Pub Date : 2024-08-27DOI: 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.
{"title":"Unlocking the Potential of Submental Intubation - Redefining Airway Management in Craniomaxillofacial Trauma Patients.","authors":"Amit Dharamvir Mahajan, Sharvari Prakash Daithankar, Pratesh Nitin Dholabhai, Aniruddh Pratap Singh, Aditya Rajesh Shah, Nirvani Pinkesh Shah","doi":"10.1177/19433875241278797","DOIUrl":"10.1177/19433875241278797","url":null,"abstract":"<p><strong>Study design: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"19433875241278797"},"PeriodicalIF":0.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649228","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}
Pub Date : 2024-08-23DOI: 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。
{"title":"Management of Le Fort I Fractures.","authors":"Jin-Yong Cho, Jaeyoung Ryu","doi":"10.1177/19433875241278796","DOIUrl":"10.1177/19433875241278796","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objective: </strong>This retrospective study aims to analyze the results of Le Fort I fracture treatment, with a focus on addressing malocclusion related to the fractures.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>P</i> = 0.044). Surgeon variability did not significantly impact occlusal outcomes (<i>P</i> = 0.25).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"19433875241278796"},"PeriodicalIF":0.8,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649148","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}
Pub Date : 2024-08-17DOI: 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.
{"title":"Orbital Trauma Epidemiologic Characteristics by Life Stage.","authors":"Aayma Irfan, Nihal Punjabi, Aishwarya Suresh, Ian Waldrop, Jared C Inman, Nicholas W Sheets","doi":"10.1177/19433875241275102","DOIUrl":"10.1177/19433875241275102","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective database review.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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]).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"19433875241275102"},"PeriodicalIF":0.8,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649216","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}
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.
{"title":"Effectiveness of a Structured Trauma Template in Improving Clinical Examination Accuracy in Maxillofacial Trauma: A Prospective Study.","authors":"Akhilesh K Pandey, Gigi Pg, Harshitha Rajanna, Abhishek Anil, Pravin Kumar, Ankita Chugh","doi":"10.1177/19433875241272435","DOIUrl":"10.1177/19433875241272435","url":null,"abstract":"<p><strong>Study design: </strong>Prospective pre-post study.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 <i>P</i> = .001, and referral with <i>P</i> = .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 <i>P</i> = .001, and extraocular muscle restriction with <i>P</i> = .004.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"19433875241272435"},"PeriodicalIF":0.8,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649056","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}
Pub Date : 2024-08-05DOI: 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.
{"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}
Pub Date : 2024-08-03DOI: 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.
{"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}
Pub Date : 2024-08-02DOI: 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.
{"title":"The Burden of Road Traffic Accidents on Facial Fractures: National Trends, Injury Patterns, and Disparities in 154,185 Patients.","authors":"Carol Y Wang, Daniel Y Kwon, Olachi Oleru, Nargiz Seyidova, Peter E Shamamian, Keisha E Montalmant, Alex Sarosi, Peter J Taub","doi":"10.1177/19433875241272440","DOIUrl":"10.1177/19433875241272440","url":null,"abstract":"<p><strong>Study design: </strong>National database study.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, <i>P</i> < .01) and more frequently Hispanic (18% vs 15%, <i>P</i> < .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, <i>P</i> < .01). The RTA group had a longer length of stay (5.3 vs 4.0 days, <i>P</i> < .01), admission charge ($127,932 vs $79,414, <i>P</i> < .01), and mortality rate (1.9% vs 1.4%, <i>P</i> < .01) than the non-RTA group.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"19433875241272440"},"PeriodicalIF":0.8,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649224","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}
Pub Date : 2024-06-21DOI: 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}
Pub Date : 2024-06-20DOI: 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.
{"title":"A Systematic Review of Local Flaps Utilized for External Auditory Canal Defects.","authors":"Anna Celeste Gibson, Olivia Speed, Jennings R Boyette, Robert Saadi","doi":"10.1177/19433875241262619","DOIUrl":"10.1177/19433875241262619","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review of the literature.</p><p><strong>Objective: </strong>The goal of this study is to review and summarize current literature on local flap reconstruction of external auditory canal (EAC) defects.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"19433875241262619"},"PeriodicalIF":0.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649116","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}
Pub Date : 2024-06-01Epub Date: 2023-01-02DOI: 10.1177/19433875221150350
[This corrects the article DOI: 10.1177/19433875221115585.].
[此处更正了文章 DOI:10.1177/19433875221115585]。
{"title":"Erratum to \"Current Evidence for the Management of Edentulous Atrophic Mandible Fractures: A PRISMA-SWiM Guided Review\".","authors":"","doi":"10.1177/19433875221150350","DOIUrl":"https://doi.org/10.1177/19433875221150350","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/19433875221115585.].</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"17 2","pages":"176"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082386","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}