1/59. A complication of submandibular intubation in a panfacial fracture patient.We present the complication of a mucocele in the floor of the mouth caused by a submandibular intubation in a patient with a panfacial fracture.- - - - - - - - - - ranking = 1keywords = floor, mouth (Clic here for more details about this article) |
2/59. 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 = 0.0078908389827449keywords = mouth (Clic here for more details about this article) |
3/59. Complications of the orbital floor and maxillary sinus 30 years after Coe-Pak misplacement in the management of pan-facial fractures.We present the case of a woman who had sustained pan-facial fractures in a road traffic accident 30 years previously, and describe the ensuing unusual problems with the orbital floor and maxillary sinus as a consequence of unrecognised misplacement of a dental periodontal dressing material into the sinus. The subsequent management is discussed.- - - - - - - - - - ranking = 4.9605458050863keywords = floor (Clic here for more details about this article) |
4/59. Chronic post-traumatic erosion of the skull base.Delayed post-traumatic erosion of the skull base is reported in three patients who presented as adults with cerebrospinal fluid fistulae and a history of recurrent meningitis. These skull defects were associated with herniation of the subarachnoid space into the diploe of the skull base, the paranasal sinuses and the orbit. This rare complication of head injury is assumed to have occurred as the result of a dural tear at the time of trauma. Its site probably determines whether a resulting meningocele widens the intradiploic space or broaches the cranial floor.- - - - - - - - - - ranking = 0.99210916101726keywords = floor (Clic here for more details about this article) |
5/59. ankylosis of the temporomandibular joint developing shortly after multiple facial fractures.A 41-year-old male patient was referred for treatment of extensive facial fractures and lateral condylar dislocations. The patient underwent open reduction and fixation under general anaesthesia. Intermaxillary fixation was released in 2 weeks and mouth opening was 21 mm. Despite postoperative physical exercises, the range of motion decreased to 10 mm at 5 weeks after the surgery. MR arthrography revealed a fibrous ankylosis in the bilateral TMJs. Coronal CT scans depicted a bony outgrowth of the left TMJ tuber. The patient underwent surgery for the ankylosis including discectomy and coronoidectomy, and removal of the bony outgrowth. An interincisal distance of 30 mm on maximal mouth opening has been maintained for 14 postoperative months. The importance of imaging assessment was emphasized for diagnosing the precise pathologic state of the ankylosis and selecting an appropriate surgical treatment of choice.- - - - - - - - - - ranking = 0.01578167796549keywords = mouth (Clic here for more details about this article) |
6/59. Frontobasilar fractures in children.OBJECT: forehead, anterior cranial base and orbito-naso-ethmoidal fractures, combined with brain injuries and dural tears, constitute a frequent pattern of injury in infants and children less than 5 years of age when major anterior craniofacial trauma occurs. Fractures of the orbital roof, despite the common blow-out floor fractures, are considered uncommon events. In children younger than 7 years this pattern of fracture may be a consequence of nonpneumatized frontal sinuses. methods: Complete assessment using CT scans combined with neurosurgical, ophthalmological, anesthesiological and craniofacial reconstructive evaluations are necessary to repair the injured dura and craniofacial skeleton. The coronal approach provides the best exposure of the fractured regions to the surrounding regular structures. CT scans are useful in defining the extent and the pattern of the fractures. Once the brain and dura injuries have been managed by the neurosurgeon, the anterior cranial base must be reconstructed by applying the basic craniofacial principles, reduction and stabilization of fractures, sealing off the anterior cranial base. We present four cases of frontobasilar fractures in children, two of which involved the orbital roof. CONCLUSIONS: The treatment of pediatric maxillofacial traumas, therefore, requires consideration of different factors from those in adults, and a different therapeutic approach: respect of the functional matrix (growth principle) and employment of the least invasive surgical approach. Fixation that adequately stabilizes the facial skeleton is also required. The need to provide rigid bony fixation in the surgical treatment of craniofacial disorders in children without impacting the growth has inspired the evolution of operative techniques and fixation devices, with the development of reabsorbable bone fixation. When bony defects are present or reconstruction of the complete orbital roof and anterior cranial base is required, autogenous cranial bone is used.- - - - - - - - - - ranking = 0.99210916101726keywords = floor (Clic here for more details about this article) |
7/59. Complex cranial base trauma resulting from recreational fireworks injury: case reports and review of the literature.Two patients who sustained complex skull base trauma secondary to recreational fireworks injuries are reported. Initial assessment and management included axial and coronal computerized tomography, control of hemorrhage, debridement of wound and brain, isolation of brain from external environment, and reconstruction of the cranial base floor. Secondary orbital and facial reconstruction used available bone fragments and iliac bone graft in one patient and vascularized free tissue transfer in the other. In both patients, reconstruction of both the intracranial and extracranial compartments was successful with acceptable cosmetic result. Modification of multiple conventional approaches, along with a multispecialty surgical team, was used to deal effectively with these unique cases.- - - - - - - - - - ranking = 0.99210916101726keywords = floor (Clic here for more details about this article) |
8/59. Late enophthalmos mimicking silent sinus syndrome secondary to orbital trauma.The authors present a retrospective case report of a patient who experienced late enophthalmos after blunt orbital trauma. A 27-year-old man presented with subacute onset of enophthalmos, hypoglobus, superior sulcus deformity, and computed tomography evidence of a collapsed maxillary sinus 6 months after sustaining an ipsilateral moderately displaced orbital floor fracture. He was taken to surgery for left endoscopic maxillary antrostomy and implantation of an alloplastic orbital floor graft. Two months after surgery, the patient's diplopia, enophthalmos, hypoglobus, and superior sulcus deformity were markedly improved. Reestablishment of maxillary sinus aeration, the orbital floor, and the medial wall successfully relieved the symptoms and signs of maxillary wall implosion. The mechanism of this rare condition, which shares features similar to silent sinus syndrome, is presented.- - - - - - - - - - ranking = 2.9763274830518keywords = floor (Clic here for more details about this article) |
9/59. Occult fractures of articular eminence and glenoid fossa presenting as temporomandibular disorder: a case report.We report an unusual case of occult fractures of the articular eminence and glenoid fossa due to a previous traffic accident presenting as a temporomandibular disorder. A 24-year-old Japanese man was referred for trismus and pain in the right temporomandibular joint, and was suspected of having temporomandibular disorder. Although the magnetic resonance image did not show displacement of the articular disk, T2-weighted images revealed disruption of the cortical low-intensity line of the right articular eminence. On a computerized tomography (CT) scan, an isolated bone fragment of the right articular eminence was clearly seen, and fractures of the right glenoid fossa and articular eminence were noted. The patient was treated by instructing him not to open his mouth widely and to remain on a soft diet for 4 weeks. A CT examination performed 1 year after the treatment showed complete healing of the fracture in the right articular eminence and glenoid fossa.- - - - - - - - - - ranking = 0.0078908389827449keywords = mouth (Clic here for more details about this article) |
10/59. A nodular calcification of the alar ligament simulating a fracture in the craniovertebral junction.We report a case of an incidental nodular calcification of the alar ligament simulating a fracture in the craniovertebral junction of a previously healthy 24-year-old man. Three-dimensional CT and MR imaging revealed a 7.2 x 7.6 x 4.0 mm nodular calcification in the right alar ligament with normal adjacent bony structures. Serial cervical dynamic radiographs and open-mouth views showed that the cervical spine was stable without any change in the calcification.- - - - - - - - - - ranking = 0.0078908389827449keywords = mouth (Clic here for more details about this article) |
| | Next -> |