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Facial or maxillofacial trauma occurs as a consequence of physical injury to the face and can include damage to soft tissue and bony structures either in isolation or combination. There is a male predominance with highest incidence in the age group of 20–40 years. The range of injuries include soft tissue damage, bruising, lacerations, burns and fractures of the underlying facial skeleton including the zygomatic complex, mandible, maxilla, orbit and nasoethmoidal complex. The concentration of special senses in the head and neck region means that even seemingly minor injuries can have a significant impact upon the long-term outcome for a patient. Careful assessment of an injured patient must include a full ATLS evaluation to ensure that associated potentially life-threatening injuries are not missed. This article describes the signs, symptoms and treatment of maxillofacial trauma, including management of hard and soft tissue trauma. [ABSTRACT FROM AUTHOR]

Introduction: The consumption of alcoholic beverages reduces the body's ability to deal with dangerous situations and exposes people to trauma. Objective: To determine the association between the consumption of alcoholic beverages and the characteristics of maxillofacial fractures treated at a Cuban university hospital in the context of COVID-19. Material and Methods: An observational, analytical, and cross-sectional study was carried out in the Maxillofacial Surgery unit at the “Carlos Manuel de Céspedes” General University Hospital during the year 2020. Prevalence ratios, 95% confidence intervals and p-values were obtained using generalized linear models. Results: In 58.23% of the cases, fractures were related to the consumption of alcoholic beverages. The fundamental etiology was interpersonal violence (47.75%), regardless of the consumption of alcoholic beverages. There was a prevalence of patients with nasal fractures (n=98; 55.06%), among which, 35.71% had consumed alcoholic beverages at the time of the trauma. Being male (p=0.005), the lack of university studies (p=0.007), the need for surgical treatment (p

BACKGROUND: To evaluate the diagnostic accuracy of clinical signs combined with the tongue blade test (TBT) to detect maxillary and mandibular fractures. METHODS: A cross-sectional study enrolled patients with maxillary and mandibular injuries in the emergency department. Physical examination and the TBT were performed, followed by radiological imaging (facial X-ray or computed tomography [CT]). The diagnostic accuracy was calculated for individuals and a combination of clinical findings at predicting maxillary and mandibular fractures. RESULTS: A total of 98 patients were identified, of whom 31.6% had maxillary fractures and 9.2% had mandibular fractures. The combination of malocclusion, tenderness on palpation and swelling with positive TBT had 100% specificity to detect maxillary and mandibular fractures. In the absence of malocclusion, the combination of tenderness on palpation and swelling with positive TBT produced a specificity of 97.8% for maxillary fracture and a specificity of 96.2% for mandibular fracture. A clinical decision tool consisting of malocclusion, tenderness on palpation, swelling and TBT revealed a specificity of 100% and a positive predictive value of 100%. CONCLUSION: The clinical decision tool is potentially useful to rule out mandibular fractures, thus preventing unnecessary radiation exposure. [ABSTRACT FROM AUTHOR]

Objective: To present the profile of hospitalizations due to transport accidents in individuals aged 0-19 years in a reference hospital for urgent and emergency traumatology care. Material and Methods: This retrospective study is grounded on analyzing medical records of children and adolescents hospitalized due to transport accidents in 2016 and 2017. The bivariate analyses included Chi-square and Fischer’s exact tests and binary logistic regression, with a 5% significance level. Results: Four hundred and seventy-five (43.7%) of the 1,088 medical records investigated corresponded to transport accidents, and accidents involving motorcycles were the most frequent (68.3%), affecting adolescents (81.3%), while children were more involved in accidents as pedestrians (57.1%). Advancing age increases the likelihood of the outcome, with a significant association in the multivariate analysis (p

Objective: To present the profile of hospitalizations due to transport accidents in individuals aged 0-19 years in a reference hospital for urgent and emergency traumatology care. Material and Methods: This retrospective study is grounded on analyzing medical records of children and adolescents hospitalized due to transport accidents in 2016 and 2017. The bivariate analyses included Chi-square and Fischer’s exact tests and binary logistic regression, with a 5% significance level. Results: Four hundred and seventy-five (43.7%) of the 1,088 medical records investigated corresponded to transport accidents, and accidents involving motorcycles were the most frequent (68.3%), affecting adolescents (81.3%), while children were more involved in accidents as pedestrians (57.1%). Advancing age increases the likelihood of the outcome, with a significant association in the multivariate analysis (p<0.001). The mandible was most frequently affected in maxillofacial fractures. Conclusion: Transport accidents predominantly affect male adolescents, involving motorcycles, and the lower limbs are the most affected. The mandible was the most affected bone in maxillofacial fractures. [ABSTRACT FROM AUTHOR]

Naso-orbito-ethmoidal (NOE) fractures are complicated fractures of the mid-face. The treatment of NOE fractures is challenging and a comprehensive treatment strategy is required. We introduce a case of NOE fracture treated with open reduction and suspension sutures. A 28-year-old woman presented with a unilateral NOE fracture. To reduce the frontal process of the maxilla, a suspension suture was made by pulling the fragment using a double arm suture via a transcaruncular incision. The suture thread was placed in the horizontal plane. Another suspension suture on the inferior orbital rim assisted reduction procedure, and they passed through the overlying skin. The reduction alignment could be finely adjusted by tightening the transcutaneous suture threads while checking the degree of bone alignment through the subciliary incision. The two suture threads were suspended using a thermoplastic nasal splint. An additional skin incision on the medial canthal area, which would have resulted in a scar, could be avoided. Four months postoperatively, computed tomography showed an accurate and stable reduction. The patient was satisfied with her aesthetic appearance, and functional deficits were not present. [ABSTRACT FROM AUTHOR]

Background: To compare the sensory change and recovery of infraorbital area associated with zygomaticomaxillary and orbital floor fractures and their recoveries and investigate the factors that affect them. Methods: We retrospectively reviewed 652 patients diagnosed with zygomaticomaxillary (n= 430) or orbital floor (n= 222) fractures in a single center between January 2016 and January 2021. Patient data, including age, sex, medical history, injury mechanism, Knight and North classification (in zygomaticomaxillary fracture cases), injury indication for surgery (in orbital floor cases), combined injury, sensory change, and recovery period, were reviewed. The chi-square test was used for statistical analysis. Results: Orbital floor fractures occurred more frequently in younger patients than zygomaticomaxillary fractures (p< 0.001). High-energy injuries were more likely to be associated with zygomaticomaxillary fractures (p< 0.001), whereas low-energy injuries were more likely to be associated with orbital floor fractures (p< 0.001). The sensory changes associated with orbital floor and zygomaticomaxillary fractures were not significantly different (p= 0.773). Sensory recovery was more rapid and better after orbital floor than after zygomaticomaxillary fractures; however, the difference was not significantly different. Additionally, the low-energy group showed a higher incidence of sensory changes than the high-energy group, but the difference was not statistically significant (p= 0.512). Permanent sensory changes were more frequent in the high-energy group, the difference was statistically significant (p= 0.043). Conclusion: The study found no significant difference in the incidence of sensory changes associated with orbital floor and zygomaticomaxillary fractures. In case of orbital floor fractures and high-energy injuries, the risk of permanent sensory impairment should be considered. [ABSTRACT FROM AUTHOR]

Background and Aim The most concern in children with head and facial trauma is the effects of the trauma and the treatment on their growth considering the possibility that the teeth with different stages of evolution in the fracture line have different prognosis in growth and deformity. The present study aims to examine the status of the teeth in the fracture lines of children in order to check the effects of head and facial trauma on these teeth. Methods & Materials Participants were 28 children under 12 years of age with jaw fracture admitted to the maxillofacial surgery department of Bahonar Hospital, Kerman, Iran from 2010 to 2016. Their information was extracted from their medical files and the teeth in the fracture line were clinically evaluated. Panoramic graphs were taken immediately after and 6 to 24 months after the surgery. The information examined in the panoramic graphs included the internal and external erosion, pathological lesion, and eruption rate of the teeth in the fracture line. Ethical Considerations This article was approved by the ethics committee of Kerman University of Medical Sciences (Ethical Code: IR.KMU.REC.1396.1398). Results It was found that 60.7% of the fractures occurred in the lower jaw, of which 67.9% were treated by closed reduction method and 10.7% by open reduction method. Moreover, 89.3% of the teeth had no pathological lesion. In 78.6% and 71.4% of cases, no dental discoloration and necrosis were observed, respectively. Moreover, 82.1% of the teeth had reached full eruption. Conclusion Most of the teeth in the fracture line reaches full eruption with no pathological lesion, discoloration, root deformity, and looseness, and there is no difference in this respect between patients received open and closed reduction methods. [ABSTRACT FROM AUTHOR]

Background/aims: No studies have characterized the morbidity and mortality of maxillary & malar fractures on a national scale. The aim of this study was to examine the risk factors for mortality in pediatric patients who had sustained maxillary and malar fractures by using a national pediatric hospital inpatient care database.Materials and Methods: This retrospective cohort study was conducted using the Kids' Inpatient Database (KID). The primary predictor variable was the cause of injury. The primary outcome variable was mortality rate. Additional predictor variables included age, gender, race, income, payer information, year and place of injury, number of facial fractures, concomitant facial fractures, other fractures of the body, and intracranial/internal organ injury. Univariate and multivariate regression models were performed to assess risk factors for mortality. Statistical significance was set to a p-value <.05.Results: A total of 5859 patients met the inclusion criteria. The most common age group was 13-17 years of age (n = 3816, 65.1%). Motor vehicle accidents were the most common mechanism of injury (n = 2172, 37.1%). The presence of cranial vault (OR = 2.81, p = .017), skull base (OR = 2.72, p < .001), and vertebral column fractures (OR = 2.13, p = .016), as well as sub-arachnoid hemorrhage (OR = 4.75, p = .005), traumatic pneumothorax/hemothorax (OR = 2.16, p = .015), and heart/lung injury (OR = 3.37, p < .001) were each independently associated with increased odds of mortality.Conclusions: Patients in their late teens most commonly sustained malar and maxillary fractures, likely due to general trends in craniomaxillofacial development. The presence of other fractures located in close proximity to the mid-face increased the risk of mortality among pediatric patients with malar and maxillary fractures. This may be explained by the anatomical approximation of the mid-face to vital neurovascular structures of the head, which, when damaged, may prove fatal. [ABSTRACT FROM AUTHOR]

Background and Aim: The most concern about children with head and face trauma is the effects of the trauma and the treatment on their growth considering the possibility that the teeth in different stages of evolution that are adjacent to the fracture line, have different prognosis in growth and deformity. The present study examines the situation of the teeth around fracture lines in order to check the effects of the trauma on the mentioned teeth. Methods and Materials: Complete information of 28 under 12 years old patients with jaw fracture that were admitted in the Bahonar hospital from 2010 until 2016, was extracted from files and Teeth adjacent to fracture line were clinically evaluated. Panoramic graphs that were taken instantly after the surgery and in the next 6 to 24 months period were inspected. The information examined in the panoramic graphs contained the level of internal and external erosion pathological lesion, and growth rate of teeth adjacent to the fracture line. Ethical Considerations: This article was ethically approved by ethical committee of Kerman University of Medical Sciences (ethical code: IR.KMU.REC.1396.1398). Result: 60/7 percent of the fractures were occurred in the lower jaw which in 67/9 percent of the times were treated by internal fixation and 10/7 were treated by Open Fracture Reduction. 89/3 percent of cases were free of pathological lesion. In 78/6 percent of cases change in color and in 71/4 percent of cases dental necrosis was not observed. 82/1 percent of the teeth had reached full growth. Conclusion: Most of the teeth adjacent to the fracture line had reached full growth and lacked pathological, color change, root deformation and loose teeth problems and there was no Difference in Open Fracture Reduction and internal fixation.

Pediatric maxillofacial trauma is a rare entity, which is primarily the reason for an individual surgeon's inexperience in managing such injuries. More so, maxillary injuries are infrequent. Pediatric maxillofacial injuries are usually a result of blunt force trauma such as falls, motor vehicle accidents, bicycle injuries, sports-related injuries, assault, and child abuse. The atypical pattern of facial injuries in the pediatric population necessitates each surgeon to approach individual cases with a unique and innovative technique of management, while still following the basic principles of surgical management of maxillofacial injuries. Since facial trauma and surgical interventions both have the potential to lead to disturbance in growth and development, management should be as conservative as possible. The foundation of any surgical intervention must be developed keeping in perspective, the future growth, and development of dentofacial structures. Pediatric facial trauma management is in itself a disconcerting situation for a maxillofacial surgeon, but when a special needs child is involved it becomes an even more perplex decision. We present a case of maxillary trauma in a pediatric patient with global developmental delay, the treatment dilemma, and a review of current literature. [ABSTRACT FROM AUTHOR]

Background: Traumatic brain injury (TBI) is one of the leading causes of death and disability worldwide. In various combinations, a high frequency of facial bone fractures has been reported. However, the results are still conflicting. Methods: We retrospectively reviewed medical records of patients with maxillofacial trauma who were admitted to Dr. Sardjito Hospital, Yogyakarta, Indonesia, between January 2016 and December 2017. Results: A total of 70 patients with maxillofacial trauma were involved (57 males and 13 females, 18–65 years). Moreover, most of them were 18–25-year-old males (34.3%). The average patient age was 35.5 ± 14 years. No significant association was found between the sex and age group of the patient (p = 0.774). Motorcycle accident was the most frequent cause of maxillofacial fractures (84%) with midfacial and multiple maxillofacial fractures being the most frequent types found in patients (40% and 40%, respectively). The most common facial fracture was in the zygomatic bone (28%) and most cases showed mild facial injury (81%). A significant association was found between the Glasgow Coma Scale (GCS) and types of traumatic brain injury (TBI) (p = 0.031). However, when GCS was compared with facial injury, no statistically significant level was reached and its correlation was low (p = 0.267, r = 0.134). Conclusions: There was a significant association between types of traumatic brain injury with head injury severity. However, we found no correlation between head injury severity and facial injury severity. To explain and validate our results, further multicenter studies with a larger sample size are required. Level of evidence: Level IV, Risk/Prognostic. [ABSTRACT FROM AUTHOR]

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Background and Aim: The most concern about children with head and face trauma is the effects of the trauma and the treatment on their growth considering the possibility that the teeth in different stages of evolution that are adjacent to the fracture line, have different prognosis in growth and deformity. The present study examines the situation of the teeth around fracture lines in order to check the effects of the trauma on the mentioned teeth. Methods and Materials: Complete information of 28 under 12 years old patients with jaw fracture that were admitted in the Bahonar hospital from 2010 until 2016, was extracted from files and Teeth adjacent to fracture line were clinically evaluated. Panoramic graphs that were taken instantly after the surgery and in the next 6 to 24 months period were inspected. The information examined in the panoramic graphs contained the level of internal and external erosion pathological lesion, and growth rate of teeth adjacent to the fracture line. Ethical Considerations: This article was ethically approved by ethical committee of Kerman University of Medical Sciences (ethical code: IR.KMU.REC.1396.1398). Result: 60/7 percent of the fractures were occurred in the lower jaw which in 67/9 percent of the times were treated by internal fixation and 10/7 were treated by Open Fracture Reduction. 89/3 percent of cases were free of pathological lesion. In 78/6 percent of cases change in color and in 71/4 percent of cases dental necrosis was not observed. 82/1 percent of the teeth had reached full growth. Conclusion: Most of the teeth adjacent to the fracture line had reached full growth and lacked pathological, color change, root deformation and loose teeth problems and there was no Difference in Open Fracture Reduction and internal fixation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of the study was to evaluate the results and immediate postoperative complications following open reduction and internal fixation of mandibular fractures with or without postoperative maxillo-mandibular fixation MATERIALS AND METHODS: The study spanned over a period of 24 months, extending from October 2015 to October 2017. The study sample comprised 24 subjects between the age range of 18 to 65 years. They were randomly divided into two groups: Group A included subjects in whom open reduction and internal fixation was followed by maxilla-mandibular fixation for 15 days, and Group B subjects in whom only open reduction and internal fixation was done, followed by immediate mobilization. The outcomes evaluated were swelling, pain, simplified oral hygiene index and occlusion. The subjects were followed for all these outcomes on 1st, 7th and 15th days. The occlusion was assessed for 5 days. Any other intra/post-operative complications were additionally noted. RESULTS: There was no statistical difference between the groups for swelling, pain and occlusion. The patients with postoperative maxilla-mandibular fixation had poorer oral hygiene when compared to the other group (p<0.001). CONCLUSIONS: The use of maxilla-mandibular fixation post open reduction and internal fixation seems to offer no additional benefits to the patients. According to the results of the study, this traditional surgical dictum seems to be used by the surgeons due to the lack of any scientific evidence. However, further studies should be conducted to confirm this statement. [ABSTRACT FROM AUTHOR]

Slaven Lupi-Ferandin,1 Sandro Glumac,2 Nancy Poljak,3 Tea Galic,4,5 Natalija Ivkovic,6 Ognjen Brborovic,7 Renata Pecotic,5,6 Zoran Dogas5,6 1Department of Maxillofacial and Oral Surgery, University Hospital of Split, Split, Croatia; 2Department of Anesthesiology and Intensive Care, University Hospital of Split, Split, Croatia; 3Study of Dental Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia; 4Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia; 5Department of Neuroscience, School of Medicine, University of Split, Split, Croatia; 6Sleep Medicine Center, School of Medicine, University of Split, Split, Croatia; 7Department of Social Medicine and Organization of Health Care, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, CroatiaCorrespondence: Zoran DogasDepartment of Neuroscience, School of Medicine, University of Split, Soltanska 2, Split 21000, CroatiaTel +385 21557903Fax +385 21557895Email zdogas@gmail.comAim: To evaluate the health-related life quality of patients after surgically treated midface fractures.Patients and Methods: This retrospective cohort study compared the 36-Item Short Form Health Survey (SF-36) scores of 42 male patients following surgically treated maxillary or zygomatic fractures with the reported normative data of the SF-36 for the Croatian population.Results: The current study showed that the health-related life quality of surgically treated patients was comparable to similar age, gender, and regional demographics in the Croatian population norm. However, we revealed a significant deterioration of the “Emotional wellbeing” domain in younger patients (P = 0.03) and a severely affected domain of “Physical functioning” in older patients (P = 0.049).Conclusion: There was a significant negative psychological impact from facial trauma on younger patients. In contrast, older patients were more prone to physical impairment. Therefore, follow-up visits are an opportunity to screen and refer younger patients to mental health services in a timely manner to prevent severe psychological difficulties and an opportunity to identify older patients who require physical therapy.Keywords: quality of life, patient outcome assessment, maxillary fractures, zygomatic fractures, surgery, oral

Resumen Objetivo: Describir la incidencia, la causa, el patrón y el tratamiento de fracturas maxilofaciales en sujetos que solicitaron atención en un Servicio de Urgencias Odontológicas del Área Metropolitana de Buenos Aires. Materiales y métodos: Se analizaron las historias clínicas de los individuos que concurrieron al Servicio de Urgencias y Orientación de Pacientes de la Facultad de Odontología de la Universidad de Buenos Aires (SUyOP) en el período comprendido entre marzo de 2018 y diciembre de 2019. Se registró la frecuencia de consultas vinculadas con diagnóstico de algún tipo de fractura del esqueleto maxilofacial y en el caso de estos pacientes, se registraron sexo, edad, etiología, ubicación y tratamiento. Resultados: Durante el periodo evaluado asistieron al SUyOP un total de 13.919 pacientes por algún tipo de urgencia odontológica, entre los cuales 47 (0,33%) se presentaron con traumatismos en la región bucomaxilofacial; 39 fueron del sexo masculino (83%). En total fueron diagnosticadas 66 fracturas. La edad media se extendió entre los 30 y los 51 años. Las fracturas se encontraron con mayor frecuencia en la mandíbula (95,45%). La agresión interpersonal fue la principal causa (53,19%). El tratamiento realizado con mayor frecuencia fue el bloqueo intermaxilar en el 57,44% de los pacientes. Conclusión: Las fracturas de maxilar inferior fueron las que se registraron con mayor frecuencia. Si bien estas fracturas no ponen en riesgo la vida del paciente, la falla en el diagnóstico y el tratamiento apropiados puede derivar en la pérdida de funciones del sistema estomatognático, y desarrollar deformidades secundarias que requieren de un tratamiento más complejo. Palabras clave: Cirugía maxilofacial, traumatismos faciales, traumatismos mandibulares, traumatismos maxilofaciales// Abstract Aim: To describe the incidence, etiology, pattern and treatment of maxillofacial fractures in a dental emergency department of the Buenos Aires Metropolitan Area. Materials and methods: A study was conducted, recording sex, age, etiology, location and treatment of maxillofacial fractures in patients who visited the Emergency and Patient Orientation Service of the School of Dentistry of the University of Buenos Aires (SUyOP) from March 2018 to December 2019. Data were obtained from dental medical records. Results: During the evaluated period, a total 13,919 patients visited the SUyOP for dental emergencies, of whom 47 (0.33%) presented with trauma in the oral-maxillofacial region, and 39 were male (83%). Age range was 30 to 51 years. Overall, 66 fractures were diagnosed. Fractures were most frequent in the mandible (95.45%). Interpersonal aggression was the most prevalent cause (53.19%). The most frequent treatment was intermaxillary fixation, which was performed in 57.44% of the cases. Conclusion: Fractures of the lower jaw were the most frequently reported. Although these fractures are not life-threatening, failure to diagnose and treat them properly can lead to loss of function of the stomatognathic system and development of secondary deformities requiring more complex treatment. Key words: Jaw fractures, mandibular fractures, maxillary fractures, maxillofacial surgery.

Background/aim: Paediatric maxillozygomatic complex (MZC) fractures are uncommon, and there is a scarcity of data regarding their surgical treatment. The aim of this study was to analyse choices and outcomes of open reduction and internal fixation (ORIF) for MZC fractures among 14 maxillofacial centers around the world., Materials and Methods: This multicentric retrospective observational study included patients ≤16 years of age with quadripod MZC fractures treated with ORIF from January 2011 and December 2022. The following data were collected: age, gender, dentition stage (deciduous, mixed, and permanent), cause of injury, type of fracture, surgical approach, site of osteosynthesis (infraorbital rim, zygomaticomaxillary buttress, frontozygomatic, and zygomaticotemporal sutures), material (titanium or resorbable) and number of plates used, and outcome. The minimum follow-up was 6 months. Statistical analyses were performed with Fisher's exact test or chi-squared test, as appropriate., Results: Sixty-four patients (mean age, 12.3 years) with quadripod MZC fractures were included. Seventy-two percent of patients received a single-point fixation. The zygomaticomaxillary buttress was the most common site for fixation, both in single-point and two-point fixation schemes, especially in combination with the frontozygomatic suture. Increasing age was associated with a higher rate of plate removal (p < .001). Postoperative complications included 5 (7.8%) cases of wound infections, 2 (3.1%) infraorbital paraesthesia, 1 (1.6%) ectropion. Residual facial asymmetry was found in 5 (7.8%) patients and was not associated with the type of fixation (p > .05)., Conclusions: This study highlights the possibility of using ORIF, even with a single point of fixation, for the treatment of displaced quadripod MZC fractures in the paediatric population. The zygomaticomaxillary buttress was the preferred site of fixation and allowed for adequate stabilization with no external scars and a low risk of tooth damage. Future prospective studies with long-term follow-up are needed to establish definitive surgical protocols and clarify the surgical decision-making., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Facial or maxillofacial trauma occurs as a consequence of physical injury to the face and can include damage to soft tissue and bony structures either in isolation or combination. There is a male predominance with highest incidence in the age group of 20–40 years. The range of injuries include soft tissue damage, bruising, lacerations, burns and fractures of the underlying facial skeleton including the zygomatic complex, mandible, maxilla, orbit and nasoethmoidal complex. The concentration of special senses in the head and neck region means that even seemingly minor injuries can have a significant impact upon the long-term outcome for a patient. Careful assessment of an injured patient must include a full ATLS evaluation to ensure that associated potentially life-threatening injuries are not missed. This article describes the signs, symptoms and treatment of maxillofacial trauma, including management of hard and soft tissue trauma. [ABSTRACT FROM AUTHOR]

Aim: Quality of life is crucially affected by maxillofacial appearance and function. Facial trauma can cause dysfunction in chewing, speech, communication, and other daily activities. Maxillofacial trauma unexpectedly changes the patients' physical and psychological well-being and potentially impairs their quality of life. The present study aimed to evaluate the quality of life after maxillofacial trauma. Materials and methods: This cohort study evaluated the quality of life in patients older than 15 years with maxillofacial fractures. Patient demographic information, type of facial bone fracture, etiology of trauma were recorded. Patients were asked to report their quality of life at one day, 30 days, and 90 days after the surgery through a 15-D questionnaire. Results: A total of 100 patients, including 68 men and 32 women, participated in this study. The mean age of the participants was 50.5 (age range 15 to 86 years old). The mean scores of quality of life one day, 30 days, and 90 days after the surgery were 0.65±0.12, 0.8±0.07, and 0.95±0.02, respectively. There was a significant correlation between the quality of life and the number of days passed from the surgery (P-value <0.001). The most common facial fracture among this population was mandible fracture, and the leading cause was road traffic accidents. Conclusion: Road traffic accident is still a significant etiology in maxillofacial trauma, and mandible fracture was the most common maxillofacial bone fracture. Clinical Significance: immediate surgical interventions significantly improve patient's quality of life in patients with maxillofacial fractures. [ABSTRACT FROM AUTHOR]

Introduction: Aim of the retrospective study is to determine the type and frequency of the maxillofacial fractures and to assess their sex, age, site distribution, and treatment accordingly. Materials and Methods: Study was conducted based on year-wise data collected from 2015 to 2018, with 280 cases recorded. Results: Study group consists of total 280 patients, out of which 28(10%) were females and rest 252(90%) were males. The most common maxillofacial fractures are mandibular fractures in which body of the mandible have the highest occurrence rate and among 280 cases, 187(66.78%) were treated by open reduction and fixation. Conclusion: Results of the study shows the majority of injuries were in males and Mandible was the most commonly fractured bone with the body of the mandible region as the most frequent site. Open reduction and fixation remain the choice of treatment. [ABSTRACT FROM AUTHOR]

The purpose of this study is to discuss several approaches to addressing naso-orbito-ethmoidal (NOE) fracture. Orbital fracture, especially infraorbital fracture, can be treated through the transconjunctival approach easily. However, in more severe cases, for example, fracture extending to the medial orbital wall or zygomatico-frontal suture line, only transconjunctival incision is insufficient to secure good surgical field. And, it also has risk of tearing the conjunctiva, which could injure the lacrimal duct. Also, in most complex types of facial fracture such as NOE fracture or panfacial fracture, destruction of the structure often occurs, for example, trap-door deformity; a fracture of orbital floor where the inferiorly displaced blowout facture recoils to its original position, or vertical folding deformity; fractured fragments are displaced under the other fragments, causing multiple-packed layers of bone. [ABSTRACT FROM AUTHOR]

Objective: Perioperative antibiotic prophylaxis in patients undergoing surgery for maxillofacial fractures is standard practice. However, the use of postoperative antibiotic prophylaxis remains controversial. This systematic review and meta-analysis sought to evaluate the effect of postoperative antibiotic therapy on the incidence of surgical site infection (SSI) in patients with maxillofacial fractures.Methods: MEDLINE, Embase, and the Cochrane Library were searched from inception through October 2017. Randomized controlled trials (RCTs) and cohort studies evaluating the efficacy of pre-, peri-, and postoperative antibiotic prophylaxis in preventing SSI in maxillofacial fractures were included. Data were extracted from studies using a standardized data collection form, with two reviewers independently performing extraction and quality assessment for each study. Risk ratios (RRs) for SSI were pooled using a random-effects model.Results: Among 2,150 potentially eligible citations, 13 studies met inclusion criteria and provided data to be included in a meta-analysis. The addition of postoperative antibiotic prophylaxis to a standard preoperative and/or perioperative antibiotic regimen showed no significant difference in the risk of SSI (RR = 1.11 [95% CI: 0.86-1.44], P > .1). There were also no differences in the risk of SSI when restricting the analysis to mandibular fractures (eight studies, RR = 1.22 [95% CI: 0.92-1.62]) or open surgical techniques (eight studies, RR = 1.02 [95% CI: 0.62-1.67]). A sensitivity analysis did not find any significant differences in risk when restricting to RCTs (seven trials, RR = 1.00 [95% CI: 0.61-1.67]) or cohort studies (six studies, RR = 1.21 [95% CI: 0.89-1.63]).Conclusions: Our findings, along with the available evidence, does not support the routine use of postoperative antibiotic prophylaxis in patients with maxillofacial fractures. Avoiding the unnecessary use of antibiotic therapy in the postoperative period could have important implications for healthcare costs and patient outcomes. Laryngoscope, 129:82-95, 2019. [ABSTRACT FROM AUTHOR]

Background: Nasoorbitoethmoid (NOE) fractures impact growth of the craniofacial skeleton in children, which may necessitate differentiated management from adult injuries. This study describes characteristics, management, and outcomes of NOE fractures in children seen at a single institution., Methods: A retrospective review of patients under 18 years who presented to our institution from 2006 to 2021 with facial fractures was conducted; patients with NOE fractures were included. Data collected included demographics, mechanism of injury, fracture type, management, and outcomes., Results: Fifty-eight patients met inclusion criteria; 77.6% presented with Manson-Marcowitz Type I fractures, 17.2% with Type II, and 5.2% with Type III. The most common cause of injury was motor vehicle accidents (MVAs, 39.7%) and sports (31%). Glasgow Coma Scale and injury mechanism were not predictive of injury severity in the pediatric population ( P =0.353, P =0.493). Orbital fractures were the most common associated fractures (n=55, 94.8%); parietal bone fractures were more likely in Type III fractures ( P =0.047). LeFort III fractures were more likely in type II fractures ( P =0.011). Soft tissue and neurological injuries were the most common associated injuries regardless of NOE fracture type (81% and 58.6%, respectively). There was no significant difference in type of operative management or in the rates of adverse outcomes between types of NOE fractures., Conclusions: These findings suggest that pediatric NOE fractures, although rare, present differently from adult NOE fractures and that revisiting predictive heuristics and treatment strategies is warranted in this population., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 by Mutaz B. Habal, MD.)

This study aims to provide patient characteristics and short-term clinical outcomes of Le Fort fractures. Using the National Surgical Quality Improvement Program database from 2016 to 2019, cases involving Le Fort fractures on initial encounters were reviewed. 130 cases from 3293 facial fractures were identified. 70 cases were diagnosed with type I, 41 with type II, and 19 with type III. The male-to-female ratio was 4.9:1. Compared to geriatric patients (>65 years old), Le Fort fractures were more common among patients between the ages of 18 and 65 ( P < .003). 5.4% of patients had in-hospital complications, including sepsis, superficial-deep incisional surgical site infection, and wound disruption. Two patients (1.5%) were readmitted, while three (2.3%) underwent reoperation. Type I fractures in adult males are the most common presentation. Overall complication rates for surgical repairs are low.

Abstract Facial or maxillofacial trauma occurs as a consequence of physical injury to the face and can include damage to soft tissue and bony structures either in isolation or combination. There is a male predominance with highest incidence in the age group of 20–40 years. The range of injuries include soft tissue damage, bruising, lacerations, burns and fractures of the underlying facial skeleton including the zygomatic complex, mandible, maxilla, orbit and nasoethmoidal complex. The concentration of special senses in the head and neck region means that even seemingly minor injuries can have a significant impact upon the long-term outcome for a patient. Careful assessment of an injured patient must include a full ATLS evaluation to ensure that associated potentially life-threatening injuries are not missed. This article describes the signs, symptoms and treatment of maxillofacial trauma, including management of hard and soft tissue trauma. [ABSTRACT FROM AUTHOR]