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Headguard use is appropriate during some combat sports activities where the risks of injury to the face and ears are elevated. Headguards are highly effective in reducing the incidence of facial lacerations in studies of amateur boxers and are just as effective in other striking sports. They should be used in scenarios – especially sparring prior to competitions – where avoidance of laceration and subsequent exposure to potential blood-borne pathogens is important. Headguards are appropriate where avoidance of auricular injury is deemed important; limited data show a marked reduction in incidence of auricular injury in wrestlers wearing headguards. Headguards should not be relied upon to reduce the risk of concussion or other traumatic brain injury. They have not been shown to prevent these types of injuries in combat sports or other sports, and human studies on the effect of headguards on concussive injury are lacking. While biomechanical studies suggest they reduce linear and rotational acceleration of the cranium, changes in athlete behavior to more risk-taking when wearing headguards may offset any risk reduction. In the absence of high-quality studies on headguard use, the Association of Ringside Physicians recommends that further research be conducted to clarify the role of headguards in all combat sports, at all ages of participation. Furthermore, in the absence of data on gender differences, policies should be standardized for men and women. [ABSTRACT FROM AUTHOR]

The periosteum plays a critical role in bone repair and is significantly influenced by the surrounding immune microenvironment. In this study, we employed 10× single-cell RNA sequencing to create a detailed cellular atlas of the swine cranial periosteum, highlighting the cellular dynamics and interactions essential for cranial bone injury repair. We noted that such injuries lead to an increase in M2 macrophages, which are key in modulating the periosteum's immune response and driving the bone regeneration process. These macrophages actively recruit periosteal stromal cells (PSCs) by secreting Neuregulin 1 (NRG1), a crucial factor in initiating bone regeneration. This recruitment process emphasizes the critical role of PSCs in effective bone repair, positioning them as primary targets for therapeutic interventions. Our results indicate that enhancing the interaction between M2 macrophages and PSCs could significantly improve the outcomes of treatments aimed at cranial bone repair and regeneration. [ABSTRACT FROM AUTHOR]

The periosteum plays a critical role in bone repair and is significantly influenced by the surrounding immune microenvironment. In this study, we employed 10× single-cell RNA sequencing to create a detailed cellular atlas of the swine cranial periosteum, highlighting the cellular dynamics and interactions essential for cranial bone injury repair. We noted that such injuries lead to an increase in M2 macrophages, which are key in modulating the periosteum’s immune response and driving the bone regeneration process. These macrophages actively recruit periosteal stromal cells (PSCs) by secreting Neuregulin 1 (NRG1), a crucial factor in initiating bone regeneration. This recruitment process emphasizes the critical role of PSCs in effective bone repair, positioning them as primary targets for therapeutic interventions. Our results indicate that enhancing the interaction between M2 macrophages and PSCs could significantly improve the outcomes of treatments aimed at cranial bone repair and regeneration.

Background: Traumatic brain injury (TBI) is a severe neurosurgical emergency and a significant public health concern. Fishing-speargun TBIs are included in nonmissile injuries and have been implicated in only few cases of TBI in the past 68 years, mainly of accidental etiology., Objective: To introduce a novel case report of a TBI in a 38-year-old man who shot himself with a speargun in a suicide attempt and to present a thorough review of related case reports along with the management strategies, prognosis, and outcomes., Methods: We conducted a literature review of case reports in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including incidents of TBI by speargun published in PubMed, Scopus, and Web of Science until January 2024., Results: A total of 22 publications, reporting 26 cases of speargun-related TBIs, formulated the 27 investigated cases including the current patient which were used in this descriptive and inferential statistical analysis. Predominantly affecting males (88.89%) with a median age of 29 years, these injuries were primarily due to accidents (65.38%), with a noticeable shift toward suicide. Outcome variability ranged from intact recovery (48.15%) in majority of cases to a range of unfavorable outcomes. Significant factors impacting outcomes included initial Glasgow Coma Scale score <8, major initial computed tomography head findings, and major complications. Survival analysis indicated early manifestation of unfavorable outcomes., Conclusions: In summary, the diverse presentation, management, outcomes, and identified influencing factors highlight the complexity of managing speargun-related injuries, and the need for personalized approaches and further research to enhance care protocols., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Current treatment options for craniofacial volumetric muscle loss (VML) have disadvantages and cannot fully restore normal function. Bio-inspired semisynthetic acrylated hyaluronic acid (AcHyA) hydrogel, which fills irregularly shaped defects, resembles an extracellular matrix, and induces a minimal inflammatory response, has shown promise in experimental studies of extremity VML. We therefore sought to study AcHyA hydrogel in the treatment of craniofacial VML. For this, we used a novel model of masseter VML in the rat. Following the creation of a 5 mm × 5 mm injury to the superficial masseter and administration of AcHyA to the wound, masseters were explanted between 2 and 16 weeks postoperatively and were analyzed for evidence of muscle regeneration including fibrosis, defect size, and fiber cross-sectional area (FCSA). At 8 and 16 weeks, masseters treated with AcHyA showed significantly less fibrosis than nonrepaired controls and a smaller decrease in defect size. The mean FCSA among fibers near the defect was significantly greater among hydrogel-repaired than control masseters at 8 weeks, 12 weeks, and 16 weeks. These results show that the hydrogel mitigates the fibrotic healing response and wound contracture. Our findings also suggest that hydrogel-based treatments have potential use as a treatment for the regeneration of craniofacial VML and demonstrate a system for evaluating subsequent iterations of materials in VML injuries. Impact Statement Craniofacial volumetric muscle loss (VML) is a debilitating condition for which current treatment options are unable to restore normal appearance, or function. Tissue engineering approaches, such as hydrogel implants, may be an effective strategy to fill the volumetric defects and promote de novo muscle regeneration. In this study, we describe a novel rodent model for the study of craniofacial VML and a hyaluronic acid-based hydrogel that can be used as a treatment for the regeneration of craniofacial VML.

Abstract Background Electric bikes (E-bikes) and powered scooters (P-scooters) have become increasingly popular modes of public transportation, but they have been associated with injuries of all kinds, including dental trauma. Helmet use is promoted as a means of reducing injuries in accidents involving motorized and unmotorized vehicles. The aim of the study was to evaluate the impact of helmet use on the number and severity of oral and maxillofacial injuries caused by E-bikes and P-scooters. Methods A retrospective cross-sectional study design was used. The cohort included all patients referred to the emergency department of a tertiary medical center in 2014–2020 with oral and maxillofacial injuries involving E-bikes or P-scooters. Data were collected from the medical files on demographics, types of injuries, circumstances of occurrence, work-up, treatment, and outcome. Use of a helmet was recorded in each case. Results Of the total 1417 patients referred to the emergency department for E-bike and P-scooter-related trauma, 62 had oral and maxillofacial injuries, including 57 riders and 5 pedestrians. All had hard- or soft-tissue injuries; 20 (32.2%) had head injuries and 22 (35.5%) had dentoalveolar injuries. Eleven riders had worn a helmet at the time of injury (17.7%). Helmet use was associated with time of injury (weekday/weekend, daytime/night-time), type of motorized vehicle (E-bike or P-scooter), head injury, and number of bone fractures. Head injuries occurred more often on the weekend (57.9%) than during the week (20.9%) and were more likely to occur in riders who were not protected by a helmet (37.3% vs 18.2%). Patients who used helmets also had a lower rate of fractured bones (18.2%) and dentoalveolar injuries (23.7%) than patients who did not (68.8 and 37.3%, respectively). Interestingly, helmet use had no protective effect on soft-tissue injuries. Conclusions Helmet use by E-bike and P-scooter riders decreased the probability of head injury and of hard tissue and dentoalveolar injuries. These results may provide guidance for effective legislation and regulation of helmet use and improved treatment protocols for general and dental physicians.

Parichat Tanmit, Phati Angkasith, Panu Teeratakulpisarn, Chaiyut Thanapaisal, Palakorn Surakunprapha, Amnat Kitkuandee, Phumtham Limwattananon Department of Surgery, Faculty of Medicine, Khonkaen University, Khon Kaen, ThailandCorrespondence: Parichat TanmitDepartment of Surgery, Khonkaen University, 123 Moo16 Mittraphap Road, Nai-Muang, Muang District, Khon Kaen, 40002, ThailandTel +66850001714Email pari.tanmit@gmail.comIntroduction: Craniofacial trauma may potentially have significant blood loss which may lead to death in some trauma patients.Case Report: We report a case of a 43-year-old male who had a lethal noncompressible arterial hemorrhage from a penetrating wound on his left frontotemporal and preauricular region. Extensive bleeding was successfully temporarily controlled by external carotid artery (ECA) occlusion. The definitive operation was completed in a staged fashion following a computed tomography angiography assessment extension of the injury.Conclusion: Temporarily controlling the bleeding from the carotid artery should be considered as a life saving procedure in a lethal craniofacial injury.Keywords: craniofacial injury, external carotid artery ligation, temporary external carotid artery control, maxillary artery bleeding

Frontal sinus fractures account for 5 to 15% of craniofacial trauma. Road traffic accidents account for most of the cases. Combined injury of the anterior and posterior table with nasofrontal outflow tract contributes to 67% of craniofacial trauma. We here present an interesting case of a 33-year-old male patient with a traumatic left frontal sinus fracture with a unique presentation of a cutaneous--frontonasal fistula. Treatment algorithms for the management of frontal sinus fractures have been proposed in the past but they should be tailored to the need of the individual patient. Obliteration of the frontonasal outflow tract should be advocated in these cases as they minimize complications. [ABSTRACT FROM AUTHOR]

Background: Electric bikes (E-bikes) and powered scooters (P-scooters) have become increasingly popular modes of public transportation, but they have been associated with injuries of all kinds, including dental trauma. Helmet use is promoted as a means of reducing injuries in accidents involving motorized and unmotorized vehicles. The aim of the study was to evaluate the impact of helmet use on the number and severity of oral and maxillofacial injuries caused by E-bikes and P-scooters. Methods: A retrospective cross-sectional study design was used. The cohort included all patients referred to the emergency department of a tertiary medical center in 2014–2020 with oral and maxillofacial injuries involving E-bikes or P-scooters. Data were collected from the medical files on demographics, types of injuries, circumstances of occurrence, work-up, treatment, and outcome. Use of a helmet was recorded in each case. Results: Of the total 1417 patients referred to the emergency department for E-bike and P-scooter-related trauma, 62 had oral and maxillofacial injuries, including 57 riders and 5 pedestrians. All had hard- or soft-tissue injuries; 20 (32.2%) had head injuries and 22 (35.5%) had dentoalveolar injuries. Eleven riders had worn a helmet at the time of injury (17.7%). Helmet use was associated with time of injury (weekday/weekend, daytime/night-time), type of motorized vehicle (E-bike or P-scooter), head injury, and number of bone fractures. Head injuries occurred more often on the weekend (57.9%) than during the week (20.9%) and were more likely to occur in riders who were not protected by a helmet (37.3% vs 18.2%). Patients who used helmets also had a lower rate of fractured bones (18.2%) and dentoalveolar injuries (23.7%) than patients who did not (68.8 and 37.3%, respectively). Interestingly, helmet use had no protective effect on soft-tissue injuries. Conclusions: Helmet use by E-bike and P-scooter riders decreased the probability of head injury and of hard tissue and dentoalveolar injuries. These results may provide guidance for effective legislation and regulation of helmet use and improved treatment protocols for general and dental physicians. [ABSTRACT FROM AUTHOR]

Introduction: The most common mechanism of post-traumatic facial nerve palsy are road accidents and falls. Treatment schemes as well as proper timing of surgery are still controversial. Aim: The aim of the study was the evaluation of the effects of surgical treatment in patients with post-traumatic facial nerve palsy. Treatment results were correlated with epidemiological factors, mechanism of injury, level of nerve damage, time of surgery and its extent. Material and methods: 9 patients with facial nerve palsy after head trauma were analyzed. In all patients complete paresis of the VII nerve occurred immediately after the injury. In 5 patients the nerve was damaged in the course of the longitudinal fracture of the temporal bone, in 3 as a result of its transverse fracture while in one woman there was no evident fracture line. In all cases, surgical treatment was performed between 4 days and 13 weeks after the trauma. In all cases transmastoid approach was used. Edema lesions of the nerve dominated in 6 patients, in two cases a bone fragment was noted along its course, in one person nerve was disrupted but primary reconstruction was not possible - the man was excluded from further analysis. The results of treatment were assessed by House-Brackmann (HB) scale 12 months after the procedure. Results: Very good (HBI) or good (HBII) recovery of facial nerve function was achieved in 2 and 4 out of 8 patients respectively. Surgical timing, the extent of surgery, patient's age, mechanism of injury and level of nerve damage had no effect on the final outcome. Conclusions: The management of post-traumatic facial nerve palsy should be individual. The commonly accepted recommendation on surgical treatment is to undertake it in patients with immediate-onset and complete paralysis. Patients who, due to their severe general condition, cannot undergo early facial nerve decompression may benefit from delayed treatment for up to 3 months after the injury. [ABSTRACT FROM AUTHOR]

Penetrating craniofacial trauma can lead to massive injury to the facial tissue and craniofacial skeleton with retained bone as well as foreign body. We present a case of 45-year-old man who sustained massive penetrating craniofacial injuries due to polyvinyl chloride (PVC) pipe. CT scan with bone window of the brain and craniofacial region showed in driven fragment of PVC pipe into the nasal cavity with multiple fractures and soft tissue swelling. CT brain showed compound and comminuted depressed fracture of the right frontal bone with underlying contusion of the brain and specks of pneumocephalus. However, detailed examination of the CT scan showed that there was no breach in the anterior cranial fossa and that both the injuries were caused by separate pipe fragments. The wound was debrided; all loose bone fragments, necrotic brain matter, and broken pipe fragments were removed. The patient recovered well after surgical procedure. The approach is aimed to protect the airway, maintain vital parameters followed by remove all the foreign body and necrotic tissue, and restore the functioning and aesthetics. A careful evaluation of the CT scan is mandatory to rule out breach in the skull base, and if the skull base is intact, a limited craniotomy will save the time and associated morbidity.

Beveling of the calvarial bone is reported in firearm exit wounds and stabbing injuries in forensic literature. Beveling in entry wounds is rare. We report a case of a 27-yearold man who sustained a nonfatal penetrating craniofacial injury due to motorbike brake handle, and completely recovered after conservative management. We describe the characteristic inward as well outward beveling on imaging due the penetrating trajectory of the motorbike break handle. [ABSTRACT FROM AUTHOR]

Penetrating craniofacial trauma can lead to massive injury to the facial tissue and craniofacial skeleton with retained bone as well as foreign body. We present a case of 45-year-old man who sustained massive penetrating craniofacial injuries due to polyvinyl chloride (PVC) pipe. CT scan with bone window of the brain and craniofacial region showed in driven fragment of PVC pipe into the nasal cavity with multiple fractures and soft tissue swelling. CT brain showed compound and comminuted depressed fracture of the right frontal bone with underlying contusion of the brain and specks of pneumocephalus. However, detailed examination of the CT scan showed that there was no breach in the anterior cranial fossa and that both the injuries were caused by separate pipe fragments. The wound was debrided; all loose bone fragments, necrotic brain matter, and broken pipe fragments were removed. The patient recovered well after surgical procedure. The approach is aimed to protect the airway, maintain vital parameters followed by remove all the foreign body and necrotic tissue, and restore the functioning and aesthetics. A careful evaluation of the CT scan is mandatory to rule out breach in the skull base, and if the skull base is intact, a limited craniotomy will save the time and associated morbidity. [ABSTRACT FROM AUTHOR]

In developing countries, during the harvest season, winnower blade injuries occur very frequently in children and results in lifelong disability. Nine children were managed during 1 month, all resulting due to winnower blade induced craniofacial trauma. PubMed search for "fan blade injury" showed two case series and three case reports. In our study, 88% had compound depressed fracture; brain matter leak in 56%, cerebrospinal fluid (CSF) leak alone in 22%. 66.7% had injury involving the frontal bone. Two patients had eye injury with visual loss. Seven underwent debridement craniectomy, five augmentation duroplasty and three contusectomy. All had vegetable material, sand particles. Complications in 66.6% with two cases of CSF leak settled with lumbar drain, one case of CSF otorrohea, 22.2% of wound infection, 44.4% wound dehiscence requiring redebridement and suturing in five patients. Two patients had postoperative seizures, two patients had hemiparesis both improved. Two low Glasgow Coma Scale remained so on postoperative period. One case of subdural empyema needed debridement and duroplasty with glue. No mortality noted. These findings were consistent with previous reports. Follow-up at 1.5 months showed good functional recovery. Early surgery debridement, steps to minimize postoperative infections, identifying putative risk factors early in the management are the principles of a successful treatment regimen. [ABSTRACT FROM AUTHOR]

Introducción: los accidentes de tránsito emergen como un factor de muerte que requiere ser reducido y evitado. Objetivo: describir la epidemiología de la mortalidad por accidentes de tránsito. Métodos: se realizó un estudio descriptivo y retrospectivo, de corte transversal, que incluyó a los pacientes fallecidos por accidentes de tránsito en la provincia Granma, en el período 2005-2011. Resultados: se observó una disminución progresiva de la mortalidad por esta causa, con una media anual de 59,8 defunciones. Predominaron los fallecidos del sexo masculino, con edades comprendidas entre 25 y 44 años, para una razón promedio hombre/mujer de 3,5. Como indicadores de mortalidad, las tasas brutas ajustadas a la población y de años de vida potencialmente perdidos descendieron con el paso de los años, pero permanecen altas. Conclusiones: las muertes por accidentes de tránsito en la citada provincia se produjeron predominantemente en hombres jóvenes, aún con altos indicadores de mortalidad.Introduction: traffic accidents emerge as a death factor that requires to be reduced and prevented. Objective: to describe the epidemiology of traffic accident mortality. Methods: a descriptive, retrospective and cross-sectional study, which included patients dead by traffic accidents in Granma province in the period 2005 - 2011, was carried out. Results: there was a progressive decrease in mortality from this cause, with an annual average of 59.8 deaths. Dead males aged between 25 and 44 years predominated, for an average male/female ratio of 3.5. As indicators of mortality, the gross rates adjusted to the population and those of potentially lost years of life decreased over the years, but remain high. Conclusions: deaths from traffic accidents in that province occurred predominantly in young men, even with high mortality indicators.

Penetrating craniofacial injuries caused by stick-like foreign bodies occur as a result of accidents particularly in children, and often lead to significant morbidity. We describe a 5-year-old boy who sustained facial trauma after falling on a wooden stick which penetrated his left cheek. At the initial visit, his vital and neurological signs were normal. However, the stick had penetrated the frontal lobe to a depth of 3 cm via the orbital cavity and the anterior skull base. The stick was successfully removed while visualizing the anterior skull base in an endoscopic transethmoidal approach. A follow-up examination one year after the accident demonstrated normal visual acuity and ocular motility, with no diplopia, tearing or pain. Penetrating facial injuries caused by stick-like objects carry a significantly higher risk of serious neurological involvement. Even if penetrating facial injuries sometimes appear trivial, the external injury site is often insufficient to determine the position of the object within the head. Although the cheek is a rare entry site for intracranial injuries, the extent of damage should be assessed fully before attempting removal. [ABSTRACT FROM AUTHOR]

We describe significant brain, craniofacial, and dental lesions in a free-ranging wolf ( Canis lupus) involved in a human attack. On postmortem examination, the wolf presented asymmetric atrophy and bone remodeling affecting the mandible, incisive, maxilla, lacrimal, palatine, frontal, and ethmoid bones. There was an asymmetrical skeletal malocclusion and dental abnormalities including rotated, malpositioned, partially erupted teeth, and an odontogenic cyst associated with an unerupted canine tooth. Brain changes were bilateral loss and atrophy of extensive cortex regions including olfactory bulb, peduncles, and tract, and the frontal lobe. We highlight the relevance of a thorough postmortem examination of wildlife to elucidate disease-based abnormal behavior as the reason for human-animal conflict. [ABSTRACT FROM AUTHOR]

Objectives. The purpose of this prospective study was to identify selection criteria for immediate single-stage reconstruction in patients with severe complex craniofacial trauma to improve their functional outcome and reduce complications. Patients and methods. In this series, 24 new patients (16 men and 8 women) were added to our previous group (26 patients) with an age range from 10 to 55 years with mean of 26 years and Glasgow Coma Scale scores of 5-13; all patients had a combined single-stage repair of their complex craniofacial injuries within 6 h of their admission. We added some modifications to our standard technique using three-dimensional computed tomography, intracranial pressure monitoring, and support of dural repair/graft using dural patch and glue. The esthetic facial outcome was evaluated by an independent plastic assessor based on objective scale criteria. This series was carried out in Prince Salman Military Hospital between November 2010 and September 2013. Results. Early neurosurgical outcome was considered good in 22/24 patients (92%), moderate in one patient (4%), and poor in the last one (4%). At late evaluation, 20 cases (83%) regained their consciousness without any cognitive deficit. One patient (4%) remained in neurovegetative status. Early esthetic outcome was considered to be excellent in 18/24 patients (75%), good in 3 patients (12.5%), deemed fair in 2 patients (8%), and labeled poor in only 1 patient (4%). At late evaluation, the patient labeled fair had improved to good with topical scar management and the patient deemed poor had improved to fair with two successive plastic procedures. Complications included a cerebrospinal fluid leak in 2 patients (8%), one was managed conservatively and the second was treated surgically with intra- and extradural grafting. Conclusion. In complex frontofaciobasal injuries, successful facial repair depends on immediate and definitive reconstruction. However, improved neurological outcomes in these patients depend on judicious selection of the appropriate candidates from severely head-injured patients. [ABSTRACT FROM AUTHOR]

Introduction: traffic accidents emerge as a death factor that requires to be reduced and prevented. Objective: to describe the epidemiology of traffic accident mortality. Methods: a descriptive, retrospective and cross-sectional study, which included patients dead by traffic accidents in Granma province in the period 2005 - 2011, was carried out. Results: there was a progressive decrease in mortality from this cause, with an annual average of 59.8 deaths. Dead males aged between 25 and 44 years predominated, for an average male/female ratio of 3.5. As indicators of mortality, the gross rates adjusted to the population and those of potentially lost years of life decreased over the years, but remain high. Conclusions: deaths from traffic accidents in that province occurred predominantly in young men, even with high mortality indicators. [ABSTRACT FROM AUTHOR]

Objective. To characterize craniofacial injuries due to golf cart trauma.Study Design. Case series with chart review.Setting. Level 1 trauma center.Subjects and Methods. A tertiary academic medical center’s trauma database was queried for golf cart–related trauma from 2000 to 2009 and returned 68 patients. Data were obtained from the trauma database and by individually reviewing patient charts.Results. Of the 68 patients identified, 55% were male, with a median age of 13.4 years. Sixty-nine percent had head injuries, with 32% sustaining skull or facial fracture and 20.6% intracranial hemorrhage. The highest Abbreviated Injury Scale (AIS) by region was the head and neck. The average Glasgow Coma Scale score was 14.2, Injury Severity Score (ISS) 9.0, hospital stay 4.5 days, and intensive care unit (ICU) stay 2.8 days; 36.8% were admitted to the ICU. Ejection and rollover were the most common mechanisms of injury, with ejection having a significantly higher head and neck AIS compared with rollover and hitting a stationary object (P = .0055). Alcohol was detected in 59.2% of patients older than 16 years; the average blood alcohol concentration was 182.6 mg/dL. Children were involved 60.3% of the time, with an average age of 9.2 years, and children were passengers in the golf cart 69.2% of the time.Conclusions. Golf cart trauma can cause significant craniofacial injuries, particularly in the pediatric population and in adults who consume alcohol. [ABSTRACT FROM PUBLISHER]

Penetrating craniofacial trauma, although uncommon, has a high potential for death or serious morbidity from injury to vital neurovascular structures. An in situ facial foreign body, particularly if large, presents significant challenges beyond safe and timely removal. Airway management, stabilization of the object, management of increased intracranial pressure, and identification of injuries to local structures are all issues that may require addressing. We present a case of penetrating facial trauma from a vice clamp, with an in situ foreign body, that illustrates several of these challenges and provides a forum for their discussion. [ABSTRACT FROM AUTHOR]

Interpersonal aggression is assessed paleoepidemiologically in a large skeletal population from the CA-ALA-329 site located on the southeastern side of San Francisco Bay, California. This comprehensive analysis included all currently recognized skeletal criteria, including craniofacial fracture, projectile injury, forearm fracture, and perimortem bone modification. Craniofacial injury is moderately common, showing an adult prevalence of 9.0% with facial lesions accounting for >50% of involvement. Clinical studies suggest that such separate evaluation of facial involvement provides a useful perspective for understanding patterns of inter-personal aggression. In this group male facial involvement is significantly greater than in females, paralleling the pattern found widely in contemporary populations as well as in African apes. When compared to other North American skeletal samples the prevalence of adult cranial vault injury (3.3%) and especially projectile injury (4.4%) are quite high. However, well documented populations from southern California show markedly higher prevalence for both types of skeletal markers of aggression. Forearm fracture is also assessed using a rigorous radiographic methodology and results suggest that these injuries are not reliable indicators of interpersonal aggression. Lastly, perimortem bone modification was not observed in this population, although it has been recorded from other (older) sites nearby. This study provides an evaluation of multiple skeletal markers of inter-personal aggression in the largest sample from a single site yet reported in North America and, joined with consideration of cultural context, helps further illuminate both geographic and temporal patterns of interpersonal aggression in California. [ABSTRACT FROM AUTHOR]

Introduction: The most common mechanism of post-traumatic facial nerve palsy are road accidents and falls. Treatment schemes as well as proper timing of surgery are still controversial. &lt;br/&gt;&lt;br/&gt;Aim: The aim of the study was the evaluation of the effects of surgical treatment in patients with post-traumatic facial nerve palsy. Treatment results were correlated with epidemiological factors, mechanism of injury, level of nerve damage, time of surgery and its extent. &lt;br/&gt;&lt;br/&gt;Material and methods: 9 patients with facial nerve palsy after head trauma were analyzed. In all patients complete paresis of the VII nerve occurred immediately after the injury. In 5 patients the nerve was damaged in the course of the longitudinal fracture of the temporal bone, in 3 as a result of its transverse fracture while in one woman there was no evident fracture line. In all cases, surgical treatment was performed between 4 days and 13 weeks after the trauma. In all cases transmastoid approach was used. Edema lesions of the nerve dominated in 6 patients, in two cases a bone fragment was noted along its course, in one person nerve was disrupted but primary reconstruction was not possible - the man was excluded from further analysis. The results of treatment were assessed by House-Brackmann (HB) scale 12 months after the procedure. &lt;br/&gt;&lt;br/&gt;Results: Very good (HBI) or good (HBII) recovery of facial nerve function was achieved in 2 and 4 out of 8 patients respectively. Surgical timing, the extent of surgery, patient's age, mechanism of injury and level of nerve damage had no effect on the final outcome. &lt;br/&gt;&lt;br/&gt;Conclusions: The management of post-traumatic facial nerve palsy should be individual. The commonly accepted recommendation on surgical treatment is to undertake it in patients with immediate-onset and complete paralysis. Patients who, due to their severe general condition, cannot undergo early facial nerve decompression may benefit from delayed treatment for up to 3 months after the injury.