-
Australian Dental Journal Jun 2017Alcohol-related facial trauma is an increasingly prominent social problem and health hazard. Interpersonal violence (IPV) is often implicated in these trauma...
BACKGROUND
Alcohol-related facial trauma is an increasingly prominent social problem and health hazard. Interpersonal violence (IPV) is often implicated in these trauma presentations and the facial skeleton frequently targeted. This paper examines the characteristics of admitted patients with alcohol-related facial fractures.
METHODS
Electronic data of patients assessed or treated for facial fractures from January 2012 to December 2014 at Western Health was obtained through the Clinical Record Department. Variables analysed include patient age and gender, fracture site(s), alcohol involvement, country of birth, injury mechanism and surgical intervention.
RESULTS
Of 659 patient records analysed, 18% presentations had alcohol involvement. In the alcohol group, 88% were male, 44% in the 20-34 year age group, 41% suffered nasal fractures, 65% presented following IPV and 60% required surgery. Thirty-seven per cent of patients were non-Australians. Alcohol involvement was significantly correlated with gender, age group and fracture sites but not with surgical intervention or ethnic origin.
CONCLUSIONS
A binge drinking culture has contributed to prevalence of alcohol-related trauma. This study reports alcohol involvement in facial fractures to have high predilection for gender, age group of patients and fracture location. Facial trauma frequently necessitates surgical intervention. Educational programmes should be implemented to raise awareness of this potentially preventable health burden among health providers.
Topics: Accidents, Traffic; Adolescent; Adult; Aged; Alcohol Drinking; Alcoholism; Australia; Child; Child, Preschool; Data Collection; Facial Bones; Female; Hospitalization; Humans; Infant; Male; Maxillofacial Injuries; Middle Aged; Skull Fractures; Software; Spouse Abuse; Treatment Outcome; Violence; Young Adult
PubMed: 27743391
DOI: 10.1111/adj.12471 -
Tidsskrift For Den Norske Laegeforening... Apr 2022
Topics: Humans; Orbital Fractures; Tomography, X-Ray Computed
PubMed: 35383443
DOI: 10.4045/tidsskr.21.0586 -
CMAJ : Canadian Medical Association... Jan 2024
Topics: Humans; Skull Fractures; Nose
PubMed: 38253375
DOI: 10.1503/cmaj.231013 -
Acta Clinica Croatica Dec 2018- A case of a 37-year-old female patient is presented. The patient was admitted to the Surgical Emergency Unit after accidental fall on a metal rod when she had...
- A case of a 37-year-old female patient is presented. The patient was admitted to the Surgical Emergency Unit after accidental fall on a metal rod when she had sustained stab injury of the right orbit with penetration into the right frontal brain lobe. Multi-slice computed tomography (MSCT) showed penetrating injury and fracture of the right orbital roof without eyeball damage and endocranial impressed bone fragments into the right frontal brain lobe. Urgent surgical intervention was performed by a maxillofacial surgeon and neurosurgeon, including reposition of bone fragments of the orbital roof and cranioplasty. Reconstruction of Tenon's capsule of the right eyeball was performed by an ophthalmologist. From the intraoperative wound swab of the orbit, was isolated, therefore the patient was administered ciprofloxacin and rifampicin as recommended by an infectious disease (ID) specialist. Follow up brain MSCT at 15 days and magnetic resonance imaging of the brain at 25 days showed brain edema in the right frontal area and signs of local brain abscess. Intravenous administration of the ciprofloxacin and metronidazole antibiotics with corticosteroids for edema suppression were ordered by the ID physician. Fourteen weeks after this therapy, brain MSCT showed complete abscess regression and no neurologic deficit with only mild psychomotor changes.
Topics: Adult; Anti-Bacterial Agents; Brain Abscess; Eye Injuries; Female; Fracture Fixation; Humans; Magnetic Resonance Imaging; Neurosurgical Procedures; Ophthalmologic Surgical Procedures; Orbit; Orbital Fractures; Postoperative Complications; Skull; Tomography, X-Ray Computed; Treatment Outcome; Wounds, Penetrating
PubMed: 31168221
DOI: 10.20471/acc.2018.57.04.26 -
The Indian Journal of Surgery Dec 2015Elevated skull fractures form a rare subset of compound skull fractures. Owing to the paucity of cases studied and reported, these fractures still remain an... (Review)
Review
Elevated skull fractures form a rare subset of compound skull fractures. Owing to the paucity of cases studied and reported, these fractures still remain an under-recognized entity. We attempt to highlight the incidence of these relatively rare presentations of head injury. We had prospectively studied eight cases of elevated skull fractures in a mixed population of adults (five patients) and pediatric age group (three patients). Patients were evaluated in terms of clinical presentation, mode and mechanism of injury, treatment options, and final outcome, highlighting the appropriate management strategies taken in each case. The injury in these patients was due to tangential impact of a heavy object or assault weapon. Compounding of the fracture externally and dural tears was an inconstant feature. Associated intracranial injuries were cerebral contusions and extradural hematomas. An initial conservative therapy was given to all pediatric patients while adult patients underwent explorative craniectomy and evacuation of hematoma. Although an unusual presentation of skull fractures, elevated skull fractures warrant an early diagnosis, careful clinical evaluation, and prompt surgical therapy (whenever needed) for a successful outcome.
PubMed: 27011556
DOI: 10.1007/s12262-014-1093-7 -
International Journal of Molecular... Feb 2018The temporomandibular joint (TMJ) is an articulation formed between the temporal bone and the mandibular condyle which is commonly affected. These affections are often... (Review)
Review
The temporomandibular joint (TMJ) is an articulation formed between the temporal bone and the mandibular condyle which is commonly affected. These affections are often so painful during fundamental oral activities that patients have lower quality of life. Limitations of therapeutics for severe TMJ diseases have led to increased interest in regenerative strategies combining stem cells, implantable scaffolds and well-targeting bioactive molecules. To succeed in functional and structural regeneration of TMJ is very challenging. Innovative strategies and biomaterials are absolutely crucial because TMJ can be considered as one of the most difficult tissues to regenerate due to its limited healing capacity, its unique histological and structural properties and the necessity for long-term prevention of its ossified or fibrous adhesions. The ideal approach for TMJ regeneration is a unique scaffold functionalized with an osteochondral molecular gradient containing a single stem cell population able to undergo osteogenic and chondrogenic differentiation such as BMSCs, ADSCs or DPSCs. The key for this complex regeneration is the functionalization with active molecules such as IGF-1, TGF-β1 or bFGF. This regeneration can be optimized by nano/micro-assisted functionalization and by spatiotemporal drug delivery systems orchestrating the 3D formation of TMJ tissues.
Topics: Adipose Tissue; Animals; Bone Marrow Cells; Bone Regeneration; Cell Differentiation; Fibroblast Growth Factor 2; Humans; Insulin-Like Growth Factor I; Regenerative Medicine; Skin; Skull Fractures; Stem Cell Transplantation; Stem Cells; Temporomandibular Joint; Tissue Engineering; Tissue Scaffolds; Transforming Growth Factor beta1
PubMed: 29393880
DOI: 10.3390/ijms19020446 -
Otology & Neurotology : Official... Dec 2022Report the incidence of and treatment patterns for facial nerve palsy after skull base fracture.
OBJECTIVE
Report the incidence of and treatment patterns for facial nerve palsy after skull base fracture.
STUDY DESIGN
Retrospective cohort study.
SETTING
IBM MarketScan Commercial Database (2006-2019).
PATIENTS
Human subjects with skull base fracture, per International Classification of Diseases-9th and 10th Revisions-Clinical Modification diagnosis codes.
MAIN OUTCOME MEASURES
The primary outcomes were the incidence and median time to facial nerve palsy diagnosis within 30 days of skull base fracture. Secondary outcomes were treatments (corticosteroids, antivirals, facial nerve decompression, botulinum toxin, and facial reanimation), demographics, and rates of hearing loss, vertigo, tympanic membrane rupture, cerebrospinal fluid leak, comorbidities, and loss of consciousness.
RESULTS
The 30-day incidence of facial nerve palsy after skull base trauma was 1.0% (738 of 72,273 patients). The median (95% confidence interval [CI]) time to diagnosis was 6 (6-7) days, and only 22.9% were diagnosed within 1 day. There were significantly higher rates (risk difference, 95% CI) of hearing loss (26%, 22-29%), tympanic membrane rupture (6.3%, 4.5-8.1%), cerebrospinal fluid leak (6.4%, 4.5-8.3%), comorbidity (14%, 10.4-17.6%), and loss of consciousness (24.3%, 20.7-27.9%). Loss of consciousness was associated with longer median (95% CI) time to facial nerve palsy diagnosis: 10 (9-10) days. Corticosteroids were the most common treatment but only reported for less than one-third of patients. Only eight patients underwent facial nerve decompression.
CONCLUSIONS
Facial nerve palsy after skull base fracture is associated with higher comorbidity, and the diagnosis is often delayed. Few patients were treated with surgery, and there are inconsistencies in the types and timing of treatments.
Topics: Humans; Facial Paralysis; Incidence; Retrospective Studies; Tympanic Membrane Perforation; Craniocerebral Trauma; Skull Base; Cerebrospinal Fluid Leak; Hearing Loss; Unconsciousness; Skull Fractures
PubMed: 36214506
DOI: 10.1097/MAO.0000000000003721