Facial Fractures

Ghosh, Rajarshi; Gopalkrishnan, K.

doi:10.1097/scs.0000000000004269

Cited by 34 publications

(34 citation statements)

References 20 publications

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“…Основними хірургічними методами лікування переломів щелеп є кістковий шов, остеосинтез з використанням спиці Кіршнера, остеосинтез з використанням накісткових конструкцій у вигляді мініпластин та міні-cіток, переважно з титану [30,31], а також репозиція відламків без фіксації, репозиція з тампонадою верхньощелепної пазухи йодоформним тампоном, з використанням катетеру Фолея [32,33].…”

Section: обговорення результатів дослідженняunclassified

Support System of Doctor’s Decision-Making on the Choice of a Method for Treating Fractures of the Midface Area

Kochina¹,

Firsov²

2021

Ukr. ž. med. bìol. sportu

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The purpose of the study is to develop a support system of doctor’s decision-making on the choice of a method for treating fractures of the midface are. Materials and methods. The study includes the results of examination and treatment of 112 patients with fractures of the midface area, who were undergoing inpatient treatment in the Department of Head and Neck Surgery of the Municipal Noncommercial Enterprise of Kharkiv Regional Council «Regional Clinical Hospital», Kharkiv. All patients at hospitalization underwent examination according to the local protocol. The diagnosis was based on the results of cone-beam computed tomography, or multislice computed tomography. To determine the initial condition, as well as to assess the functional and cosmetic effects in the treatment process (1st, 3rd, 5th and 7th days) a visual analogue scale was used, at hospitalization we also used a visual analogue scale modified by us, which contains a point evaluation of the patient's condition for 12 signs of trauma. The Scilab computer algebra system was used to develop models for predicting the results of treatment of the midface area fractures using various methods, and a graphical application for the Windows operating system was developed for the practical use of the support system of doctor’s decision-making, in which the Sugeno fuzzy inference machine was integrated into the developed models Results and discussion. To predict the displacement of bone fragments that will remain after the surgery, the following indicators and signs were used: the nature of the fracture, the presence of paraesthesia in the infraorbital area, the presence of hemosinus; method of treatment; indicator by the modified visual analogue scale. To predict the indicator on a visual analogue scale a day after the surgery, the following indicators and signs were used: the nature of the fracture, the presence of paraesthesia in the infraorbital area, the presence of hemosinus; method of treatment, the number of plates in the case of metal osteosynthesis, the indicator by a visual analogue scale before surgery. To predict indicators by a visual analogue scale in the subsequent terms, the values of indicators by this scale in the previous terms are added to the input indicators of the model. Conclusion. As a result of the research it was found that the following can be used as the functional and cosmetic results of treatment of the midface area fracture in the development of predicting models: the amount of displacement of bone fragments, which was determined by computed tomography after surgery, and the values of indicators by a visual analogue scale after a day, 3, 5 and 7 days after surgery. The developed models for predicting functional and cosmetic results of treatment as a result of testing using indicators of 112 patients with fractures of the midface area showed an overall accuracy of 91.6%, sensitivity – 95%, specificity –96.4%.

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Section: обговорення результатів дослідженняunclassified

Support System of Doctor’s Decision-Making on the Choice of a Method for Treating Fractures of the Midface Area

Kochina¹,

Firsov²

2021

Ukr. ž. med. bìol. sportu

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“…Facial fractures are common after maxillofacial trauma in addition to soft tissue injury and pattern may vary based on mechanism. 14,15 These injuries can be categorized into 3 groups depending on the bone(s) involved: upper face (involving fronto-zygomatic processes, sinuses, or frontal bone fractures), middle face (involving zygomatic arch, nasal bone, orbital floor, naso-orbital-ethmoid, or maxillary fractures), and lower face (involving mandibular fractures). Retro-displaced midface fractures may obstruct the nasopharyngeal airway, mandibular fractures may release anterior attachments of the tongue base leading to prolapse and airway obstruction, and fracture of the hyoid or laryngeal cartilage may directly obstruct the airway and present a risk for further damage if intubation is attempted.…”

Section: Introductionmentioning

confidence: 99%

Securing the Airway in Maxillofacial Trauma Patients: A Systematic Review of Techniques

Patel

Saadi

Lighthall

2020

Craniomaxillofacial Trauma & Reconstruction

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Study Design: The present study is a systematic review of the literature. Objective: The goal of this study is to review our experience and the current literature on airway management techniques in maxillofacial trauma. Methods: Independent searches of the PubMed and MEDLINE databases were performed from January 1, 2019 to February 1, 2019. Articles from the period of 2008 to 2018 were collected. All studies which described both airway management and maxillofacial trauma using the Boolean method and relevant search term combinations, including “maxillofacial,” “trauma,” and “airway,” were considered. Results: A total of 452 relevant articles in total were identified. Articles meeting inclusion criteria by abstract review included 68 total articles, of which 16 articles were focused on airway management techniques for maxillofacial trauma in the general population and were deemed appropriate for inclusion in the literature review. Conclusions: Establishing an effective and stable airway in patients with maxillofacial trauma is of paramount concern. In both the acute setting and during delayed reconstruction, special considerations must be taken when securing a reliable airway in this patient population. The present article provides techniques for securing the airway and algorithms for utilization of these techniques, including both during the initial evaluation and the definitive operative management.

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“…In less economically advanced countries, interpersonal violence like ghts, assaults, and gunshots are frequent reasons for midface fractures. (4) The presence of a bilateral midface fracture is associated with high-velocity trauma, caused by, e.g., road tra c accidents, jumps in suicidal intent, or work-related accidents. (5) In most cases, the structure, function, and the appearance of the midface, including the globe, are altered by the midfacial fractures.…”

Section: Introductionmentioning

confidence: 99%

“…(4, 6, 7) Restoration of the function and form of the face by respecting the original facial width, facial height, and facial projection aims at preventing long-term complications and enabling the patient's re-integration into everyday life. (4,8,9) Helpful tools for the precise restauration of midface fractures are up-to-date preoperative imaging modalities, like magnetic resonance imaging (MRI) or computed tomography (CT), and intraoperative tools, like imaging (cone beam CT (CBCT)) and navigation by using computer-assisted surgery (CAS) for complex trauma, oncologic resections, and reconstructions and congenital deformity cases. (10) For unilateral fractures, CAS is well established.…”

Section: Introductionmentioning

confidence: 99%

The Statistical shape model as a quality assurance measure in the treatment of complex midface fractures: A Case control study

Fuessinger

Steffen

Gass

et al. 2020

Preprint

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BackgroundComplex bilateral midface fractures necessitate a surgically challenging procedure to preserve or restore the occlusion and the sensitive eye area. In this case control study, we aim to show the potential of a statistical shape model (SSM) for measuring the quality of the midface reconstruction, compared to the estimated preoperative situation.MethodsAn individualized SSM was postoperatively registered on 19 reconstructed complex bilateral midface fractures. Using this SSM, the distances from the simulated preoperative situation to the postoperative positions of the fracture segments were calculated. The fracture lines for Le Fort II, Le Fort III, and NOE fractures were chosen as reference points for the distance measurements.ResultsThe SSM could be registered on all 19 complex bilateral midface fractures. All analyzed fractures show a dorsal impaction (negative values) of the midface. Le Fort II fractures show deviation values of − 0.98 ± 4.6 mm, Le Fort III fractures show values of − 3.68 ± 3.6 mm, NOE type 2 fractures show values of − 0.25 ± 4.6 mm, and NOE type 1 fractures show values of − 0.25 ± 4.6 mm.ConclusionThe SSM can be used to measure the quality of the achieved reduction of complex bilateral midface fractures based on the estimated preoperative situation.Trial registrationDRKS00009719

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Facial Fractures

Abstract: This study was performed to compare the different etiologic factors leading to diverse facial fracture patterns. By statistical analysis of this record the authors come to know about the relationship of facial fractures with gender, age, associated comorbidities, etc.

Cited by 34 publications

References 20 publications

Support System of Doctor’s Decision-Making on the Choice of a Method for Treating Fractures of the Midface Area

Support System of Doctor’s Decision-Making on the Choice of a Method for Treating Fractures of the Midface Area

Securing the Airway in Maxillofacial Trauma Patients: A Systematic Review of Techniques

The Statistical shape model as a quality assurance measure in the treatment of complex midface fractures: A Case control study

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