1/49. Assessment, documentation, and treatment of a developing facial asymmetry following early childhood injury.Prepubertal trauma is often implicated as the cause of asymmetric growth of the mandible. A series of photographs taken before and after early childhood injury to the orofacial complex illustrates the development of a three-dimensional dentofacial deformity in a patient. The diagnosis and combined surgical orthodontic treatment plan to correct the facial asymmetry and malocclusion are discussed.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/49. Unusual dental injuries following facial fractures: report of three cases.We report 3 cases of unusual dental injuries following facial fractures. The first patient sustained intrusion of a maxillary incisor into the nasal cavity following a mandibular fracture. The tooth dislocated into the pharynx and was found lodged in the piriform fossa during surgery. The second patient sustained intrusion of molars into the maxillary sinus following maxillary and mandibular fractures. His treatment was delayed due to life-threatening hemorrhage. The third case involved ingestion of multiple avulsed teeth into the alimentary tract following severe maxillofacial fractures. Although the diagnosis was made more than a week after the injury, the patient did not suffer any complications as a result of the dental avulsion. The aim of this report is to emphasize the possibility of associated dental injuries in patients with facial fractures. The trauma surgeon should be cognizant of the importance of carrying out a thorough intraoral examination during the initial evaluation. Any missing tooth should be considered as possibly displaced into other tissue compartments, and must be routinely searched for with x-rays of the skull, cervical spine, chest, and abdomen. If full intrusion injury is suspected, further diagnostic investigation with facial computed tomography scanning may be worth while.- - - - - - - - - - ranking = 0.40000485548742keywords = injury, chest (Clic here for more details about this article) |
3/49. Non-free osteoplasty of the mandible in maxillofacial gunshot wounds: mandibular reconstruction by compression-osteodistraction.We have treated 33 young men with medium to large (3-8 cm) bony and soft tissue defects of the lower third of the face caused by gunshot wounds. After debridement, collapsing the proximal segments for primary approximation of soft and hard tissues and a closed osteotomy of a small fragment of mandible, we used an original compression-distraction device, designed in 1982 and tested during 1983 (analogous devices were absent at that time) to reposition the mandible and cause callus to form (during distraction) between the fragment and to use the remaining stumps of bone to fill in the defect. The soft tissues were repaired at the same time. Twenty-eight of the patients presented within a few hours of injury, and the remaining five had old injuries. The only complications were in the group with old injuries where four patients developed abscesses that required drainage, but these did not interfere with the process of osteogenesis. All 33 patients had good functional and aesthetic results within 3-4.5 months. The method allows a bloodless minimally traumatic procedure which can be carried out in one stage. The results compare very favourably with the classic methods of the treatment of mandibular gunshot injuries.- - - - - - - - - - ranking = 0.2keywords = injury (Clic here for more details about this article) |
4/49. Malformation in the primary and permanent dentitions following trauma prior to tooth eruption: a case report.Dento-facial injuries that occur prior to the eruption of teeth in the primary dentition are rare, but can result in damage to the primary dentition. We report a rare case where an injury to the anterior maxilla and mandible of an infant prior to primary tooth eruption resulted in hypoplasia, displacement and impaction of the primary dentition and damage to a developing permanent tooth.- - - - - - - - - - ranking = 0.2keywords = injury (Clic here for more details about this article) |
5/49. Maxillofacial-transclival juxtabasilar penetrating butcher's knife injury: a case report.A 90-year-old woman presented with an accidental maxillofacial-clival penetrating injury with a butcher's knife, with its tip reaching the immediate proximity of the basilar artery. The knife was removed at surgery, with no untoward sequelae.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
6/49. Craniofacial impalement injury: a rake in the face.Impalement injuries describe unusual objects and circumstances in which a body part is either partially embedded (one end sticking out) or transected (through-and-through) by a foreign material. In either case, the object remains as part of the wound and is highly conspicuous. These injuries are much more common on the trunk and extremities because of their larger surface areas and the relative ease in which the object may penetrate them without lethal consequences. In the face, however, such injuries are more rare because of protective reflexes that either move the face away from the coming object or permit it only to be deflected away without being embedded. In addition, the face presents a much smaller target than the rest of the body and, therefore, is more infrequently impaled. This paper presents a case that illustrates many of the classic features of the craniofacial impalement-type injury.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
7/49. The use of osseointegrated implants in craniofacial trauma.The objective in treating patients with injuries sustained in craniofacial trauma is to reinstate preinjury facial projection and function. The capability of providing spatially related facial reconstruction is predicated on basic craniofacial surgical principles, generally accepted as the standard of care. These principles include early surgical intervention, immediate bone grafting, and the use of internal rigid fixation. The introduction of osseointegrated dental implants has significantly improved the overall reconstruction of patients with cranio-maxillofacial injuries, including soft tissue repair and cosmetic surgery. The purpose of this article is to review the utilization of dental implants in the context of maxillofacial trauma, using three cases to document the clinical procedure.- - - - - - - - - - ranking = 0.2keywords = injury (Clic here for more details about this article) |
8/49. Priorities in the management of penetrating maxillofacial trauma in the pediatric patient.Penetrating facial trauma is uncommon in children; a large series published by Cooper et al revealed that only 1% to 2% of the total population of infants and children admitted for trauma during their study period had a diagnosis of penetrating trauma to the head or neck. Little has been published specifically addressing these injuries in the pediatric population. The records of 20 patients treated for penetrating facial injuries at Kosair-Children's Hospital in Louisville, kentucky from January 1991 through December 1994 were reviewed. The location, mechanism and extent of injury, as well as the diagnostic and management practices used in patient treatment, were collected. Categorizing the injuries relative to the involvement of one or more facial zones helped guide diagnostic studies and therapeutic intervention and predict associated injuries. This article evaluates the authors' method of management and any differences in management between pediatric and similarly injured adult patients.- - - - - - - - - - ranking = 0.2keywords = injury (Clic here for more details about this article) |
9/49. Delayed signs and symptoms after oropharyngeal trauma in a child.Injury to the oropharynx can be potentially life threatening. Innocent-looking injuries of the oropharynx may result in intravascular thrombosis of the internal carotid artery. The symptoms often appear some time after the initial injury. We present a case in which an apparently minor injury of the oropharynx developed into a life-threatening thrombus stretching from the internal carotid to the brain. Our patient underwent endarterectomy and thrombectomy. The case is presented with a review of the literature.- - - - - - - - - - ranking = 0.4keywords = injury (Clic here for more details about this article) |
10/49. Elevated blood lead resulting from maxillofacial gunshot injuries with lead ingestion.PURPOSE: The purpose of this study was to identify the contribution of ingested lead particles to elevated blood lead concentrations in victims of gunshot injury to the maxillofacial region. patients AND methods: As part of a larger study of the effects of retained lead bullets on blood lead, a retrospective review of study findings was completed on 5 of 8 patients who sustained injuries to the maxillofacial region. These 5 patients were recruited into the larger study within 11 days of injury and showed a penetration path for the projectile that engaged the upper aerodigestive tract. All subjects were recruited from patients presenting for care of their gunshot injuries to a large inner-city trauma center with a retained bullet resulting from a gunshot injury. An initial blood lead level was measured for all recruited patients and repeated 1 to 17 weeks later. Medical history was taken along with a screening and risk factor questionnaire to determine other potential or actual sources (occupational/recreational) of lead exposure. (109)Cd K-shell x-ray fluorescence determinations of bone lead were completed to determine past lead exposure not revealed by medical history and risk factor questionnaire. Radiographs taken of the abdomen and chest, required as a part of the patient's hospital care, were retrospectively reviewed for signs of metallic fragments along the aerodigestive tract. RESULTS: All 5 patients retained multiple lead pellets or fragments at the site of injury, sustained fractures of the facial bones, and showed increases in blood lead. Three of the 5 study subjects who sustained maxillofacial gunshot injuries involving the mouth, nose, or throat region showed metallic densities along the gastrointestinal tract indicative of ingested bullet fragments. Each patient with ingested bullet fragments showed rapid elevation of blood lead exceeding 25 microg/dL and sustained increases well beyond the time when all ingested fragments were eliminated. A 3-year follow-up on these 3 patients showed significantly sustained elevation of blood lead but less than that observed during the initial 6 months after injury. None of the 5 study subjects showed any evidence of metallic foreign bodies within the tracheobronchial regions indicative of aspiration. CONCLUSION: Ingestion of lead fragments can result from gunshot injuries to the maxillofacial region and may substantially contribute to a rapid increase in blood lead level. Prompt diagnosis and elimination of ingested lead fragments are essential steps necessary to prevent lead being absorbed from the gastrointestinal tract. Increased blood lead in victims after gunshot injuries must be fully evaluated for all potential sources, including recent environmental exposure, absorption of lead from any remaining bullets in body tissues, and the possibility of mobilization of lead from long-term body stores such as bone.- - - - - - - - - - ranking = 1.0000048554874keywords = injury, chest (Clic here for more details about this article) |
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