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Nasal Fractures

Jean-Pierre Frat, Jean-Damien Ricard, Jean-Pierre Quenot, Nicolas Pichon, Alexandre Demoule, Jean-Marie Forel, Jean-Paul Mira, Rémi Coudroy, Guillaume Berquier, Benoit Voisin, Gwenhaël Colin, Bertrand Pons, Pierre Eric Danin, Jérome Devaquet, Gwenael Prat, Raphaël Clere-Jehl, Franck Petitpas, Emmanuel Vivier, Keyvan Razazi, Mai-Anh Nay, Vincent Souday, Jean Dellamonica, Laurent Argaud, Stephan Ehrmann, Aude Gibelin, Christophe Girault, Pascal Andreu, Philippe Vignon, Laurence Dangers, Stéphanie Ragot, Arnaud W Thille
BACKGROUND: Non-invasive ventilation has never been compared with high-flow oxygen to determine whether it reduces the risk of severe hypoxaemia during intubation. We aimed to determine if preoxygenation with non-invasive ventilation was more efficient than high-flow oxygen in reducing the risk of severe hypoxaemia during intubation. METHODS: The FLORALI-2 multicentre, open-label trial was done in 28 intensive care units in France. Adult patients undergoing tracheal intubation for acute hypoxaemic respiratory failure (a partial pressure of arterial oxygen [PaO2 ] to fraction of inspired oxygen [FiO2 ] ratio of ≤300 mm Hg) were randomly assigned (1:1; block size, four participants) to non-invasive ventilation or high-flow oxygen during preoxygenation, with stratification by PaO2 /FiO2 ratio (≤200 mm Hg vs >200 mm Hg)...
March 14, 2019: Lancet Respiratory Medicine
M Goodfellow, A Burns
Patients with a low socioeconomic status suffer disproportionately from trauma, and have a high incidence of mandibular fractures. To explore how deprivation affects the incidence of facial fractures in the north east of England, we reviewed 1096 patients who were admitted to the oral and maxillofacial surgical (OMFS) unit at Sunderland Royal Hospital for treatment of a facial fracture between December 2013 and December 2017. Levels of socioeconomic deprivation, which were obtained from postcodes and the UK Government Open Data Communities database, were compared with a random sample of deprivation data from the catchment area of our hospital...
March 18, 2019: British Journal of Oral & Maxillofacial Surgery
Maher M Abosadegh, Norkhafizah Saddki, Badr Al-Tayar, Shaifulizan Ab Rahman
Background/Aim: Epidemiology of maxillofacial fractures (MFF) varies between populations. This study investigated the epidemiology of MFF treated at the Oral and Maxillofacial Surgery (OMFS) Unit, Hospital Universiti Sains Malaysia (USM). Methods: A retrospective review of 473 medical records of patients with MFF treated from June 2013 to December 2015 was conducted. Information on demographic characteristics of patients, aetiology of injury, types of MFF, and treatment was obtained...
2019: BioMed Research International
Hussam Abou-Al-Shaar, Yair M Gozal, Philipp Taussky, William T Couldwell
Petrous internal carotid artery (ICA) aneurysms are rare, complicated lesions to treat. The management paradigms include observation, endovascular exclusion, or surgical trapping with or without revascularization. The case described in this video involved a 67-yr-old woman with a known history of chronic lymphocytic leukemia, who presented after a mechanical ground-level fall. Clinically, she had a nasal deformity and resolving epistaxis consistent with mild facial trauma. Computed tomography (CT) revealed a comminuted nasal bone fracture and an incidental 3-cm right petrous ICA aneurysm...
March 14, 2019: Operative Neurosurgery (Hagerstown, Md.)
Jérôme Adnot, Cyril Desbarats, Luc-Marie Joly, Olivier Trost
PURPOSE: Nasomaxillary fractures can be mistaken for fractures confined to the nasal bones, resulting in inappropriate treatments that jeopardize patient outcomes. Our purpose here was to provide information on nasomaxillary fractures via a retrospective study and literature review. MATERIAL AND METHODS: We retrospectively collected clinical, computed tomography (CT), therapeutic, and outcome data in consecutive patients managed for unilateral impacted nasomaxillary fractures at our centre over a 5-year period (2013-2017)...
March 9, 2019: Journal of Stomatology, Oral and Maxillofacial Surgery
Thuy-My T Le, Nicholas C Oleck, Wajiha Khan, Jordan N Halsey, Farrah C Liu, Ian C Hoppe, Edward S Lee, Mark S Granick
PURPOSE: Facial fractures are a harbinger when it comes to airway management. Facial fractures can cause airway obstruction or preclude the use of intubation. We aim to examine the etiologies, types of facial fractures, and the risk factors that may lead to requirement of an advance airway. METHODS: A retrospective chart review was performed of all facial fractures in the adult population in a level 1 trauma center in an urban environment (University Hospital in Newark, NJ)...
April 2019: Annals of Plastic Surgery
Kun Hwang, Hun Kim
The aim of this study was to investigate the occurrence of facial trauma in handball players in South Korea.Forty-one handball coaches responded to an 11-item standardized questionnaire. Twenty-three coaches (56.1%) stated that their players had experienced a facial injury and reported 56 patients.The nose was the most common site of the injuries (51.7%), followed by the eye (19.6%) and cheek (12.5%). The most common causes of nose injuries were being hit by a hand (26.8%), elbow (12.5%), and ball (8.9%). Most of the nose injuries were fractures (41...
February 9, 2019: Journal of Craniofacial Surgery
Seung Bin Jang, Dong Gil Han
BACKGROUND: After closed reduction, patients are sometimes concerned that their external nasal shapes have changed. The aim of this study was to investigate and explain changes in nasal shape after surgery through objective photogrammetric anthropometry measurements taken through three-dimensional (3D) reformed computed tomography (CT) images. METHODS: Our study included 100 Korean patients who underwent closed reduction of isolated nasal bone fracture from January 2016 to June 2017...
February 2019: Archives of Craniofacial Surgery
Young-Jae Lee, Kyeong-Tae Lee, Jai-Kyong Pyon
BACKGROUND: Closed reduction of the fracture under general or local anesthesia with elevators or forceps is widely used to treat nasal bone fractures. However, operating under general anesthesia increases the risk of morbidity and raises the cost of management. Furthermore, using forceps or elevators may cause undercorrection, new fractures, mucosal damage, and nasal hemorrhage. We therefore performed manual reduction under local anesthesia, using the little finger, to minimize the demerits of treatment under general anesthesia with forceps or elevators and aimed to assess functional and aesthetic outcomes, and patient satisfaction...
February 2019: Archives of Craniofacial Surgery
Minseok Jeon, Youngjun Kim, Youngwoong Choi
Nasal fractures are the most common facial bone fractures, and soft tissue injuries are frequently accompanied. This study intends to make a deep analysis on the relationship between the 2.Patients diagnosed with nasal fracture between 2015 and 2017 were included. Patients younger than 17 years and those with previous facial fractures or aesthetic surgeries were excluded. Nasal fractures were classified according to the Stranc-Robertson (S-R) classification, and the severity of soft tissue injury was evaluated by length and depth...
March 1, 2019: Journal of Craniofacial Surgery
Kyle P O'Connor, Ali H Palejwala, Robert G Briggs, Landon Massoth, Jimmy L Argo, Chad A Glenn
BACKGROUND: and Importance: Penetrating injuries are dangerous because they can damage intracranial structures. Removal of the object carries this same risk of injury so neurosurgeons often visualize the injury via craniotomy during removal. CASE DESCRIPTION: This report illustrates the case of a 41-year-old male who had a penetrating injury with a knife that started in the left nasal passage and extended to the parasellar region. CT angiogram revealed an associated sphenoid fracture and showed the tip of the knife within the parasellar space with preservation of the internal carotid artery, ophthalmic artery, optic nerve, and pituitary gland...
February 27, 2019: World Neurosurgery
Ioannis Papadiochos, Stavros-Evangelos Sarivalasis, Nickolaos Papadogeorgakis
Pneumomediastinum (PM) implies an abnormal condition where a collection of free air or gas is entrapped within the fascial planes of mediastinal cavity. It is considered as benign entity, but an uncommonly seen complication of craniofacial injuries. We report a case of a 63-year-old male patient with the presenting sign of closed rhinolalia who was diagnosed with retropharyngeal emphysema and PM due to a linear and nondisplaced fracture of midface. The patient cited multiple efforts of intense nasal blowing shortly after a facial injury by virtue of a motorcycle accident...
March 2019: Craniomaxillofacial Trauma & Reconstruction
Farrah C Liu, Jordan N Halsey, Nicholas C Oleck, Edward S Lee, Mark S Granick
Mechanical falls are a common cause of facial trauma in the elderly population. It has been shown that the likelihood of sustaining a facial fracture due to a fall or activities of daily life significantly increases with age. Craniomaxillofacial fractures are most common during the first three decades of life; however, elderly patients more frequently require lengthy hospital stays and surgical intervention, and have shown increased complication rates compared with younger patients. The objective of this study was to examine the prevalence of facial fractures secondary to mechanical falls in the elderly population to analyze mechanism of injury, comorbidities, and fracture management...
March 2019: Craniomaxillofacial Trauma & Reconstruction
Shahrooz S Kelishadi, Matthew R Zeiderman, Karan Chopra, Joseph A Kelamis, Gerhard S Mundinger, Eduardo D Rodriguez
Traumatic optic neuropathy (TON) is rare. The heterogeneity of injury patterns and patient condition on presentation makes diagnosis difficult. Fracture patterns associated with TON have never been evaluated. Retrospective review of 42 patients diagnosed with TON at the R. Adams Cowley Shock Trauma Center from May 1998 to August 2010 was performed. Thirty-three patients met criteria for study inclusion of fracture patterns. Additional variables measured included patient demographics and mechanism. Cluster analysis was used to form homogenous groups of patients based on different fracture patterns...
March 2019: Craniomaxillofacial Trauma & Reconstruction
L X Li, Y J Ji, R Liu, Z Q Han, C Q Zhao
Objective: To investigate the surgical technique and curative effect of transnasal endoscopic anterior lacrimal approach for the treatment of sacral wall fractures. Method: Retrospective clinical analysis of 5 patients with inferior orbital walls fracture treated by expanding prelacrimal recess-maxillary ainus under nasal endoscope was studied, and the surgical method and its efficacy were annalyzed. Result: After 1 year of follow-up,4 patients' diplopia symptom disappeared, and 1 patient's diplopia symptom was significantly relieved compared with preoperation, the range of eye movement was normal and enophthalmos were totally corrected...
February 5, 2019: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Alberto Pérez-García, Juan Ramón Esteban-Vico, Concepción Lorca-García, Jose María García-Sánchez, Luis Miranda Gómez, Abel Llinás Porte, Pilar García-Sanz
This study investigated the use of endonasal infiltrative anesthesia for the management of pain associated with nasal bone fracture reduction. Fifty-two patients with nasal bone fractures were distributed in 2 groups. In the first group, topical endonasal anesthesia and external transcutaneous infiltrative anesthesia were employed. In the second group, endonasal infiltrative anesthesia was also added. Visual analog scale pain scores related to the different steps of the procedure were registered. The addition of endonasal infiltrative anesthesia was associated with a significant decrease (p < ...
January 2019: Plastic Surgical Nursing
Jan Oliver Voß, Nadine Thieme, Sven Märdian, Christian Doll, Stefan Hartwig, Max Heiland, Jan-Dirk Raguse, Nicolai Adolphs
INTRODUCTION: The treatment of facial fractures is an integral part of the oral and maxillofacial surgical treatment spectrum. In the case of complex fractures that involve multiple levels of the facial skeleton associated with severe concomitant injuries, an individual and interdisciplinary treatment approach is needed, which requires the infrastructure of a national trauma center. OBJECTIVE: The aim of this study was to analyze the incidence and management of patients with complex facial fractures and considering the concomitant injury pattern...
February 19, 2019: Der Unfallchirurg
Roman Povolotskiy, Pavly Youssef, Rachel Kaye, Boris Paskhover
OBJECTIVES: "Young adulthood" is a term used to define individuals falling within the 18- to 22-year-old age range. Injuries account for more than a third of emergency department visits in this population. A particular area of concern is accidents that lead to injuries of the facial bones because they can have long-term functional, aesthetic, and psychosocial impacts. As many as 30 million young adults participate in some sort of sport in the United States per year, and facial injuries from these activities are not uncommon and thus require further exploration...
February 8, 2019: Annals of Otology, Rhinology, and Laryngology
Kwan-Sub Kim, Sung Chul Yu, Jung-Woo Han, Sung-Min Shim, Soohyun Kwak, Yong-Min Kim, Seong-Su Kim
PURPOSE: Nasal bone fracture reduction surgery is normally followed by nasal packing to control bleeding. Yet, patients suffer from pain and require further analgesic treatments following nasal packing and removal. This study aimed to evaluate the effect of fentanyl-soaked packing as a method of controlling pain after nasal surgeries in a prospective, randomized, double-blind controlled trial. METHODS: Sixty-five patients that have undergone closed nasal bone fracture reduction surgery were included in this study...
February 8, 2019: Journal of Plastic Surgery and Hand Surgery
Elizabeth George, Catherine H Phillips, Nandish Shah, Annie Lewis-O'Connor, Bernard Rosner, Hanni M Stoklosa, Bharti Khurana
Purpose To assess the radiologic findings associated with intimate partner violence (IPV). Materials and Methods Electronic medical records of 185 patients referred to the IPV support program from the emergency department (ED) between January 2015 and October 2016 were retrospectively reviewed and compared with an age- and sex-matched control group of 555 subjects (1:3 ratio of IPV victims to control subjects) who presented to the ED. Reports of all imaging studies performed within 5 years prior to the index ED visit were reviewed...
February 5, 2019: Radiology
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