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Facial Trauma
Published in Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal, Plastic Surgery for Trauma, 2022
Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal
If you have any suspicion of a facial fracture (either from the mechanism of injury or your examination findings) obtain imaging. The gold standard for suspected midfacial fractures is CT. For suspected mandibular fractures plain films are adequate. In any patient who is found to have a facial fracture ensure that a full ATLS primary survey has already been carried out including assessment of the C-spine, airway and CNS as facial fractures are often associated with severe concomitant injuries. The most common mechanisms causing facial fractures are: Assault, Road traffic collision, Falls and Sports. The most common facial bones fractured are: Nasal (+ frontal sinus), Mandible, Zygoma and Maxilla. Maxillary fractures are high energy injuries. They are classified as Le Fort 1, 2 and 3 which reflect increasing craniofacial dysjunction. Fractures involving the orbit require urgent ophthalmology review. See below for a summary of common fracture sites and structures affected (Figure 10.1).
Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
The maxillae are the bones which form the medial aspect of the cheek (Figure 3.4), positioned between the nasal bone and zygoma. They have three primary functions: Allowing a point of anchor for the upper teeth in the alveolar processForming the floor and lateral wall of the nasal cavityForming part of the medial wall of the orbit The point of fusion of the maxillae is at the midline immediately inferior to the nose at the intermaxillary suture. Aside from structural support, the maxillae contain sinuses which are important in both altering the depth of voice as well as keeping decreasing the weight of the facial bones. The maxilla is also the site of the infra-orbital foramen, which is located just below the infraorbital margin of the orbit, at an average distance of 6–10 mm inferiorly in the midline. The infraorbital foramen is important in the transmission of the infraorbital artery, vein and nerve, and therefore, this region must be respected, especially in the context of dermal filler administration as it is at risk of avascular necrosis, filler embolisation and neuronal damage.
Maxillofacial Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
The facial bones should be palpated to detect fractures. Painful bruising and swelling may mask any underlying step deformity. Fractures of the zygoma and orbit are particularly easy to miss when there is a swollen black eye. Table 14.1 summarizes the common clinical features of the common facial bone fractures and identifies which is the most appropriate imaging to request. Computed tomography scanning of Le Fort fractures should be done only after discussion with the maxillofacial surgeon.
Sporadic Burkitt Lymphoma Involving the Orbit – A Report of Two Cases and Review of Literature
Published in Orbit, 2023
Surabhi Saxena, Kirthi Koka, Julius Xavier Scott, Bipasha Mukherjee
Sporadic BL (sBL) accounts for 30% of pediatric lymphomas.5 Both cases in our series presented in the pediatric age group. As per literature, the peak incidence of sBL is around 10 years of age.5 EBV is positive in 20–30% of sBL.1 Our cases presented with orbital and CNS involvement. The most common site of involvement in sBL is the abdomen.1,5 Facial bones and other extranodal sites in the head and neck are involved in around 10% of cases, commonly as cervical lymphadenopathy.6 Orbital and ocular involvement in sBL is rare.1,2 CNS involvement is also uncommon in sBL and indicates a poor prognosis.1,6 Our patients presented with a rapidly progressing proptosis and stretch optic neuropathy. Rapid growth of BL within the orbit can lead to optic nerve compression and thus vision loss.5
Partial vs full glottic view with CMACTM D blade intubation of airway with simulated cervical spine injury: a randomized controlled trial
Published in Expert Review of Medical Devices, 2023
Chao Chia Cheong, Soon Yiu Ong, Siu Min Lim, Wan Zakaria Wan A., Marzida Mansor, Sook Hui Chaw
Our result shows the time to tracheal intubation was shorter in group of POGO < 50% compared to the group with POGO 100%. The difference in median time to intubation of 5 seconds between the two groups may not be significant in an elective surgical setting, whereby patients have adequate pre-oxygenation before intubation. This time difference may be relevant in patients with lung pathology, young children, elderly, obese individuals or when unexpected difficult airway occurs. Shortening time to tracheal intubation is crucial to prevent hypoxemic hypoxia in emergency trauma management. Following facial bone injury, rapid establishment of a definitive airway is paramount to minimize the accumulation of blood in the oral cavity which may obscure the glottic view. In addition, a shorter time to intubation may reduce risk of aspiration pneumonitis in inadequately fasted patients. Our finding echoes the result of the study conducted by Gu et al. The finding was similar despite the difference in blade design and camera system between GlidescopeTM and CMACTM D blade [17,18].
Radiographic evaluation of the mandible to predict age and sex in subadults
Published in Acta Odontologica Scandinavica, 2022
The mandible presents greater growth than other facial bones and is associated with the most representative morphological changes in terms of size and remodelling throughout human growth [5] from both a developmental and functional point of view; therefore, the mandible is naturally expected to be an appropriate bone for use in estimating the age of children and adolescents [6]. Since growth rates and duration differ distinctly between males and females throughout the lifespan, mandibular morphology differentiates between sexes according to the age of the individual. Moreover, the numerous anatomical landmarks provided by the mandible have led many studies to be conducted using various linear dimensions as well as gonial angles to provide sex [7–12] and age [6,13] estimations of children, albeit with controversial results.