Management of orbital fractures continues to present some difficulties, particularly regarding the prediction of late complications. Radiographic assessment provides a detailed evaluation, but the results lack consistency to be considered a standard factor in the decision-making process. Studies focusing on reliability of post-operative imaging are lacking. Materials and methods: We performed a retrospective study using patients from a major trauma center with unilateral orbital floor fracture who underwent surgery. Using three-dimensional volume assessment software, we performed a volume calculation and determined the intra-and interreader variation by intraclass correlation coefficient analysis. Results: Twenty-four orbits were assessed. Mean orbital volume (SD) was 24.02 (2,43) cm 3 for reader 1 and 24.08 (2,51) cm 3 for reader 2. The intraclass correlation coefficient (95% CI) was 0.95 (0.91e0.98) between readers and 0.96 (0.91e0.98) for intra-reader variability. Normal and reconstructed orbits assessed separately also showed very high correlation coefficient for both intra-and inter-subject variability. Conclusion:Results show an almost perfect agreement of volume assessment between readers. The presence of reconstruction material does not seem to add variability. Although reproducible and reliable, radiological volume assessments have not yet shown a clear correlation with clinical outcomes and postoperative management decisions should be based mainly on clinical findings.

Maxillofacial trauma can occur with high frequency while playing sports. Skeletal and soft tissue lesions can occur, with different degrees of severity and impact for the athlete.Sports-related facial fractures most frequently affect the nose, zygoma and mandible, regardless of the country and sport. During initial evaluation it is important to distinguish between stable injuries that can be treated on the sidelines or after the match and emergencies requiring prompt hospital transfer.Athletes could benefit from a more personalized approach to treatment, aimed at optimizing the timeframe for return to play. There is a lack of evidence-based studies on return to play after facial trauma, and currently no specific guidelines exist. Return to sport depends on a variety of factors, such as type of fracture, the risk of impact within the sport, the player’s motivation for an early return and the surgeon’s knowledge and experience.

Metástasis mandibular como primera presentación de adenocarcinoma de pulmón -a propósito de un caso. / Jaw metastasis as first presentation of lung adenocarcinomaa case report

Due to COVID-19 pandemic, social distancing policies were enacted worldwide, including by the Portuguese official authorities. However, the impact of these measures on maxillofacial trauma and fracture surgical repair remains poorly understood. The aim of this study was to evaluate and compare the incidence and aetiology of facial fractures submitted to surgical repair during 1-year of COVID-19 pandemic versus the previous 4 years, in a level III Trauma Centre located in Lisbon, Portugal. Materials and methods: All emergency episodes registered in our hospital between March 2016 and February 2021 that resulted in patient admittance for surgical treatment of facial fracture were included. Comparative analysis was performed for variables such as fracture type and aetiology.Results: Analysis showed that surgeries performed during the 1 st year of COVID-19 were reduced by 37.5 %. Considering only the 75-day lockdown period at the beginning of the pandemic, reduction was even more pronounced and reached -66.7 %. Significant diffe rences in the aetiology were also found, with physical assault and sport accidents relative frequency decreasing. Moreover, despite being systematically the second most common cause of fracture, during lockdown, fall ranked first, over physical assault. The relative frequency of nasal fractures, the most common facial fracture treated in our hospital, decreased during both the 1 st year of COVID-19 and the lockdown period, while mandible fractures ranked first during lockdown. Conclusions:Our study shows that COVID-19 pandemic and enacted policies have significantly changed the epidemiology of maxillofacial trauma.

Introduction The COVID-19 pandemic has forced Portuguese healthcare institutions to adapt management protocols and prioritize resources. These adjustments had a significant impact, affecting both clinical care and also training programs. The aim of this study was to access the maxillofacial surgery resident’s perspective on the pandemic’s impact on specialty training. Methods We designed a nationwide questionnaire to evaluate surgical activity of maxillofacial surgery residents, the impact on surgical training and the perceived effect on their future. Results We collected results of all maxillofacial surgery residents currently in training. Three out of 32 reported a decline in surgical activity of 90-100%, 11 stated a reduction of 75%, 12 expressed a decrease of 50% and 6 described a decline of 25%. Discussion The majority of residents stated the need to consider an extension of training time. Alternative training tools such as virtual activities and simulation training should be considered as formal complements to residency programs. Conclusion We found a significant decrease in surgical activity among all trainees coupled with a unanimous concern regarding their training progression.