This study involves mandibular and midface fractures recorded in the trauma reports of OMFS department, SCB dental college, Cuttack, Odisha. The reports were studied between December 2004 and November 2009. The 503 patients had 539 mandibular fractures and 117 midface fractures. Males accounted for 442 (87.87%) and females accounted for 61 (12.12%). Male to female ratio was 7.25:1. The most common cause of fracture was road traffic accident and accounted for 404 (80.31%). The most common site of fracture mandible was parasymphysis where as in middle third fracture it was zygomatic complex fracture. The most common age groups involved in fracture were 21-30 years and the incidence of head injury was 97(19.28%). Many of these variations may be related to socioeconomic, cultural and environmental conditions.
Kimura's disease is an uncommon allergic disorder of unknown etiology affecting sporadic populations. A male patient in his third decade presented with a swelling in his left facial region. His investigations showed a raised eosinophil count. The lesion was excised surgically. He was put on a short term steroid therapy. Biopsy revealed it as Kimura's disease. Subsequent follow-ups have been satisfactory with no recurrences.
Ameloblastic carcinoma (AC) is a rare primary odontogenic tumor that has histological features of both ameloblastoma and carcinoma. A total number of 92 case reports speak about its rare incidence, affecting mostly the mandible as a locally destructive lesion. The maxilla is affected even more rarely as only 35 cases have been reported until 2012 in scientific literature. The clinical course of AC is generally aggressive, with extensive local bone destruction. The most common clinical features include swelling, pain, trismus, significant bone resorption with tooth mobility, dysphonia and intraoral fistula. We report two cases of AC with aggressive behavior.
Objectives
As the craniofacial and neck regions are prime areas of injury in bear attacks, the careful management of soft and hard tissue injuries and selection of reconstructive options is of the utmost importance. This study will review the incidence and patterns of bear mauling in eastern India reported to our department and the various modalities used for their treatment over a period of 7 years. It also documents the risks of infection in bear mauling cases and the complications that have occurred.
Materials and Methods
Twenty cases were treated over the study period. Cases were evaluated for soft and hard tissue injuries including tissue loss and corresponding management in the craniofacial region. Cases were also evaluated for other associated injuries, organ damage and related complications.
Results
Various modalities of treatment were used for the management of victims, ranging from simple primary repairs to free tissue transfers. Simple primary repairs were done in 75% of cases, while the management of the injured victims required reconstruction by local, regional or distant flaps in 25%. Free tissue transfers were performed in 15% of cases, and no cases of wound infection were detected in the course of treatment.
Conclusion
Knowledge of various reconstructive techniques is essential for managing maxillofacial injuries in bear mauling cases. Modern reconstructive procedures like free tissue transfer are reliable options for reconstruction with minimal co-morbidity and dramatic improvement in treatment outcomes.
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