Cases Of Facial Trauma Research Articles

Facial trauma education in radiology: using surgeon feedback as the benchmark for success.

Interpreting CT studies of facial trauma is challenging, and there are often substantial differences in the characterization of complex facial trauma between radiologists and surgeons. We designed a collaborative multidisciplinary project to reconcile differences in facial fracture interpretation through an educational intervention. The effectiveness of this intervention was evaluated through surgeon feedback on radiology reports. Radiology residents, neuroradiology fellows, and neuroradiology attendings were recruited as participants at a single tertiary care academic center. Otolaryngology residents were recruited as evaluators. Participants completed surveys and provided preliminary reports for example cases of facial trauma before and after attending an educational session. Evaluators performed a blinded review of these preliminary reports based on ideal reports developed by surgical and neuroradiology attendings. 26 participants (20 residents, 1 neuroradiology fellow, 5 neuroradiology attendings) completed the study. Six otolaryngology residents participated as evaluators. To assess interrater reliability, three evaluators graded a shared set of 15 reports and demonstrated substantial agreement with a Kendall's W of 0.71. Participants demonstrated significant improvement in overall report accuracy, clarity, and organization. In subunit analysis, there were significant improvements in reporting Le Fort, nasoseptal, and nasoorbitoethmoid fractures. No significant improvements occurred in the reporting of upper face, zygomaticomaxillary complex, or mandibular fractures. In contrast, survey analysis demonstrated significantly improved confidence in interpreting trauma involving all facial subunits. Compared with survey results, surgeon assessment of radiology reports better demonstrated areas of improvement after an educational intervention. A multidisciplinary approach to assessing educational efforts may better evaluate the practical effectiveness of educational interventions.

A Comparison of the Specific Facial Trauma Cases at the Department of Maxillofacial Surgery, Gdansk, Poland, from March 2019 to August 2023.

Background: Accidents involving the maxillofacial area are sudden and unforeseen, such as traffic accidents and physical altercations. The COVID-19 pandemic was a critical threat to the public in aspects not only involving physical health but also those affecting psychological health due to isolation, leading to a higher incidence of stress and depression among the general population and specifically in patients with OMF trauma. This study assessed the relationship between the impact of the COVID-19 pandemic and the quantity and severity of maxillofacial injuries. Methods: Data were retrieved from the Department of Maxillofacial Surgery of the University Clinical Centre in Gdansk from March 2019 to August 2023. Results: There was an increased risk of injury occurrence to the condylar process of the mandible, especially the left side, Le Fort type II/III fractures, injuries of the maxillary alveolar process, and displacement of the upper facial mass. Simultaneously, a decreased occurrence of certain injuries i.e., Le Fort type III fractures and Le Fort type I/II fractures, was recorded. Conclusions: The COVID-19 pandemic led to an increased occurrence of high-energy injuries, including displacement of the upper facial mass (p = 0.010).

Rehabilitation Surgery for Peripheral Facial Nerve Injury after Facial Trauma.

Introduction Facial trauma can cause damage to the facial nerve, which can have negative effects on function, aesthetics, and quality of life if left untreated. Objective To evaluate the effectiveness of peripheral facial nerve direct end-to-end anastomosis and/or nerve grafting surgery for patients with facial nerve injury after facial trauma. Methods Fifty-nine patients with peripheral facial nerve paralysis after facial injuries underwent facial nerve rehabilitation surgery from November 2017 to December 2021 at Ho Chi Minh City National Hospital of Odontology. Results All 59 cases of facial trauma with damage to the peripheral facial nerve underwent facial nerve reconstruction surgery within 8 weeks of the injury. Of these cases, 25/59 (42.3%) had end-to-end anastomosis, 22/59 (37.3%) had nerve grafting, and 12/59 (20.4%) had a combination of nerve grafting and end-to-end anastomosis. After surgery, the rates of moderate and good recovery were 78.4% and 11.8%, respectively. All facial paralysis measurements showed statistically significant improvement after surgery, including the Facial Nerve Grading Scale 2.0 (FNGS 2.0) score, the Facial Clinimetric Evaluation (FaCE) scale, and electroneurography. The rate of synkinesis after surgery was 34%. Patient follow-up postoperatively ranged from 6 to > 36 months; 51 out of 59 patients (86.4%) were followed-up for at least 12 months or longer. Conclusion Nerve rehabilitation surgery including direct end-to-end anastomosis and nerve grafting is effective in cases of peripheral facial nerve injury following facial trauma. The surgery helps restore nerve conduction and improve facial paralysis.

Epidemiological profile of maxillofacial traumas served by the residency program of the hospital of the sugarcane suppliers of Piracicaba and hospital Santa Barbara - retrospective study

The aim of this study was to assess the epidemiological characteristics of maxillofacial trauma in the Piracicaba and Santa Barbara region - Sao Paulo, in a 4-year period. A descriptive and retrospective study was developed to analyze the epidemiological profile of facial trauma cases treated by the Residency Program of the Hospital of Sugarcane Suppliers of Piracicaba e Santa Barbara Hospital, through the evaluation of 625 medical records between March 2017 and December 2020, over a period of 04 years. Variables such as age, gender, etiology, type of trauma, type of treatment and presence or absence of postoperative complications were analyzed. The predominant age group was that of adults (20-59 years), the male gender was more affected with 76.74% of the sample. The most frequent etiology was a fall from a height (22.58%), followed by physical aggression (19.84%). Jaw fractures (17.07%) were more prevalent, followed by fractures of the nasal bone (16.26%). Conservative treatment of fractures was predominant (54.09%). The sample had a low complication rate (2.56%) and infections were the most observed complications (48.39%). The epidemiological characteristics of the population studied through data collection allowed the presentation of a profile of individuals affected by oral and maxillofacial trauma. The evaluation of the types of treatments performed and the complications allows a better perception of the particularity of the management of patients with facial trauma.

COVID-19 impact on facial trauma: Insights from Mississippi's only level 1 trauma center

PurposeOur primary aim was to understand and describe the impact of COVID-19 on the incidence and etiology of facial trauma in the state of Mississippi. MethodsRetrospective review of facial trauma-related Emergency Department encounters in Mississippi from March 11, 2019 to March 10, 2021, divided into three time periods using the state of Mississippi's Governor's Office Executive Orders. Chi-square tests and segmented linear regressions were used for analysis. ResultsPatients presenting with facial trauma were typically male, 18–44 years old, and lived in urban zip codes. Insurance payors significantly differed across time periods. There were no significant differences in self-inflicted assault or accidental injury between the 3 time periods, with pre- and pandemic patients more likely to be self-pay while patients during recovery being more likely to have private insurance. During the pandemic, facial trauma from a family member, partner or spouse, or other person in the household significantly increased. ConclusionSimilar accidental facial trauma trends may reflect lower adherence to social distancing guidelines. The increase in facial trauma perpetrated by family members is consistent with reported increases in domestic violence during the pandemic. While overall facial trauma demographic patterns did not change significantly during the COVID-19 pandemic, there were notable changes in the etiology and insurance payor of facial trauma cases. Lay summaryThe COVID-19 pandemic impacted healthcare systems worldwide, and our study seeks to understand how the pandemic affected incidence of facial trauma.Level of evidence: 2.

Factors associated with complications of submental intubation in 339 patients with facial fractures: A German retrospective cohort study

PurposeFor nearly four decades, submental intubation (SI) has been introduced and employed to avoid tracheostomy in facial trauma cases where nasal/oral intubation is infeasible or associated with possible risks. The purposes of this study were to estimate the frequency and to identify variables associated with complications of SI (CSI). MethodsThe authors organised a retrospective cohort study and enrolled a group of patients with facial trauma and SI during a seven-year interval at two German level one trauma centres where SI has routinely been used in complex facial trauma cases. The predictor variables included demographic, medical, dental, fracture-related, operative, and postoperative parameters. The outcome variable was CSI. We used descriptive, bivariate, and multivariate analyses at the 0.05 significant level. ResultsThe sample included 339 patients (24.5% females, 9.4% had complications) with an average age of 58.2 ± 12.0 years (range, 17–89). Bivariate analyses revealed nine significant variables. However, forward stepwise multiple logistic regression modelling identified three variables statistically associated with CSI: smoking (OR, 691.8; 95% CI, 75.9 to 6303.9; P < 0.0001; number needed to harm [NNH], 6), moderate to high gingival inflammation (OR, 786.7; 95% CI, 66 to 9378.9; P = 0.002; NNH, 12), and postoperative use of chlorhexidine mouthwash (OR, 0.03; 95% CI, 0.001 to 0.77; P = 0.0003; number needed to treat [NNT], 2). Conclusionssmokers and subjects with gingivitis were more likely to experience CSI. Postoperative chlorhexidine rinsing was the potentially modifiable, albeit low-OR, factor. These findings could help to draw an effective guideline against the CSI.

False-positive Xpert® Xpress SARS-CoV-2 assay in an emergency room and trauma center: A retrospective chart review study.

To review reports false-positive Xpert results in an emergency room and trauma center. Patients' data with false-positive Xpert results from November 2020 to February 2022 at Pusan National University Hospital, Busan, Republic of Korea, were extracted from the electronic medical records. The positive predictive value of Xpert was 40%. Of the 12 patients with false-positive results, 5 (41.7%) were re-positives (such as, patients recovered from coronavirus disease-19 [COVID-19]), and 4 (33.3%) had head or facial trauma. Two out of 4 head or facial trauma cases had documented sample contamination with blood. We found a high incidence of false-positive Xpert results among patients who recovered from COVID-19 and those with head or facial injury. Careful history taking for COVID-19 and physical examination of the sample collection site is essential before Xpert analysis.

Working Smarter, Not Harder: Using Data-Driven Strategies to Generate Front-End Cost Savings through Price Negotiation and Supply Chain Optimization.

Supply chain optimization is an effective method of generating front-end cost savings and increasing hospital profits. Through the negotiation and renegotiation of supply chain contracts, plastic surgeons can dramatically change the price at which they purchase surgical supplies and implants. This study characterizes the potential impact of supply chain optimization and puts forth a generalizable, systematic approach for successful sourcing. From October of 2017 to September of 2018, the authors examined all patients taken to the operating room for either a facial fracture or a hand fracture. Cost data were collected, Supply Chain Information Management numbers were used to determine whether each item used during the study period was under contract, and cost savings based on contract negotiation were calculated. Potential cost savings were calculated using the BillOnly calculator. For the 77 facial trauma cases and 63 hand trauma cases performed, a total of 330 items (70 distinct items) were used, 47 percent of which were under contract (47 percent contract use), with an average negotiated discount of 49 percent. Based on BillOnly material cost estimates, the authors' institution would need to increase its contract use to 70 percent to achieve a net savings of 19 percent, and to 90 percent to achieve a net savings of 39 percent. The authors also estimated that if contract use increased to 90 percent, net savings would increase commensurately with increases in the average discount negotiated. Supply chain optimization offers plastic surgeons the potential to significantly decrease surgical costs while maintaining surgical quality.

Comparing diagnosis of midfacial fractures by radiologists and plastic surgeons.

Clinicians who manage facial fractures often rely on radiologist interpretations to help with assessment and management. Among treating physicians, facial fractures are categorized into clinically relevant patterns of injury. On the other hand, while radiologists are unsurpassed at identifying individual breaks in the bone, larger fracture patterns are not always conveyed in radiology reports. This study aims to assess the frequency with which the terminology describing midfacial fracture patterns is concordant among radiologists and treating clinicians. The authors identified patients with different patterns of midfacial injury including Le Fort I, Le Fort II, Le Fort III, naso-orbito-ethmoid (NOE), and zygomaticomaxillary complex (ZMC) fractures. Plastic surgery consult notes and radiological imaging reports were reviewed for concordance in documentation of injury patterns. Identification of individual fractures consistent with the diagnosed fracture pattern was also recorded. Radiologists were noted to be highly successful in describing individual fractures of the facial bones, identifying at least two defining components of a fracture pattern in 96% of Le Fort, 88% of NOE, and 94% of ZMC injuries. However, when injury patterns were considered, only 32% of Le Fort, 28% of ZMC, and 6% of NOE fractures were explicitly identified in radiology reports. Radiologists are highly skilled in discerning individual fractures in facial trauma cases. However, less reliability was seen in the identification of fracture patterns in midfacial injury, with particular weaknesses in descriptions of NOEand ZMC fractures. This data suggests that greater focus on patterns of midfacial injury would improve the clinical applicability of radiological reports.

EPPOCRATIS: Expedited Preoperative Point-of-Care Reduction of Fractures to Normalized Anatomy and Three-Dimensional Printing to Improve Surgical Outcomes.

Virtual surgical planning and three-dimensional printing have been invaluable tools in craniomaxillofacial surgery. From planning head and neck reconstruction to orthognathic surgery and secondary reconstruction of maxillofacial trauma, virtual surgical planning and three-dimensional printing allow the surgeon to rehearse the surgical plan and use patient-specific surgical guides for carrying out the plan accurately. However, the process of virtual surgical planning and three-dimensional printing requires time and coordination between the surgeon on one hand and the biomedical engineers and designers on the other hand. Outsourcing to third-party companies contributes to inefficiencies in this process. Advances in surgical planning software and three-dimensional printing technology have enabled the integration of virtual surgical planning and three-dimensional printing at the treating hospital, the point of care. This allows for expedited use of this process in semiurgent surgical cases and acute facial trauma cases by bringing the surgeon, radiologist, biomedical engineers, and designers to the point of care. In this article, the authors present the utility of EPPOCRATIS, expedited preoperative point of care reduction of fractures to normalized anatomy and three-dimensional printing to improve surgical outcomes, in the management of acute facial trauma.

Orbital Floor Fractures: Epidemiological, Clinical and Therapeutical Study at Sylvanus Olympio University Teaching Hospital in Lom&amp;#233; about 51 Cases

Introduction: Orbital floor fractures are a significant pathology among maxillofacial injuries. They can cause oculomotor, sensory, and sometimes esthetic disorders. The goal of this study was to determine the epidemiological profile of orbital floor fractures and show their clinical and therapeutic approach in Lomé. Patients and method: This was a descriptive retrospective study of orbital floor fractures collected in the ENT and maxillofacial surgery department of Sylvanus Olympio University Hospital in Lomé over 8 years (January 1, 2011 to December 31, 2018). Results: We reviewed 63 cases of orbital floor fractures out of 552 cases of facial trauma. According to the inclusion and non-inclusion criteria, we retained 51 cases. The hospital frequency of orbital floor fractures was 9.24% of facial fractures. The average age of the patients was 35 ± 10.34 years. Males were predominant (ratio = 7.5). The main etiology was road accidents (92.16%). Ophthalmological signs were dominated by vertical diplopia (31.37%), limited eye movement (25.49%), and enophthalmia (29.41%). The sensory sign was dominated by suborbital hypoesthesia (13.73%). Surgical treatment was performed in 86.27% of patients. The average intervention time was 17.84 ± 12.69 days after the trauma. The main approach was the subciliary route (65.91%). The surgical procedures consisted of muscle and fat removal (20.45%) and orbital floor repair by mesh plate (50%). The average length of hospitalization was 9.63 ± 5.23 days. Surgical site infection was the main postoperative complication observed in 3.92% of patients. The main sequelae were diplopia (4.55%), suborbital hypoesthesia (4.55%), and enophthalmos (4.55%). Conclusion: Orbital floor fractures are mainly due to road accidents. Management must be multidisciplinary and adequate in order to avoid irreversible functional and/or morphological sequelae. Their prevention consists of effective combat of road accidents.

Quantifying Aerosolization of Facial Plastic Surgery Procedures in the COVID-19 Era: Safety and Particle Generation in Craniomaxillofacial Trauma and Rhinoplasty.

Background: COVID-19 poses a potentially significant infectious risk during procedures of the head and neck due to high viral loads in the nasal cavity and nasopharynx. Facial plastic surgery has significant exposure to these areas during craniomaxillofacial trauma procedures and rhinoplasty. Methods: Airborne particulate generation in the 1-10 μm range was quantified with an optical particle sizer in real time during cadaveric-simulated rhinoplasty and facial trauma conditions. Procedures tested included mandibular plate screw drilling, calvarial drilling, nasal bone osteotomy, nasal dorsal rasping, and piezoelectric saw use. Particulate generation was measured both adjacent to the surgical site and at surgeon mouth level (SML). Results: Mandibular plate screw drilling without irrigation generated significant particulate both adjacent to the surgical site and at SML (p < 0.01). Irrigation mitigated particulate generation at SML to nonsignificant levels. Calvarial drilling additionally produced substantial particulate above baseline adjacent to the surgical site (p < 0.01). Standard nasal osteotomies and dorsal rasping did not generate detectable airborne particulate, whereas piezoelectric saw use was associated with significant particulate generation both adjacent to the surgical site (p < 0.001) and at SML (p < 0.01). At SML, smaller particulate represented a significantly higher proportion of total particulate detected. Conclusions: The majority of craniomaxillofacial trauma procedures involve particle generation that may be limited in spread by the use of local irrigation. Most bony work involved in rhinoplasty can be safely performed without a high degree of particle formation. The use of piezoelectric instruments in rhinoplasty should be avoided when concerned for particulate generation.

Assessment of Craniomaxillofacial Injuries After Electric Scooter Accidents in Turku, Finland, in 2019

Since the introduction of rental electric scooters (ESs), clinicians have increasingly encountered facial trauma patients whose injuries were caused by ES use. Despite this fact, few studies have analyzed these patients, particularly in Nordic countries, where the climate may cause additional challenges. We hypothesized that ESs have caused several facial trauma cases in Turku, Finland, that might be related to the timing of ES use, that is, month, day, and hour. The medical records of all patients in whom craniofacial fractures or dental injuries caused by ES use were diagnosed at Turku University Hospital, Turku, Finland, in 2019 were reviewed. The occurrence and characteristics of injuries, with special reference to time of the accident, intoxication, hospital stay, and additional injuries sustained were analyzed. A total of 23 patients were identified for this analysis. The mean age was 30years, and most patients (n=16) were men. Four patients had not used helmets, whereas for 19, there was no mention whatsoever about helmet use. Of the patients, 21 were intoxicated and 18 had a blood alcohol content greater than 0.1%.A great majority of the accidents occurred in the nighttime (n=17) and during weekends (n=19). Most injuries (n=15) occurred between September and November. We observed craniofacial fractures in 15 patients and dental injuries in 14; brain injuries occurred in 5 patients, and multiple chest injuries occurred in 1. All patients with dental injuries and 9 of the 15 patients with craniofacial fractures required interventions. An average of 3days of hospitalization was required for 14 patients. Injuries associated with ESs result from driving under the heavy influence of alcohol and occur mostly during weekend nights without helmet use.

Sociological and Medical Factors Influence Outcomes in Facial Trauma Malpractice

Medical error in the United States carries substantial economic and safety costs, which manifest in a large number of malpractice suits filed each year. The aim of this study was to characterize the various sociologic and medical factors that influence malpractice suits occurring from cases of facial trauma. This retrospective cohort study examined defendant data from facial trauma malpractice cases extracted from the Westlaw database, a database composed of representative federal litigations. Study variables of interest included geographic region, type of trial, injury category, and provider specialty, which were analyzed for impact on initial and final legal decisions. Descriptive statistics, Pearson χ2 test, and Fisher t test were performed using SPSS. Of the 69 defendants (76.8% men and 23.2% women; age range, 17 to 57yr), which resulted from 53 claims, 12 (17.4%) involved plastic surgeons and 10 (14.5%) involved emergency physicians. Most complaints consisted of inadequate care that deviated from treatment standards (32 [46.4%]) and delayed diagnosis (24 [34.8%]). Of delayed diagnosis cases, 14 patients had radiographic imaging performed. Geographic location of the claim was statistically significant-the Midwest upheld 40% of complaints (P=.007) and the South dismissed 91.4% (P=.027). The impact of sociologic factors, including geographic region, informed consent, and cosmesis, and medical factors, such as delayed diagnosis and deviation from standard of care, in facial trauma litigation were found to be incongruent with previous studies describing the medicolegal influences in facial plastic procedures. This analysis provides greater insight to surgical practitioners across subspecialty disciplines regarding the potential legal implications of malpractice.

Projectile, blunt, or sharp force trauma? A facial lesion on a Bronze Age skull from Uglemose, Denmark.

This study presents and discusses the differential diagnosis of a unique case of facial trauma. The adult male skull was excavated in 1948 from Uglemose (Owl Bog) outside of Birket, on the island of Lolland (Denmark). Carbon-14 samples from an adult tibia excavated with the skull dates to the end of the Danish Bronze Age and transition period into the pre-Roman Iron Age. The skull shows a traumatic ante-mortem lesion to the left maxilla, directly below the orbit, that opens into the maxillary sinus. The left margin of the injury is slightly rounded and angled into the lesion while the right margin is pulled out from the lesion and has a much sharper border, suggesting a directional force from left to right. A previous assessment of the lesion suggested that projectile trauma caused the injury, but the lesion does not conclusively demonstrate features of projectile trauma. CT scans and 3D visualization of the skull show no evidence of structural changes to the maxillary sinus to support a conclusion of projectile trauma. Differential diagnosis through macroscopic and microscopic analysis of the lesion would suggest rapid blunt force or slow sharp force trauma as a potential etiology. The aim of this case study is to discuss the potential mechanisms of injury, including type of trauma as well as accidental versus intentional etiologies.

Novel Use of a Disposable Syringe Barrel as a Mouth Prop in Emergency Maxillofacial Trauma Cases to Access Intraoral Soft Tissue Injuries.

Oral and maxillofacial surgeons are often called in emergency situations during odd hours to manage facial trauma cases. While addressing these patients, many a times the surgeon might require to keep the patients mouth open for long time while accessing intraoral injuries. This can become difficult for a surgeon if in case regular dental mouth props/mouth gags are not available at a particular surgical setup. The author here describes a technique of using a standard disposable syringe as a mouth prop in emergency cases to access and repair any intraoral injury in absentia of a regular mouth prop/mouth gag.

An Update on Osteomyelitis Treatment in a Pycnodysostosis Patient

The aims of the present study were to discuss the demographic distribution and clinical characteristics of patients with pycnodysostosis (PYCD) and the onset of osteomyelitis and its treatment using a literature review. The authors also report on an update of treatment of mandibular osteomyelitis in a patient with PYCD using a buccal fat pad (BFP) as a free graft. The study was carried out in 2 steps. In the first step, an electronic search was undertaken in PubMed in March 2018, with 17 articles being included. In the second step, the authors present a case of mandibular osteomyelitis in a 30-year-old woman with PYCD treated by sequestrectomy and a BFP as a free graft (follow-up, 24months). Twenty-one cases of osteomyelitis of the jaws in patients with PYCD were included. Dental extraction, mandibular fracture, and 1 case of facial trauma represented the causes of mandibular osteomyelitis. Treatments included resection associated with antibiotics and sequestrectomy alone or associated with antibiotics. Despite the good results of the present case, further studies using the BFP as an adjuvant for jaw osteomyelitis are necessary to elucidate its clinical efficiency and safety.

A Facial Trauma Simulation Course for Evaluation and Treatment of Facial Fractures.

Traditional facial trauma laboratories are used for teaching basic concepts of fracture reduction and hardware manipulation. Facial trauma simulation laboratories allow training physicians the opportunity to develop unique treatment plans as they would in real patient encounters. To assess the value of a novel facial trauma simulation course requiring residents to practice advanced decision making. Data were prospectively collected July 23 and August 23 and 24, 2016, in a survey study during a resident physician trauma simulation course. Fresh frozen cadaver heads were fractured using an impactor that applied a measurable amount of force. Each head was scanned with high-resolution computed tomography. Residents were paired and tasked with evaluating their specimen's imaging findings and developing a treatment plan. Before the course, residents were asked their postgraduate year level, number of facial fractures treated as a resident surgeon, and their comfort level based on the Otolaryngology Milestone for Facial Trauma (OMFT; ratings range from 0-5, with 5 indicating equivalent to fellow-level experience). After the course, residents were asked to assess the course's value relative to a theoretical number of actual operative cases, and a posttraining OMFT assessment was obtained. Thirty resident physicians completed the course at 2 institutions. Residents represented an equivalent distribution of postgraduate year levels. The residents stated that the course was worth a mean (SD) of 6.4 (2.8) operative cases of facial trauma in terms of surgical learning. The mean change in self-reported OMFT rating after the course was 0.87 (95% CI, 0.67-1.07; P < .001, paired t test). On the basis of this change in self-perceived OMFT rating, the course was deemed to be worth 1.5 years of residency training in the management of facial fractures. Conducting a facial trauma simulation course increases resident experience with advanced surgical decision making. NA.

Maxillofacial Trauma at LOM&amp;#201; (TOGO): About 501 Cases

Objective: We conducted a retrospective study to determine the epidemiological profile and describe the diagnostic aspects of maxillofacial trauma. Methods: It was a retrospective descriptive study over 20 years (January 1995-December 2014) in Oral and Maxillofacial Surgery Department of the Sylvanus Olympio Teaching Hospital in Lomé. All the hospitalized patients for facial trauma were included. Results: 501 cases of facial trauma were retained with an annual incidence of 25 cases. The average age was 33 years and the most represented age groups are those of 20 to 29 years (35.53%) and 30 to 39 years (30.14%); and the sex ratio was 9. Traffic roads accidents represented the main circumstance (89.81%) and the motorcycle was the most involved (80.34%). Patients were admitted in the first week (75.65%) with 35.93% on the first day. The maxillofacial CT-Scan was the most requested radiological examination (33.75%). Bone lesions were: mandible (31%), zygomatic (23.26%) and maxillary (18.99%). Dental lesions were found in 68 cases. Extra-facial lesions were found in 44 cases. The patients were treated in the first week (62.48%) and in the first day after admission (20.76%). Conclusions: Maxillofacial trauma is increasing, mainly in young adults due to road traffic accidents.

Six years of facial trauma care: an epidemiological analysis of 355 cases

AbstractFacial traumas are frequent in emergencies, and they require the diagnosis of fractures and associated lesions. AimTo analyze epidemiological data concerning facial trauma care. Materials and MethodsThree hundred and fifty-five charts from patients with facial trauma treated by the Service of Otorhinolaryngology, from January 2002 to December 2008, were revised. The following data was collected: age, gender, etiology, anatomical localization of the fracture, associated injuries, alcohol consumption, treatment, and hospitalization. Study DesignA retrospective historical longitudinal study. ResultsMost of the patients are young adult men (p<0.05) with a male:female ratio of 4:1(p<0.05). Interpersonal violence is the most prevalent cause of facial trauma (27.9%), followed by motor vehicle accidents (16.6%) (p<0.05). The mandible is the most prevalent facial bone fractured (44.2%), followed by nasal fracture (18.9%) (p<0.05). 41.1% of the patients consumed alcohol with a male:female ratio of 11.2:1 (p<0.05). Seventy-seven percent of the patients required surgical intervention (p<0.05) and 84.5% were hospitalized (p<0.05). ConclusionYoung male adults are the most prevalent victims of facial trauma, and interpersonal violence is responsible for the majority of the facial injuries. Most of the cases of facial trauma are associated with the consumption of alcohol. Further studies will be necessary to provide a clear understanding of the trends in the etiology of facial trauma.