Pattern Of Maxillofacial Trauma Research Articles

A Changing Trend in Pattern of Maxillofacial Trauma in Mumbai: A Prospective Study.

Maxillofacial skeleton is the most vulnerable site for trauma due to its prominence. The aim of our study was to analyse the cause and pattern of maxillofacial injuries & to correlate the aetiology and pattern of facial injury. This prospective study includes 304 patients with facial trauma, who reported to our institute within a time span of 2 years. Data were collected on basis of sociodemographic status plus additional data obtained on type of injury, aetiology, location and status of the victim. The most frequent cause of maxillofacial trauma (MFT) was fall (43.3%) followed by RTA (34.2%) and assault (15.1%). In upper 3rd face region frontal bone fracture was prevalent with 1.3%, while in the midface, zygomatic complex (ZMC) fracture (3.9%) and in lower 3rd part of face, mandible fracture (42.8%) and dentoalveolar fracture (30.2%). Mandible was the most prevalent site for trauma. Although fall was the main aetiological factor in our study, midfacial injuries were mainly due to assault and RTA. Combination of mandibular fracture and soft tissue injury were mainly seen in RTA and injury due to fall. Conservative management was mainly employed for treatment with 46.1% followed by ORIF with 36.2%. Changing trend in aetiology of MFT was noted. Furthermore, study should be conducted for better understanding, and to carry out preventive measure for the same.

Etiological factors and patterns of maxillofacial trauma among school-going children: A cross-sectional study at Khyber College of Dentistry, Peshawar

Maxillofacial trauma, such as superficial cuts and bruises, lacerations, and facial bone fractures, is a common health concern in youngsters. In this cross-sectional study, we sought to determine the prevalence and pattern of maxillofacial trauma in school-aged children (5 to 16 years) with a history of trauma. The study was conducted at the oral and maxillofacial surgery department, Khyber College of Dentistry, Peshawar. We excluded firearm injuries and maxillofacial trauma older than 15 days, whether treated or untreated, from the study. We enrolled 153 schoolchildren of both genders consecutively using non-probability sampling. To determine the etiology and nature of the trauma, we did radiographic confirmation utilizing many imaging modalities and comprehensive clinical assessments of the craniofacial region. The data was analyzed using SPSS version 22.0. The results of our study indicate that falls are the leading cause of maxillofacial injuries among school-aged children. A total of 52 (16.3%) of the patients had maxillary fractures, 30 (19.6%) had mandibular fractures, 30 (19.6%) had zygomatic-maxillary complex fractures, 23 (15%) had dentoalveolar injuries, and 45 (29.4%) had soft tissue injuries. In our study, soft tissue injuries were most prevalent among school-aged children, followed by mandibular, zygomatic-maxillary complex, and maxillary fractures. To investigate the pattern and etiology of maxillofacial injuries, we stratified the data by age, gender, and kind of school. Our findings may aid in developing effective strategies for preventing and managing maxillofacial trauma in school-aged children. These findings emphasize the necessity for focused interventions to reduce the frequency of maxillofacial trauma among school-aged children.

Etiology and pattern of maxillofacial trauma.

Maxillofacial trauma can be limited to superficial lacerations, abrasions, and facial bone fractures. The objective of this study was to determine the etiology, pattern, and predictors of soft tissue and bony injuries. This study was conducted in the department of maxillofacial surgery Lady Reading hospital Pakistan from Jan 2019 to June 2021. The nonprobability consecutive sampling technique was used for the selection of patients. All patients were assessed clinically and radiologically. The neurosensory examination was done for any altered sensation, anesthesia, or paresthesia. Motor nerve function was also assessed clinically. Data were analyzed using SPSS version 26. The etiology and pattern of maxillofacial trauma were stratified among age and genders using the chi-square test to see effect modifiers. Tests for regression analysis were also applied. P≤0.05 was considered significant. A total of 253 patients meeting inclusion criteria were included in this study. The majority of these patients were males, 223 (88.1%), while only 30 (11.9%) were females. The mean age for the group was 25.4 ± 12.6 years. RTAs were the most common causes of trauma (63.6%) followed by assault (15.0%), falls (11.5%), FAIs (5.9%), and sports (0.4%). The most vulnerable skeletal part was the mandible (22.9%) followed by Zygoma (7.1%), significantly predicted by RTAs. Soft tissue laceration analysis showed a high frequency of multiple lacerations (38%) significantly predicted by FAIs. The frequency of trigeminal nerve injury was 5.5% (14 patients) and that of the facial nerve was 1.6% (4 patients). The strongest association of nerve injury was with firearm injury (47%), followed by road traffic accidents and sports injuries. Road traffic accident was the most common etiological factor and mandible fracture was commonly predicted by RTA. Trigeminal nerve injuries were common, frequency of nerve injuries was highly associated with mandible fracture and was predicted by FAI.

World Oral and Maxillofacial Trauma (WORMAT) project: A multicenter prospective analysis of epidemiology and patterns of maxillofacial trauma around the world.

The World Oral Maxillofacial Trauma (WORMAT) project was performed to analyze the causes and characteristics of maxillofacial fractures managed in 14 maxillofacial surgery divisions over a 1-year period. The following data were collected: age, sex, cause and mechanism of maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score (FISS), associated injury, day of trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software. Between 30 September 2019 and 4 October 2020, 2,387 patients (1,825 males and 562 females [ratio 3.2:1], 47.6% aged 20-39 years [mean age 37.2 years, median 33.0 years]) were hospitalised. The main cause of maxillofacial fracture was road traffic accidents (RTA), which were statistically associated with male adults as like as assault, sport, and work (p<0,05). Half of the fractures involved the middle third of the face, statistically associated with fall and assault (p<0.05). Trauma in multiple locations was significantly associated with longer hospital stay (p<0.05). The mean length of hospitalization was 3.9 days (95% Confidence Interval 3.7-4.2). This prospective, multicenter epidemiological study confirmed that young adult males were the ones most commonly affected by maxillofacial fracture. RTAs and assaults are statistically associated with the adult population, while falls are associated with females and older population.

Patterns of maxillofacial trauma in helmet vs. non helmet wearing two wheeler drivers in a tertiary care center.

The frequency and patterns of maxillofacial fractures vary by country, based on demographic, socioeconomic, cultural and environmental factors. Wearing a helmet is an efficient form of head protection for two-wheeler drivers and is now required in the vast majority of countries. The aim of this study was to compare the patterns of maxillofacial trauma in patients who wore helmets and those who did not. The data were gathered from clinical records of patients presenting with maxillofacial trauma between January 2019 and February 2022. The inclusion criteria were met by subjects involved in two-wheeler accidents with comprehensive case records and radiological investigations. A total of 177 people presented following maxillofacial trauma. The mean age was 34.2 ± 12.7 years. There were 151 (85.3%) males and 26 (14.6%) females. One hundred and two patients had not been wearing a helmet, while 75 patients were wearing a helmet at the time of the accident. Mandible fractures were the most common injury in both groups, followed by zygomatic arch fractures (which were more common in non-helmet users) and dentoalveolar fractures in helmet users. There was a significant difference in the pattern and severity of maxillofacial trauma in helmet users and non-helmet users.

The Influence of COVID-19 Lockdown Measures on Maxillofacial Trauma at a Rural Tertiary Academic Center

Introduction: Following the onset of the COVID-19 pandemic, there was an abrupt and widespread shift in the social, political, and economic landscape. The purpose of this study is to analyze the pandemic’s impact on maxillofacial trauma patterns in a predominantly rural setting; the resultant implications for plastic surgery and other trauma-related departments was also considered. Methods: We reviewed records of patients that presented to the University of Vermont with facial trauma who were referred to Plastic Surgery and Otolaryngology during the period spanning from March 25th, 2020 to June 15th, 2020, the first full lockdown in Vermont. We compared this data with referrals made from 2016 to 2019 during the same period. Results: We found 41 patients who presented to UVM with operative facial fractures during the first COVID-19 lockdown period, which compared to an average of 51 over the prior years. Although this is a 20% decrease, it was not statistically significant ( P = .285887). There were also decreases in the mean age (48 vs 40; P = .061333) and increases in the proportion of female patients ( P = .0782055) compared to prior years, but once again no statistically significant change. Mechanism of injury patterns remained consistent with falls being the most common cause during these periods. Fracture types also remained consistent with nasal bone fractures being the most common. Conclusion: Our study shows no statistically significant decrease in volume, change in mechanism, or change in demographics of operative facial trauma patients during the first COVID-19 lockdown period. This was contrary to our expectations and to conventional wisdom, but it does have important implications for hospital staffing and resource allocation. In short, at least for our tertiary care institution serving a large rural population, these results highlight the importance of continued support of plastic and reconstructive surgery as well as related disciplines.

An overview of the prevalence and pattern of maxillofacial trauma in the south of Iran

Objective: The purpose of the current study is to determine the prevalence and pattern of maxillofacial trauma. Methods: This is a cross sectional study of maxillofacial trauma cases treated in the referral trauma center of south of Iran. Data of 264 patients were extracted from patients’ records and analyzed. Data included patient’s demographics, injury mechanism, types of maxillofacial injuries, Injury Severity Score (ISS), associated injuries, length of hospital stay and outcome. Binary logistic regression by backward method was applied to determine the effects of independent variables on mortality odds ratio. Results: 85.23% of patients were males and of all patients 87.5% survived. The mean of age was 34.95 ± 16.51. The commonest cause of maxillofacial injury was road traffic accidents (86.31%). The median of ISS was 20.39± 10.24 and patients aged 30-39 years had the highest ISS. Overall, the most common maxillofacial injuries were orbital (59.47%, n=157) followed by maxillary (48.11%, n=127); common associated injuries were related to head (81.44%, n=215) followed by thorax (58.33%, n=154). Age and gender (being male) increased the odds ratio of mortality. An increase in ISS decreased the odds ratio of mortality, but it was not significant. Conclusion: Most of maxillofacial trauma patients suffered from orbital injuries and there were a huge percentage of associated injuries. Gender (male), age and length of hospital stay were the significant variables of mortality in maxillofacial patients. The findings of the current study sheds light on further investigation to treat these patients and enforce road traffic legislation and public education to prevent these traumas.

Patterns of Pediatric Facial Fractures.

The aim of this study was to assess patterns of maxillofacial trauma in the pediatric population in Atlanta. This information is important to help guide management and allocate resources for treatment of maxillofacial injuries at Children's Healthcare of Atlanta (CHOA). This study was a retrospective chart review of children who presented from 2006 to 2015. Inclusion criteria were: (1) age 18 years old or younger, (2) presentation to emergency department, (3) diagnosis of maxillofacial fractures, and (4) evaluation by Oral and Maxillofacial Surgery, Otolaryngology, or Plastic Surgery services. Medical records were reviewed to record demographic, mechanism of injury, fracture location, and yearly incidence of injury. Descriptive statistics were computed to summarize findings and overall trends. During the study period, 39,833 patients were identified. Of them, 1995 met the inclusion criteria. The majority were male (n = 1359, 68%) with an average age of 9.4 years old (range of 1 month to 18 years old). Mechanisms of injury were motor vehicle collisions (MVC) (n = 597, 29.9%), fall (n = 565, 28.3%), sports injury (n = 317, 15.9%), pedestrian struck (n = 215, 10.8%), assault/abuse (n = 204, 10.2%), other (n = 81, 4.1%), or gunshot wound (n = 16, 0.8%). Fracture sites were mandible (n = 519, 26%), complex (n = 479, 24%), nasal (n = 419, 21%), dentoalveolar (n = 279, 14%), orbital (n = 259, 13%), and maxilla (n = 40, 2%). Males had a higher incidence of assault than females (n = 185, 91% of assaults). The incidence of maxillofacial trauma increased with age with a peak incidence in 13 to 16-year-olds (n = 566, 28.3%). During the years examined, there was an upward trend in MVCs as the etiology with a peak incidence of facial fractures due to MVCs occurring in 2015. All other mechanisms remained constant during this time period. There was an increase in pediatric facial fractures secondary to motor vehicle collisions from 2007 to 2015 despite improvements in regulations, traffic safety, and technology.

Adult Maxillofacial Trauma Patterns in American Football

The authors aimed to identify and categorize adult maxillofacial trauma patterns in the setting of American football. The National Electronic Injury Surveillance System was accessed to identify adult patients presenting with football-related head and facial injuries from 2009 to 2018. Data surrounding each event were collected including age, injury type, injury location, and disposition of the patient. Chi-squared testing was performed to compare categorical variables, with a Bonferroni correction applied. During the study period, 1784 total patients (national estimate = 65,052) were identified. The average age for this cohort was 27.26 (SD ± 8.49), with young adults (86.1%) and males (87.9%) sustaining the majority of injuries. Lacerations were the most common injury type (43.1%). Maxillofacial fractures comprised 15.8% of the sample, with nasal bone (52.8%) being the most common subtype. Female patients were significantly more likely to present with head injuries than men (46.8% versus 29.0%, P < 0.001). Young and middle-aged adults combined were more likely to be discharged from the emergency department, whereas the elderly were significantly less likely (P = 0.002). Patients with fractures were significantly more likely to be admitted to the hospital compared to all other types of injuries (P < 0.001). An understanding of maxillofacial injuries while participating in American football is important in developing safety initiatives. To address these, it is crucial that providers understand the patterns of craniofacial injuries as they relate to American football trauma.

Maxillofacial trauma due to traffic accidents and falls: an exploratory study of associated factors

Background This study aimed to determine the pattern of Maxillofacial trauma (MFT) due to traffic accidents and falls in a reference hospital in a rural region of northeastern Brazil between December 2011 and December 2018 and to identify associated factors. Material and Methods This was a cross-sectional study using 585 medical records of patients with MFT. The data were subjected to a Poisson-Tweedie multiple regression analysis to estimate the Prevalence ratio (PR), with a 95% confidence interval (95% CI) and a significance level of p<0.05. Results MFT due to traffic accidents was more prevalent among patients 21 to 40 years old (PR=2.30; 95% CI=1.20-4.41; p<0.001) diagnosed with zygomatic-orbital complex fractures (PR=1.80; 95% CI=1.08-2.98; p=0.023). Falls were more frequent among older groups of 41 to 60 years (PR=1.83; 95% CI=1.09-3.06; p=0.022) and over 61 years (PR=2.23; 95% CI=1.09-3.06; p=0.022). In traffic accidents, alcohol consumption increased the length of stay (PR=2.081; 95% CI=1.553-2.787; p<0.001), and patients who did not use personal protective equipment (PPE) had higher hospital costs (PR=179.964; 95% CI=1.485-1.994; p<0.001) for this etiology. Traffic accidents and falls are two of the main etiologies of MFT, especially for males in the young adult age group (traffic accidents) and those above 41 years (falls). Alcohol consumption and the nonuse of PPE influenced the length of the hospital stay and hospital costs. Conclusions Strategies to confront this problem, such as road and highway improvements, effective enforcement of laws and intersectoral coordination involving the entire community to implement policies and prevention programs targeted at these populations, can be implemented. Key words:Maxillofacial Injuries, public policy, hospital cost.

Pattern of Maxillofacial Trauma and Associated Factors in Traffic Accident Victims.

Maxillofacial trauma (MFT) due to road traffic accidents are responsible for part of care provided at trauma centers. This research aimed to analyze the pattern of MFTs and associated factors in victims of road traffic accidents. A total of 873 medical records of patients with MFTs in 2 reference hospitals for trauma in Northeastern Brazil during the period from January 2011 to December 2018 were analyzed. Data were included in the Tweedie multiple regression analysis to estimate the prevalence ratio (PR), with 95% confidence interval (95%CI) and P < 0.05. Motorcycle accidents were the most prevalent (76.4%). Higher hospital costs were the result of patients victims of motorcycle accidents (PR = 1.56; 95%CI = 1.29-1.88; P < 0.001), diagnosed with mandible fracture (PR = 1.41; 95%CI = 1.07-1.86; P = 0.001) who had consumed alcoholic beverages (PR = 1.12; 95%CI = 1.00-1.25; P = 0.04) and did not use personal protective equipment (PPE) (PR = 1.29; 95%CI = 1.10-1.50; P = 0.001). Patients victims of motorcycle accidents remained in hospital longer than other etiologies (PR = 1.47; 95%CI = 1.23-1.76; P < 0.001). The consumption of alcoholic beverages resulted in more severe MFTs (PR = 2.05; 95%CI = 1.34-3.14; P = 0.001). Victims of motorcycle accidents remained hospitalized longer and resulted in higher hospital costs compared to other etiologies. Alcohol consumption increases hospital costs and the severity of MFTs. Higher hospital costs were also observed in patients who did not use PPE. Strategies need to be adopted to understand associated factors in MFTs such as the reallocation of resources to fund, implement and improve services and the surveillance in roads and highways, as well as prevention programs aimed at this health problem.

An Update on Maxillary Fractures: A Heterogenous Group.

The purpose of this study was to review the different types of maxillary fractures and highlight their diagnostic and therapeutic differences. A retrospective chart review of patients who sustained maxillary fractures was conducted through the Einstein Healthcare Network during the years 2016-2017. Descriptive statistics and chi-square analysis were used to categorize continuous and categorical variables, respectively. The cohort of patients (n = 141) were predominately African American (62%) and male (75%) with a mean age 45.3 years. The most common maxillary fracture was maxillary sinus (29%), followed by zygomaticomaxillary complex (ZMC) (26%), frontal process (20%), dentoalveolar (16%), and LeFort (9%). Dentoalveolar fractures were mostly evaluated by the oral maxillofacial surgery service (74%), while ZMC and LeFort fractures were more commonly referred to an otolaryngologist (56% and 67%, respectively). Patients with dentoalveolar fractures were more likely to undergo wire splinting (61%). All patients with frontal process and maxillary sinus fractures were managed non-operatively. Most patients with ZMC fractures were managed non-operatively (78%) while the remainder underwent open reduction internal fixation (ORIF) (22%). Patients with LeFort fractures more commonly underwent maxillomandibular fixation (MMF)/ORIF (83%). Dentoalveolar fractures were the most likely to be operated on the same day (93%) while ZMC and LeFort fractures were repaired within 1 week (88% and 100%, respectively). Maxillary trauma is very heterogenous in comparison to other maxillofacial trauma patterns. Each fracture type is treated uniquely and can involve one or more provider teams depending on the extent and severity of the injury, as well as hospital resources.

Comparison of Maxillofacial Trauma Patterns in the Urban Versus Suburban Environment: A Pilot Study.

Assault appears to be the most frequent cause of facial fractures in certain urban trauma centers, possibly due to the ease of acquiring weapons and increasingly aggressive behavior. The objectives of this study were to identify specific demographic, socioeconomic, maxillofacial fracture, and assault patterns in urban versus suburban communities. A retrospective chart review of patients who sustained maxillofacial fractures from August 2014 through August 2016 at one urban campus, Einstein Medical Center, Philadelphia, and two suburban campuses, Einstein Medical Center Montgomery and Elkins Park. The χ2 testing was used to compare the categorical variables between the 2 groups. A total of 259 maxillofacial trauma patients were identified, with 204 (79%) in the urban and 55 (21%) in the suburban environment. Patients in the urban population were more likely to be African American (70% vs 33%) and Hispanic (15% vs 6%) but less likely to be Caucasian (12% vs 55%, P < .0001). Urban patients were more likely to be single (70% vs 47%, P < .01), unemployed (64% vs 44%, P < .001), and receive Medicaid coverage (58% vs 26%, P < .001). Urban patients were more likely to be victims of assault (63% vs 44%), whereas suburban patients were more likely to sustain accidental injuries (16% vs 2%, P < .0001). Urban victims were more likely to be assaulted with an object (30% vs 12%) or gun (7% vs 0%, P = .05). Maxillofacial trauma patterns were shown to be significantly different in the urban versus suburban environment.

Pediatric Maxillofacial Trauma Patterns Among Different Types of Road Traffic Accidents

Traffic accidents are one of the most leading cause of maxillofacial trauma. Defining the bone fracture patterns in different type of traffic accidents may enable for appropriate surgical approach. This study research the pattern of pediatric maxillofacial fractures in terms of different type of traffic road accidents and age groups. The data on road traffic accidents that caused maxillofacial trauma between May 2014 and January 2019 was gained from the University of Gaziantep hospital data system. Road accident type, age groups, and the type of fractures were the evaluation parameters. A total of 61 patients meet the criteria and 41 of those were boys. The midface bones of orbital, maxillar, and frontal are the most fractured structures with a total number of 48. The least fractured bone was mandibula with a number of 4. The comparisons of these fractures among the different type of road traffic accidents and age groups were found to be statistically significant. Car-pedestrian and car-passengers type of road traffic accident mostly seem to cause midface fractures at the primary and secondary school-aged children.

Prevalence and patterns of maxillofacial trauma: a retrospective descriptive study

IntroductionWe aimed to describe the prevalence and pattern of maxillofacial trauma in Qatar.MethodsThis is a retrospective study of trauma registry data at Hamad General Hospital during the period from January 2011 to December 2014. The study included all traumatic maxillofacial patients who underwent CT scan and were admitted during the study period.ResultsA total of 1187 patients with maxillofacial injuries were included in the study and 18.5% of all trauma admissions were related to maxillofacial injuries. Young age and males were predominantly affected. Mechanisms of injury were mainly traffic-related and fall. Orbital injuries were the commonest followed by maxillary injuries. The median and range face abbreviated injury score (AIS) was 2 [1–3] with 66% had a score of 2. Maxillofacial fractures were frequently associated with traumatic brain injuries. One out of five patients was managed with surgery and had median length of stays in ICU and hospital 5 and 7 days, respectively. Overall, in-hospital mortality was 8.3%. Mortality in isolated maxillofacial was low (0.3%) in comparison to 15% in polytrauma patients (p = 0.001). Multivariable regression analysis showed that Injury Severity Score, face AIS and Glasgow Coma Scale were predictors of mortality with age-adjusted odd ratio of 1.15, 2.48 and 0.82; respectively.ConclusionsMaxillofacial trauma requiring admission is not uncommon in our trauma center and mostly it is mild to moderate in severity. Associated injuries are present in most of the maxillofacial injured patients and further diagnostic investigations should be part of the assessment in maxillofacial injuries.

Pattern of Maxillofacial Trauma in the Nigerian Population

Introduction: The pattern of trauma to the maxillofacial region differs in various parts of the world. Studies have shown that not only does it differ from one continent to the other, it differs from one country to another within the same continent and from one zone to another within the same country. These have been ascribed to the prevailing socioeconomic, cultural and environmental factors in the study area. It is important that patterns of maxillofacial injuries should be continuously evaluated so that efforts should be put in place to reduce the incidence. The aim of the present study is therefore to describe the patterns of maxillofacial injuries in the Nigerian literature.Methods: The MEDLINE was used to conduct a computerized literature search using for publications on maxillofacial trauma in Nigeria. For this search, the medical subject headings on "maxillofacial fractures" or "mandible fractures" or "middle-third fractures" or "facial fractures" or "zygoma fractures" were combined with "Nigeria". Also, the publications cited in these articles to look for additional important articles but were not found on MEDLINE were searched for.Results: Most of the studies were retrospective while the commonest geopolitical zone where studies were done was the South West region. The commonest cause of maxillofacial injuries was road traffic accident while the commonest age group was the 21-30 years.Conclusion: Road traffic accident is the commonest cause of maxillofacial injuries. It is therefore recommended that the appropriate authorities should enforce seat belt and helmet laws. The government should provide street lights, good roads, pedestrian bridges and traffic lights to reduce vehicular/vehicular and human/vehicular/human collisions.&#x0D; &#x0D; &#x0D;

Epidemiology of Pediatric Maxillofacial Trauma: A Review of 1995 Cases

In 2008, the National Trauma Bank concluded that motor vehicle collisions (MVCs) were the leading cause of facial fractures in the pediatric population.1 However, the number of maxillofacial fractures secondary to MVCs has been decreasing because of seat belt use, traffic safety regulations, and improved technology (i.e., air bags, electronic stability control).2 The aim of this study was to review patterns of maxillofacial trauma in Children’s Healthcare of Atlanta (CHOA). This information is important to help guide management and allocate resources for treatment of maxillofacial injuries in children nationwide.

Rattled: Analysis of Facial Trauma Among Toddlers.

The aim of this study was to determine the national incidence of facial trauma among toddlers and delineate patterns of injury and their causes. A retrospective review was designed to explore patterns of maxillofacial trauma within toddler-aged children using the National Electronic Injury Surveillance System from the Consumer Product Safety Commission. The database was searched for emergency department visits involving facial trauma sustained by children 12 months through 3 years of age from 2010 through 2014 and analyzed for patient demographics, primary diagnosis, and associated products/activities. Subset analyses were performed between age groups to determine the relationship between causes of injury and age using extrapolated national incidences. A sample of 45,249 patients extrapolated to an estimated 1.3 million emergency department visits for facial trauma in toddlers from 2010 to 2014, averaging 260,000 annually. Injuries involving foreign bodies and fractures had a higher incidence in toddlers 2 years or older, and fractures comprised fewer than 1% of facial injuries in any age group. Furniture was the most common source of trauma overall, with a higher frequency among toddlers aged 12 to 17 months. Trauma in the setting of sports was more common in toddlers aged 3 years. The low incidence of facial fractures further supports recommendations against routine imaging in toddler facial trauma and suggests that more focus should be placed on investigating for concurrent traumas and soft tissue injuries where fractures are involved. Our findings highlight prevention opportunities, particularly in furniture-related injuries for toddlers aged 12 to 17 months and sports-related traumas in toddlers aged 3 years. Our study also suggests restricting certain toys from 3-year-old toddlers to decrease the risk of aspiration.

Pattern of Maxillofacial Trauma among Patients with Head Injuries

Background: Patients with maxillofacial trauma are at high risk of having traumatic cranial injuries. Prompt determination of head injury in these patients is crucial for improving patient’s survival and smooth recovery.Objective: The purpose of this study was to find out the pattern of maxillofacial injuries in a patient with head injuries and to study their relationship.Study design: A prospective Cross-sectional descriptive study was made over 60 patients.Study setting and period: The study was conducted in the Department of Oral &amp; Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka-1000 from May 2010 to April 2011.Participants: Sixty patients with maxillofacial and head injuries were selected for the study.Methods: It was a prospective cross-sectional descriptive hospital based study. 60 patients who were diagnosed of having concomitant maxillofacial and head injuries were included in this study. Information’s based on age, sex, mode of injury, pattern of facial and head injury, GCS score and type of head injury were taken for each case. Appropriate skull X-ray was done for all patients with maxillofacial injury and patient’s with initial sign of neurological deficit an initial CT scan of brain was done. Data was analyzed using the SPSS program.Results: Majority of the patients were in the 2nd to 4th decade (75%) with a male to female ratio of 7.57:1 Motor vehicle accidents were the most common cause of injury (60%), followed by fall from height (13.3%).- Mandible was the most commonly fractured facial bone (36.67%), followed by midface fracture (18.3%).Majority of the patients had moderate head injury and were managed conservatively. Among depressed fracture of skull, frontal bone was most commonly affected. Conclusion: Adult males were most common victims in craniofacial trauma, and road traffic accidents were responsible for the majority. Most of the patients sustained moderate head injuries and were managed conservatively. Open reduction and internal fixation with miniplates were used for displaced facial bone fractures.Update Dent. Coll. j: 2017; 7 (1): 14-20

Maxillofacial trauma patterns associated with external auditory canal fractures: Cone beam computed tomography analysis.

There is a paucity of literature on external auditory canal (EAC) fractures secondary to maxillofacial trauma, with most of the literature on EAC fractures consisting of isolated case reports. To the authors' best knowledge, this is the first study to use cone beam computed tomography to evaluate the EAC region. The aim of this study was to assess the prevalence of external auditory canal (EAC) fracture following maxillofacial trauma and to evaluate the association between EAC fracture and other maxillofacial fractures and the region of trauma. One hundred patients were prospectively evaluated over 6months from February to August 2016. The patients were referred for CBCT regarding temporomandibular joint or condylar fractures following maxillofacial trauma. Two observers (both experienced radiologists) assessed the EAC and associated fractures in the maxillofacial region. External auditory canal (EAC) fracture was confirmed in 32% of the patients. Of the EAC fractures, 68.75% and 31.25% were associated with mandibular fractures and non-mandibular fractures, respectively. Of the EAC fractures, 68.75% were single fractures and 31.25% of patients had multiple comminuted fractures. Significant association was observed on cross-tabulation of the fractured region and region of trauma with the presence of EAC fracture using chi-square test. External auditory canal (EAC) fracture is associated with maxillofacial fractures with increased incidence in mandibular fractures compared to non-mandibular fractures.