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Dental Radiography
Published in Paolo Russo, Handbook of X-ray Imaging, 2017
As is obvious from this list, large parts (mandible, maxilla, palatine bones) of the facial skeleton/skull have been discussed as anatomical target areas in prior sections. However, the remaining parts (e.g., the nasal and lacrimal bones or the zygomatic bones) also represent important target regions for dental radiography. Extraoral projection radiography (Section 22.4.2.3, see also Table 22.4) focuses on imaging of these structures. Particularly trauma situations often require radiographic evaluation of the facial bones to identify or rule out fractures. In panoramic radiography (Section 22.4.2.2), some of the facial bony structures (e.g., the zygomatic bone) form a characteristic key image that is commonly used for evaluation. Measurements of facial anatomy, as carried out on cephalometric radiographs (Section 22.4.2.2.1), often include landmarks located in the anatomical region of the facial bones, yet outside the mandible or the maxilla.
The Skull and Brain
Published in Melanie Franklyn, Peter Vee Sin Lee, Military Injury Biomechanics, 2017
Kwong Ming Tse, Long Bin Tan, Heow Pueh Lee
The NUS FE Head Model I has also been used to simulate nine common impact scenarios of facial injuries to correlate traumatic brain injuries (TBI) with facial injuries (Tse et al. 2015a) (Figure 10.11e). From the study, it was concluded that the severity of brain injury is highly associated with the location of impact to the brain, whereas facial injury is not necessarily closely related to brain injury, despite the proximity of the facial skeleton and the skull. The authors hypothesised that the midface was capable of absorbing considerable energy and protecting the brain from impact. The nasal cartilages also helped to dissipate a portion of the impact energy in the form of large-scale deformation and fracture, with the vomer-ethmoid diverging stress to the ‘crumpling zone’ of air-filled sphenoid and ethmoidal sinuses; in its most natural manner, the face protects the brain. However, with anatomic proximity of the facial skeleton and cranium, any larger impact force would be sufficient to cause TBI.
The influence of helmet on the prevention of maxillofacial fractures sustained during motorcycle accidents
Published in Cogent Engineering, 2018
Muhammad Ruslin, Jan Wolff, Harmas Yazid Yusuf, Muhammad Zafrullah Arifin, Paolo Boffano, Tymour Forouzanfar
This study was approved by the Health Research Ethics Committee of Medical faculty, the University of Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, Indonesia. The study comprised of half-coverage helmeted and unhelmeted patients who had sustained maxillofacial fractures during motorcycle accidents at the urban Bandung area in Indonesia. Only hospitalized patients with maxillofacial fractures and a mild head injury that had been surgically treated within 48 h were included in this study. The riders whose helmet flied out before their head hit the ground were included as unhelmetted patients. All patients who had sustained moderate or severe head injuries were excluded from the study. Furthermore, multiple trauma and alcoholized patients were excluded from the study. The maxillofacial fractures were divided into three parts upper, middle, and lower facial. The upper part of facial skeleton comprising the frontal bone, the middle part comprising the midfacial bone: the maxilla, the nasoethmoid, and lateral midfacial bone-zygoma, and the lower part comprising the mandible. All patients in this study were scored using the GCS upon arrival at the hospital. Furthermore, computed tomography scans of all patients were also performed. Blood samples were taken from all studied patients and centrifuged for 10 min at 2.500 rotations per minute. Neuron-specific enolase measurements were performed with an electrochemiluminescence immunoassay (ECLIA) using a sandwich technique in duplicate with NSE kits (Roche, Mannheim, Germany) and the Elecsys 2010 analyzer (Roche Diagnostics, Mannheim, Germany). This study underwent NSE screening within 24 h since the half-life of NSE in the serum is approximately 48 h (Wunderlich et al., 1999). The NSE cut-off value is 10 ng/ml (Bazarian & Merchant-Borna, 2014).