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Emergency management of oromaxillofacial trauma with anterior cranial base fracture. Oromaxillofacial trauma with cranial base fracture is a case that is quite commonly found in the ER of Oral and Maxillofacial Surgery Department at Dr. Hasan Sadikin General Hospital Bandung. Emergency management aims to take any appropriate action, prevent complications, and consult to other departments involved. A man aged 28 years came with bleeding from the mouth due to a motorcycle accident approximately 6 hours before admission to the hospital. Physical examination showed facial asymmetry, bilateral periorbital edema and hematoma, rhinorrhea, and stitches in labiomental area. Intraoral examination showed maxillary, palatal, parasymphisis, dentoalveolar fractures, lacerated wound on the upper lip, lower lip, palate, gingival, difficulty in opening the mouth, and malocclusion of the teeth. Immediate and rapid surgical and maxillofacial surgical emergency was performed with minimal maxillary intervention, aiming to prevent persistent spontaneous cerebrospinal fluid leak, and prevent infection. The management of soft tissue and hard tissue injury is by reduction, fixation and immobilization of fractures, management of pain and administration of antibiotics. In conclusion, the emergency management of oromaxillofacial trauma with cranial base fracture is promptly and rapidly carried out with minimal intervention.ABSTRAKTrauma oromaksilofasial disertai fraktur basis kranii merupakan kasus yang cukup banyak ditemukan di Instalasi Gawat Darurat Bedah Mulut dan Maksilofasial RSUP Dr. Hasan Sadikin Bandung. Penatalaksanaan emergensi bertujuan untuk melakukan tindakan yang tepat, mencegah komplikasi, serta konsultasi kepada bagian lain yang terkait. Seorang laki- laki usia 28 tahun datang dengan keluhan perdarahan dari mulut akibat kecelakaan motor kurang lebih 6 jam sebelum masuk rumah sakit. Pemeriksaan fisik ditemukan wajah asimetris, edema dan hematoma pada regio periorbita bilateral, terdapat rhinorrhea, serta bekas jahitan pada regio labiomental. Pemeriksaan intra oral tampak fraktur pada daerah maksila, palatum, parasimfisis, fraktur dentoalveolar, vulnus laserasi pada bibir atas, bibir bawah, palatum, gingiva, kesulitan membuka mulut, dan maloklusi gigi geligi. Tindakan emergensi bedah mulut dan maksilofasial dilakukan segera dan cepat dengan minimal intervensi pada rahang atas bertujuan untuk mencegah kebocoran cairan serebro spinal persisten, dan mencegah terjadinya infeksi. Manajemen luka jaringan lunak dan jaringan keras, melakukan reduksi, fiksasi dan imobilisasi fraktur, manajemen nyeri serta pemberian antibiotik. Penatalaksanaan emergensi pada trauma oromaksilofasial disertai fraktur basis kranii dilakukan segera dan cepat dengan minimal intervensi.

Despite of the invasive procedure that might cause postoperative effect, OSCC patients in the current study showed a better quality of life after cancer removal.

Background: Mandibular fractures may lead to several complications, including infection, nonunion, malunion, and temporomandibular joint ankylosis. The incidence of mandibular fractures is quite common in maxillofacial trauma. The characteristics of mandible fractures could be different among countries concerning the condition of the population. The etiological differences depend on age, demographic patterns of a country, environmental conditions, social conditions, socioeconomic status and cultural configuration. This study aimed to perceive the characteristic of mandibular fractures among patients attending The Oral and Maxillofacial Surgery Department in Dr. Hasan Sadikin General Hospital during 2017- 2020.Methods: This study was a retrospective descriptive study. Samples included medical records of patients with mandibular fractures attending The Oral and Maxillofacial Surgery Department in Dr. Hasan Sadikin General Hospital during January 2017- December 2020. Samples were chosen using inclusion and exclusion criteria. The characteristics of mandibular fracture were based on gender, fracture etiology, mandibular fracture location, and treatment.Results: This study presented that the incidence of mandibular fracture rate was higher in males with 284 cases (82.08%) than females with 62 cases (17.92%) with a ratio of 4.5 to 1. Based on age, mandibular fractures were often found in the adult age group (20-60 years old) with 215 cases (62.14%). The most common etiology was road traffic accidents, with 287 cases (82.95%). Parasymphisis region was the most common site of mandibular fracture with 94 cases (25.26%).  Most treatments performed were open reduction internal fixation with 199 cases (57.51%).Conclusion: Mandibular fracture characteristics vary considerably among different study populations depending on demographic characteristics and socioeconomic status. The most frequent mandibular fracture site in Dr. Hasan Sadikin General Hospital Bandung was the parasymphisis region in a young adult age group.

Ludwig’s angina is a high severity infection because of the risk of airway obstruction due to the rapid spread of the abscess into the deeper spaces. Therefore, performing the correct treatment is one of the keys to a successful result. A 44-year-old male patient came to the Emergency Unit of Hasan Sadikin Hospital, complaining of shortness of breath, severe pain, and progressive swelling. Extraoral examination showed a localized-fluctuated swelling located at the right lower jaw that extended to the chin, left lower jaw, and the frontal region of the neck region while a sequential organ failure assessment revealed a score of 2. A diagnosis of Ludwig’s angina and septic shock was confirmed. Intravenous infusion of norepinephrine was administered and a tracheostomy was performed. The next treatment phase consisted of a drainage procedure, tooth extraction, and placement of the Penrose drain. The patient was discharged 10 days later with a satisfactory outcome.