章被纳入系统综述。由于手术技术的主要描述性和数据收集的差异性,无法进行正式的荟萃分析:结论:EAC缺损造成了难以修复的困境。修复这些缺损的方法多种多样,从二次意向愈合到游离组织转移,然而,局部皮瓣重建被证明是一种可靠且多用途的选择。本文回顾了目前治疗 EAC 缺损的局部皮瓣技术,并比较了它们的优缺点。此外,作者还提供了在外耳道重建中选择每种皮瓣的治疗算法和适应症。
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引用次数: 0
Erratum to "Current Evidence for the Management of Edentulous Atrophic Mandible Fractures: A PRISMA-SWiM Guided Review". 无牙萎缩性下颌骨骨折治疗的现有证据:PRISMA-SWiM 指导下的综述"。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-01 Epub Date: 2023-01-02 DOI: 10.1177/19433875221150350

[This corrects the article DOI: 10.1177/19433875221115585.].

[此处更正了文章 DOI:10.1177/19433875221115585]。
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引用次数: 0
期刊
Craniomaxillofacial Trauma & Reconstruction
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