Craniomaxillofacial Trauma & Reconstruction

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STUDY DESIGN: A retrospective review was conducted of all patients with mandibular fractures who were evaluated by plastic surgery at a Level I trauma center between January 1, 2017 and May 1, 2020. Data including demographic characteristics, mechanism of injury, type of presentation (e.g., primary or transfer), treatment plan, and time to intervention were recorded. OBJECTIVE: Mandibular fractures are common traumatic injuries. Because these injuries are managed by surgical specialists, these patients are often emergently transferred to tertiary care hospitals...

STUDY DESIGN: Review of the literature with report of Case. OBJECTIVE: To review the presentation of Actinomycosis specifically as it occurs with mandibular osteotomies. METHODS: A review of the literature and report of an additional case. RESULTS: While minor infections secondary to local factors are usually seen 2-3 weeks after surgery, late infections are rare. Host factors may play a role. When actinomycosis is diagnosed, long-term antibiotics are necessary...

STUDY DESIGN: Case series. OBJECTIVE: This retrospective review of frontal sinus fractures aims to describe our current experience managing these fractures at an urban level I trauma center. METHODS: An institutional database of 2081 patients who presented with maxillofacial fractures on computed tomography face/sinus in 2019 was queried for all patients with traumatic frontal sinus fractures. Demographics, trauma-related history, management approach, and follow-up data were collected and analyzed...

STUDY DESIGN: Retrospective Observational Study. OBJECTIVE: Mandibular condyle fractures are distinctive among maxillofacial injuries in which they disrupt mandibular function in a way that other traumatic injuries do not. Condylar fractures can be treated using either the conservative (closed reduction and immobilisation) or surgical (open reduction and internal fixation) approaches. Both of these modalities of treatment have advantages and disadvantages, as well as indications and contraindications...

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Malnutrition has been found to have negative effects on the immune system and inflammatory responses, impairing the wound healing process. Free flap failure is a serious complication in patients undergoing microvascular reconstruction, as it increases patient morbidity, length of stay in the hospital, patient, and hospital costs, as well as causes the need for further surgical interventions1 . Malnutrition is estimated to be present in 35-50% of head and neck cancer patients with higher rates in those experiencing hypo-oropharyngeal disease...

Study Design: Technical note. Objective: The lower nasal architecture is dependent on caudal septal integrity. Deviations of the caudal septum can compromise nasal airflow. The presence of anterior nasal spine deviations contributes to septal and medial crural shifting with ipsilateral encroachment. It is essential to identify nasal spine deviation during surgery in order to reconstruct the septum in a midline position at its base. This allows an appropriate management plan that creates a better functional and aesthetically pleasing outcome...

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: The clinical decision to pursue harmonic scalpel (HS) method vs conventional hemostasis to treat head and neck cancers has been arguably predicated on the clinical outcomes observed. This study aims to evaluate the surgical outcomes of neck dissection between both techniques and perform an updated meta-analysis using the available literature. METHODS: We searched PubMed, Scopus, and Cochrane Library through 31st December 2021, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...

STUDY DESIGN: Human bone marrow stem cells (hBMSCs) and human adipose-derived stem cells (hADSCs) have demonstrated the capability to regenerate bone once they have differentiated into osteoblasts. OBJECTIVE: This systematic review aimed to evaluate the in vitro osteogenic differentiation potential of these cells when seeded in a poly (lactic- co -glycolic) acid (PLGA) scaffold. METHODS: A literature search of 4 databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted in January 2021 for studies evaluating the osteogenic differentiation potential of hBMSCs and hADSCs seeded in a PLGA scaffold...

STUDY DESIGN: Cadaveric investigation. OBJECTIVE: Rigid internal fixation (RIF) using plates and screws is often not feasible in low and middle-income countries due to limited resources. Interosseous wiring to achieve semi-rigid fixation is often used, but lacks biomechanical force data. Herein we aim to quantitatively compare interosseous wiring to RIF. METHODS: Cadaveric mandibles were fractured at the parasymphysis and angle. Fixation was achieved using interosseous wiring in both single wire loop and figure-of-eight formations, as well as plate and screw fixation (n = 5 for each fixation type at each fracture site)...

The purpose of this study was to investigate the epidemiology, pattern of injury and management of facial dog bite injuries. Methods: The authors conducted a retrospective cohort study over a 5-year period of patients who sustained a facial dog bite injury. The study setting was an Oral and Maxillofacial Surgery Department at a level 1 trauma centre, servicing an estimated catchment population in excess of 950,000 people. Results: In total, 171 patients were managed in the designated period from January 2017 to January 2022...

STUDY DESIGN: A stereological and histopathological study in an animal model. OBJECTIVE: This study explores the effects of the nerve growth factor and photobiomodulation therapy on the damaged nerve tissue and fracture healing. METHODS: A total of 24 rabbits were divided into 4 groups: control group (n = 5), nerve growth factor (NGF) group (n = 7), photobiomodulation (PBMT) group (n = 6), and nerve growth factor and photobiomodulation therapy (NGF+PBMT) group (n = 6)...

STUDY DESIGN: A retrospective cohort study was conducted using the Kids' Inpatient Database from 2000 to 2014. Subjects were included if they were 18 years and younger and suffered any type of facial fracture. OBJECTIVE: The purpose this study was to determine the risk factors for incurring panfacial fractures among the pediatric population. METHODS: The primary predictor variables were a set of heterogenous variables that included patient characteristics, injury characteristics, hospitalization outcomes...

STUDY DESIGN: Retrospective study. OBJECTIVE: To evaluate patient demographics, surgical management, and complications of orbital and orbitozygomaticomaxillary complex (OZMC) fractures treated at a district hospital in Norway. METHODS: The medical records of patients with orbital fractures treated at Aalesund hospital between January 2002 and July 2017 were reviewed. Data on demographics, signs and symptoms, cause of injury, fracture type, associated fractures, surgical management, and complications were collected...

STUDY DESIGN: Retrospective observational study. OBJECTIVE: The purpose of this publication is to address the absence of literature detailing respiratory management in patients with syndromic craniosynostosis and obstructive sleep apnea during the immediate postoperative interval following LeFort III advancement with placement of distraction hardware but prior to sufficient midface advancement. METHODS: After IRB approval, the investigators retrospectively selected candidates for inclusion in this case series...

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STUDY DESIGN: A prospective randomized comparative study was conducted to evaluate the postsurgical scar with Supraorbital Eyebrow (SE) Approach and Upper Blepharoplasty (UB) Approach used for open reduction and internal fixation (ORIF) of zygomaticomaxillary complex (ZMC) fractures. OBJECTIVE: To evaluate and compare the post-operative scar using Vancouver Scar Scale (VSS) following ORIF of ZMC fractures with SE and UB approaches. METHODS: In this study, 88 patients with ZMC fractures requiring ORIF and meeting the inclusion criteria were recruited between 2019 and 2020...

STUDY DESIGN: PRISMA-SWiM guided systematic review. OBJECTIVE: 1. Provide consistent evidence regarding the management of atrophic mandible fractures; 2. To search, evaluate and validate existing guidelines if any for the management; 3. Provide evidence regarding specific management of condylar fractures in the atrophic mandible; 4. To address the clinical applicability of bone grafts. METHODS: A systematic review was conducted using the PRISMA-SWiM protocol...

STUDY DESIGN: A systematic review and meta-analysis. OBJECTIVE: Treatment of traumatic optic neuropathy (TON) has been a subject of debate for many decades due to the scarcity of evidence-based treatment protocols. This review compares surgical decompression (SD) and steroid therapy (ST) as treatment approaches in TON patients. METHODS: A PRISMA-guided systematic review using PubMed, Embase, Ovid and Scopus databases was performed till the last search date of July 31st 2021...

STUDY DESIGN: Face and content validation of a surgical simulation model. OBJECTIVE: Open reduction and internal fixation in displaced subcondylar mandibular fractures is standard care. This requires an extraoral (eg: retromandibular, transparotideal) or intraoral approach. An intraoral approach requires further training since specialized instrumentation such as the 90° screwdriver system and endoscopes might be needed. Currently, no simulation models are available for training residents in intraoral reduction and fixation of subcondylar mandibular fractures...