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Gugliotta Y, Roccia F, Sobrero F, Ramieri G, Volpe F. Changing trends in maxillofacial injuries among paediatric, adult and elderly populations: A 22-year statistical analysis of 3424 patients in a tertiary care centre in Northwest Italy. Dent Traumatol 2024; 40:187-194. [PMID: 37915278 DOI: 10.1111/edt.12904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND This retrospective study analysed the epidemiology of maxillofacial trauma over 22 years to assess whether there have been significant changes in the causes and characteristics of fractures in paediatric, adult and elderly populations. MATERIALS AND METHODS The following data were collected: age, sex, injury cause and mechanism, fracture site, Facial Injury Severity Scale, associated injuries, time of injury, type of treatment and length of hospital stay. The patients were analysed by age group (children [≤16 years], adults [17-60 years] and elderly [>60 years]) and divided into two time groups (group 1: 2001-2011; group 2: 2012-2022) that were compared to each other. Statistical analyses were performed using SPSS software. RESULTS Between 01 January 2001 and 31 December 2022, 3535 patients (2690 males and 845 females, mean age 39.3 years) were admitted for facial fractures. The comparison of the two temporal periods showed a decrease in the prevalence of males (p = .02), in road traffic injuries (p < .001), and in fractures of the lower third of the face (p = .005); there were significant increases in the mean age (p < .001), prevalence of the elderly (p = .006) and in fall- and assault-related injuries (p < .001 and p = .03, respectively). Assault injuries increased only in the 17-60 age group (p = .02) while RTA-related fractures decreased in all age groups (p < .05 for all comparisons). Bicycle accidents increased significantly, with a parallel decrease in motor vehicle accidents (both p < .001). Fall-related fractures increased only in 17-60 and >60 age groups (p < .001 and p = .02, respectively). CONCLUSIONS This study shows significant changing trends in the epidemiology of maxillofacial trauma. While road traffic policies have been effective in the last years, preventive measures for falls in the elderly population and new legislative measures to prevent interpersonal violence should be advocated.
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Affiliation(s)
- Ylenia Gugliotta
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Federica Sobrero
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Fabio Volpe
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
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Gugliotta Y, Roccia F, Demo PG, Rossi MB. Characteristics and surgical management of pure trapdoor fracture of the orbital floor in adults: a 15-year review. Oral Maxillofac Surg 2023; 27:625-630. [PMID: 35841436 PMCID: PMC10684415 DOI: 10.1007/s10006-022-01099-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 07/05/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This retrospective study aims to define the optimal timing of the surgical treatment of orbital floor trapdoor fractures (OFTFs) in adults according to clinical and radiological findings. METHODS From January 2006 to December 2020, 382 patients with isolated orbital floor fracture were admitted to the Division of Maxillofacial Surgery of Turin, Italy. The criteria for inclusion were age ≥ 16 years, preoperative computed tomography showing a linear (1a) or medial hinge fracture (1b), diplopia, and 6 months of follow-up data. Aetiology and mechanism of injury, presence of post-traumatic enophthalmos and oculocardiac reflex, time between trauma occurrence and surgery [stratified as < 24 h (urgent treatment), 24-96 h (early treatment), and > 96 h (late treatment)], days of hospitalisation, and clinical outcomes were examinated. RESULTS Twenty-four patients (18 males; mean age, 23.2 years) presented with OFTFs. The most common cause was sport injury (50%). Type 1a fracture was observed in eight patients (mean age, 19.5 years), type 1b fracture in 16 patients (mean age, 23.6 years). Urgent, early, and late treatments were performed in eight patients each. The mean time between trauma occurrence and surgery was 3,8 days (range: 0-17 days). Resolution of diplopia was observed 1 week after surgery in 10 patients, 1 month in 12. Diplopia persisted in 2 patient, both treated > 96 h after trauma. CONCLUSION Although the number of patients was too small to define a standard protocol, the authors recommend early treatment of adult OFTFs to promote complete resolution of diplopia.
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Affiliation(s)
- Ylenia Gugliotta
- Division of Maxillofacial Surgery, Surgical Science Department, Città Della Salute E Delle Scienze Hospital, University of Turin, Corso A.M. Dogliotti 14, 10126, Turin, Italy.
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Surgical Science Department, Città Della Salute E Delle Scienze Hospital, University of Turin, Corso A.M. Dogliotti 14, 10126, Turin, Italy
| | - Paolo Garzino Demo
- Division of Maxillofacial Surgery, Surgical Science Department, Città Della Salute E Delle Scienze Hospital, University of Turin, Corso A.M. Dogliotti 14, 10126, Turin, Italy
| | - Maria Beatrice Rossi
- Division of Maxillofacial Surgery, Surgical Science Department, Città Della Salute E Delle Scienze Hospital, University of Turin, Corso A.M. Dogliotti 14, 10126, Turin, Italy
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Sobrero F, Roccia F, Vilaplana V, Roig AM, Raveggi E, Ramieri G, Goetzinger M, Bottini GB, Rizvi AO, Laverick S, Knežević P, Dediol E, Kordić M, Sivrić A, Ganasouli D, Zanakis SN, Jelovac D, Konstantinovic VS, Birk A, Vesnaver A, Rabufetti A, Scolozzi P, Derkuş FE, Yilmaz UN, Politis C, Dubron K. Manual versus rigid intraoperative maxillo-mandibular fixation in the surgical management of mandibular fractures: A European prospective analysis. Dent Traumatol 2023; 39:448-454. [PMID: 37140473 DOI: 10.1111/edt.12851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/18/2023] [Accepted: 04/11/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE Intraoperative stabilisation of bony fragments with maxillo-mandibular fixation (MMF) is an essential step in the surgical treatment of mandibular fractures that are treated with open reduction and internal fixation (ORIF). The MMF can be performed with or without wire-based methods, rigid or manual MMF, respectively. The aim of this study was to compare the use of manual versus rigid MMF, in terms of occlusal outcomes and infective complications. MATERIALS AND METHODS This multi-centric prospective study involved 12 European maxillofacial centres and included adult patients (age ≥16 years) with mandibular fractures treated with ORIF. The following data were collected: age, gender, pre-trauma dental status (dentate or partially dentate), cause of injury, fracture site, associated facial fractures, surgical approach, modality of intraoperative MMF (manual or rigid), outcome (minor/major malocclusions and infective complications) and revision surgeries. The main outcome was malocclusion at 6 weeks after surgery. RESULTS Between May 1, 2021 and April 30, 2022, 319 patients-257 males and 62 females (median age, 28 years)-with mandibular fractures (185 single, 116 double and 18 triple fractures) were hospitalised and treated with ORIF. Intraoperative MMF was performed manually on 112 (35%) patients and with rigid MMF on 207 (65%) patients. The study variables did not differ significantly between the two groups, except for age. Minor occlusion disturbances were observed in 4 (3.6%) patients in the manual MMF group and in 10 (4.8%) patients in the rigid MMF group (p > .05). In the rigid MMF group, only one case of major malocclusion required a revision surgery. Infective complications involved 3.6% and 5.8% of patients in the manual and rigid MMF group, respectively (p > .05). CONCLUSION Intraoperative MMF was performed manually in nearly one third of the patients, with wide variability among the centres and no difference observed in terms of number, site and displacement of fractures. No significant difference was found in terms of postoperative malocclusion among patients treated with manual or rigid MMF. This suggests that both techniques were equally effective in providing intraoperative MMF.
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Affiliation(s)
- Federica Sobrero
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Valentines Vilaplana
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Antonio Mari Roig
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Elisa Raveggi
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Maximilian Goetzinger
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Gian Battista Bottini
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Ali O Rizvi
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Predrag Knežević
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Mario Kordić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Anamaria Sivrić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Dimitra Ganasouli
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Stylianos N Zanakis
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Drago Jelovac
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Vitomir S Konstantinovic
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Aleš Vesnaver
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Alessandro Rabufetti
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Fatma Eriş Derkuş
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Utku Nezih Yilmaz
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Constantinus Politis
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Kathia Dubron
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
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Roccia F, Sobrero F, Raveggi E, Rabufetti A, Scolozzi P, Dubron K, Politis C, Ganasouli D, Zanakis SN, Jelovac D, Konstantinovic VS, Birk A, Vesnaver A, Knežević P, Dediol E, Kordić M, Sivrić A, Rizvi AO, Laverick S, Vilaplana NV, Roig AM, Derkuş FE, Yilmaz UN, Goetzinger M, Bottini GB, Ramieri G. European multicenter prospective analysis of the use of maxillomandibular fixation for mandibular fractures treated with open reduction and internal fixation. J Stomatol Oral Maxillofac Surg 2023; 124:101376. [PMID: 36587846 DOI: 10.1016/j.jormas.2022.101376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The goal of mandibular fracture treatment is to restore static and dynamic occlusal functions. Open reduction and internal fixation (ORIF) of these fractures can be associated with an intraoperative and/or postoperative maxillo-mandibular fixation (MMF). The aim of this study was to analyse the use of perioperative MMF and its effects on occlusal outcomes in the management of mandibular fractures. MATERIAL AND METHODS This multicentric prospective study included adult patients with mandibular fractures treated with ORIF. The following data were collected: age, gender, pre-trauma dental status (dentate, partially dentate), cause of injury, fracture site, associated facial fractures, surgical approach, type of ORIF (rigid, non-rigid or mixed), thickness and number of plates, modality of intraoperative MMF (arch bars, self-tapping and self-drilling screws [STSDSs], manual, other) and duration of postoperative MMF. The primary outcome was malocclusion at 6 weeks and 3 months. Statistical analyses were performed with Fisher's exact test or chi-square test, as appropriate. RESULTS Between 1 May 2021 and 30 April 2022, 336 patients, 264 males and 72 females (median age, 28 years) with mandibular fractures (194 single, 124 double and 18 triple fractures) were hospitalized. Intraoperative MMF was performed in all patients. Osteosynthesis was rigid in 75% of single fractures, and rigid or mixed in 85% and 100% of double and triple fractures, respectively. Excluding patients who underwent manual reduction, postoperative MMF (median duration, 3 weeks) was performed in 140 (64%) patients, without differences by type or number of fractures (p > 0.05). No significant difference was found in the incidence of malocclusion in patients with postoperative MMF (5%, 95% confidence interval [CI], 2-10%) compared to those without (4%; 95% IC, 1-11%) (p > 0.05). CONCLUSION Postoperative MMF was performed in more than half of the patients despite adequate fracture osteosynthesis, with wide variability amongst centers. No evidence of a reduction in the incidence of postoperative malocclusion in patients treated with postoperative MMF was found.
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Affiliation(s)
- Fabio Roccia
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy
| | - Federica Sobrero
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy.
| | - Elisa Raveggi
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy
| | - Alessandro Rabufetti
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Kathia Dubron
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Constantinus Politis
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Dimitra Ganasouli
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Stylianos N Zanakis
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Drago Jelovac
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Serbia
| | | | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Aleš Vesnaver
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Predrag Knežević
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Mario Kordić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Anamaria Sivrić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Ali O Rizvi
- Department of Oral and Maxillofacial Surgery, University of Dundee, United Kingdom
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, University of Dundee, United Kingdom
| | - Nil Valentines Vilaplana
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Antonio Mari Roig
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Fatma Eriş Derkuş
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Utku Nezih Yilmaz
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Maximilian Goetzinger
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Gian Battista Bottini
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Guglielmo Ramieri
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy
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Sobrero F, Roccia F, Zavattero E, Raveggi E. Letter to the Editor: a lesson from "European multicenter prospective analysis of the use of maxillomandibular fixation for mandibular fractures treated with open reduction and internal fixation". J Stomatol Oral Maxillofac Surg 2023; 124:101390. [PMID: 36657720 DOI: 10.1016/j.jormas.2023.101390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/15/2023] [Indexed: 01/18/2023]
Affiliation(s)
- Federica Sobrero
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science dpt., Città della Salute e della Scienza Hospital, University of Turin, Italy.
| | - Fabio Roccia
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science dpt., Città della Salute e della Scienza Hospital, University of Turin, Italy
| | - Emanuele Zavattero
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science dpt., Città della Salute e della Scienza Hospital, University of Turin, Italy
| | - Elisa Raveggi
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science dpt., Città della Salute e della Scienza Hospital, University of Turin, Italy
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Sobrero F, Roccia F, Galetta G, Strada C, Gerbino G. Pediatric mandibular fractures: Surgical management and outcomes in the deciduous, mixed and permanent dentitions. Dent Traumatol 2023; 39:233-239. [PMID: 36606623 DOI: 10.1111/edt.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/17/2022] [Accepted: 12/18/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND/AIM Mandibular fractures are the most frequent type of pediatric facial traumatic injury, but their treatment remains controversial. The aim of this retrospective study was to analyze the surgical treatment and long-term outcomes of dentate mandibular fractures in children and adolescents. MATERIAL AND METHODS Patients with mandibular fractures in the dentate area who were surgically treated in the period from January 1, 2001, to December 31, 2020, were included. The following data were collected: age, gender, cause and mechanism of injury, fracture site and type, associated maxillofacial fractures, the timing of surgical treatment, Facial Injury Severity Scale (FISS) score, surgical approach, number and thickness of plates, hospitalization stay and outcome. Patients were divided into three groups: deciduous (≤6 years, group A), mixed (7-12 years, group B), and permanent (13-18 years, group C) dentitions. Statistical analyses were performed using SPSS software. RESULTS During the study 91 patients (male: female ratio, 3.8:1), 4 in group A, 12 in group B, and 75 in group C, with 65 single and 52 double fractures were included. An intraoral approach was used in 87% of patients. In group C, 90% of patients were treated with fixation schemes consistent with those suggested in the literature for adults, versus 75% in groups A and B. Median follow-up time was 20 months. No tooth germ injury or facial asymmetry was observed and only six group C patients had post-operative malocclusions. Hardware removal occurred in 22% of the patients. CONCLUSIONS This 20-year retrospective study shows that open reduction and internal fixation of pediatric dentate mandibular fractures caused no tooth germ damage or disturbances of mandibular growth in any dentition stage. Internal fixation schemes were similar to those used for adults, although it was necessary to adapt hardware size and position according to tooth and patient age.
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Affiliation(s)
- Federica Sobrero
- Division of Maxillofacial Surgery (Head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery (Head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Giovanni Galetta
- Division of Maxillofacial Surgery (Head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Carlo Strada
- Division of Maxillofacial Surgery (Head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Giovanni Gerbino
- Division of Maxillofacial Surgery (Head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
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Romeo I, Sobrero F, Roccia F, Dolan S, Laverick S, Carlaw K, Aquilina P, Bojino A, Ramieri G, Duran-Valles F, Bescos C, Segura-Pallerès I, Ganasouli D, Zanakis SN, de Oliveira Gorla LF, Pereira-Filho VA, Gallafassi D, Perez Faverani L, Alalawy H, Kamel M, Samieirad S, Jaisani MR, Rahman SA, Rahman T, Aladelusi T, Hassanein AG, Goetzinger M, Bottini GB. A multicentric, prospective study on oral and maxillofacial trauma in the female population around the world. Dent Traumatol 2022; 38:196-205. [PMID: 35390219 PMCID: PMC9321108 DOI: 10.1111/edt.12750] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIMS Approximately 20% of patients with maxillofacial trauma are women, but few articles have analysed this. The aim of this multicentric, prospective, epidemiological study was to analyse the characteristics of maxillofacial fractures in the female population managed in 14 maxillofacial surgery departments on five continents over a 1-year period. METHODS The following data were collected: age (0-18, 19-64, or ≥65 years), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment, and length of hospitalization. RESULTS Between 30 September 2019 and 4 October 2020, 562 of 2387 patients hospitalized with maxillofacial trauma were females (24%; M: F ratio, 3.2:1) aged between 1 and 96 years (median age, 37 years). Most fractures occurred in patients aged 20-39 years. The main causes were falls (43% [median age, 60.5 years]), which were more common in Australian, European and American units (p < .001). They were followed by road traffic accidents (35% [median age, 29.5 years]). Assaults (15% [median age, 31.5 years]) were statistically associated with alcohol and/or drug abuse (p < .001). Of all patients, 39% underwent open reduction and internal fixation, 36% did not receive surgical treatment, and 25% underwent closed reduction. CONCLUSION Falls were the main cause of maxillofacial injury in the female population in countries with ageing populations, while road traffic accidents were the main cause in African and some Asian centres, especially in patients ≤65 years. Assaults remain a significant cause of trauma, primarily in patients aged 19-64 years, and they are related to alcohol use.
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Affiliation(s)
- Irene Romeo
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Federica Sobrero
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Sean Dolan
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Sean Laverick
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Kirsten Carlaw
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, New South Wales, Australia
| | - Peter Aquilina
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, New South Wales, Australia
| | - Alessandro Bojino
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Francesc Duran-Valles
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Coro Bescos
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Ignasi Segura-Pallerès
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Dimitra Ganasouli
- Department Oral and Maxillofacial Surgery, Hippokration General Hospital, Athens, Greece
| | - Stelios N Zanakis
- Department Oral and Maxillofacial Surgery, Hippokration General Hospital, Athens, Greece
| | - Luis Fernando de Oliveira Gorla
- Department Diagnosis and Surgery, Araraquara Dental School, São Paulo State University, UNESP, Araraquara, São Paulo, Brazil
| | - Valfrido Antonio Pereira-Filho
- Department Diagnosis and Surgery, Araraquara Dental School, São Paulo State University, UNESP, Araraquara, São Paulo, Brazil
| | - Daniel Gallafassi
- Division of Oral and Maxillofacial Surgery, Department of Diagnosis and Surgery, São Paulo State University, UNESP, Araçatuba, São Paulo, Brazil
| | - Leonardo Perez Faverani
- Division of Oral and Maxillofacial Surgery, Department of Diagnosis and Surgery, São Paulo State University, UNESP, Araçatuba, São Paulo, Brazil
| | - Haider Alalawy
- Department Oral and Maxillofacial Surgery, Gazi Alhariri Hospital, Medical City, Baghdad, Iraq
| | - Mohammed Kamel
- Department Oral and Maxillofacial Surgery, Gazi Alhariri Hospital, Medical City, Baghdad, Iraq
| | - Sahand Samieirad
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Sajjad Abdur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Tabishur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Timothy Aladelusi
- Department Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ahmed Gaber Hassanein
- Maxillofacial Surgery Unit, Faculty of Medicine, General Surgery Department, Sohag University, Sohag, Egypt
| | - Maximilian Goetzinger
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Gian Battista Bottini
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
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Bojino A, Roccia F, Carlaw K, Aquilina P, Rae E, Laverick S, Romeo I, Iocca O, Copelli C, Sobrero F, Segura-Pallerès I, Ganasouli D, Zanakis SN, de Oliveira Gorla LF, Pereira-Filho VA, Gallafassi D, Perez Faverani L, Alalawy H, Kamel M, Samieirad S, Jaisani MR, Rahman SA, Rahman T, Aladelusi T, Hassanein AG, Duran-Valles F, Bescos C, Goetzinger M, Bottini GB. A multicentric prospective analysis of maxillofacial trauma in the elderly population. Dent Traumatol 2022; 38:185-195. [PMID: 35150461 DOI: 10.1111/edt.12736] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND/AIMS The growth of the global elderly population will lead to an increase in traumatic injuries in this group, including those affecting the maxillofacial area, with a heavier load on health systems. The aim of this multicentric prospective study was to understand and evaluate the incidences, causes and patterns of oral and maxillofacial injuries in patients aged over 60 years admitted to 14 maxillofacial surgical departments around the world. METHODS The following data were collected: gender, cause and mechanism of maxillofacial fracture, alcohol and drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment and length of hospitalization. Statistical analyses were performed using non-parametric and association tests, as well as linear regression. RESULTS Between 30 September 2019 and 4 October 2020, 348 out of 2387 patients (14.6%), 197 men and 151 women (ratio 1.3:1; mean age 72.7 years), were hospitalized. The main causes of the maxillofacial fractures were falls (66.4%), followed by road traffic accidents (21.5%) and assaults (5.2%). Of the 472 maxillofacial fractures, 69.7% were in the middle third of the face, 28% in the lower third and 2.3% in the upper third. Patients with middle third fractures were on average 4.2 years older than patients with lower third fractures (95% CI 1.2-7.2). Statistical analysis showed that women were more involved in fall-related trauma compared with males (p < .001). It was also shown that road traffic accidents cause more fractures in the lower third (p < .001) and in the middle third-lower third complex compared with upper third (p < .001). CONCLUSIONS Maxillofacial fractures in the elderly were more frequent in European and Australian centres and affected men slightly more than women. Falls were the leading cause of fractures, especially among women. The middle third of the face was most often affected, and conservative treatment was the most common choice for the management of such patients.
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Affiliation(s)
- Alessandro Bojino
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Kirsten Carlaw
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, New South Wales, Australia
| | - Peter Aquilina
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, New South Wales, Australia
| | - Euan Rae
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Sean Laverick
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Irene Romeo
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Oreste Iocca
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Chiara Copelli
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Federica Sobrero
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Ignasi Segura-Pallerès
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Dimitra Ganasouli
- Department Oral and Maxillofacial Surgery, Hippokration General Hospital, Athens, Greece
| | - Stelios N Zanakis
- Department Oral and Maxillofacial Surgery, Hippokration General Hospital, Athens, Greece
| | | | | | - Daniel Gallafassi
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, Araçatuba, São Paulo, Brazil
| | - Leonardo Perez Faverani
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, Araçatuba, São Paulo, Brazil
| | - Haider Alalawy
- Department Oral and Maxillofacial Surgery, Gazi Alhariri Hospital, Medical City, Baghdad, Iraq
| | - Mohammed Kamel
- Department Oral and Maxillofacial Surgery, Gazi Alhariri Hospital, Medical City, Baghdad, Iraq
| | - Sahand Samieirad
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehul Rajesh Jaisani
- Department Oral and Maxillofacial Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sajjad Abdur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Tabishur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Timothy Aladelusi
- Department Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ahmed Gaber Hassanein
- Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Francesc Duran-Valles
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Coro Bescos
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Maximilian Goetzinger
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Gian Battista Bottini
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
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Segura-Palleres I, Sobrero F, Roccia F, de Oliveira Gorla LF, Pereira-Filho VA, Gallafassi D, Faverani LP, Romeo I, Bojino A, Copelli C, Duran-Valles F, Bescos C, Ganasouli D, Zanakis SN, Hassanein AG, Alalawy H, Kamel M, Samieirad S, Jaisani MR, Rahman SA, Rahman T, Aladelusi T, Carlaw K, Aquilina P, Rae E, Laverick S, Goetzinger M, Bottini GB. Characteristics and age-related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study. Dent Traumatol 2022; 38:213-222. [PMID: 35146900 PMCID: PMC9305543 DOI: 10.1111/edt.12735] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 01/29/2023]
Abstract
Background/Aims Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1‐year period. Methods The following data were collected: age (preschool [0–6 years], school age [7–12 years], and adolescent [13–18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software. Results Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0–18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001). Conclusion The main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0–6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.
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Affiliation(s)
- Ignasi Segura-Palleres
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Federica Sobrero
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | | | | | - Daniel Gallafassi
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, São Paulo, Brazil
| | - Leonardo Perez Faverani
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, São Paulo, Brazil
| | - Irene Romeo
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Alessandro Bojino
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Chiara Copelli
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Francesc Duran-Valles
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Coro Bescos
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Dimitra Ganasouli
- Department Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Stelios N Zanakis
- Department Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Ahmed Gaber Hassanein
- Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Haider Alalawy
- Department Oral and Maxillofacial Surgery, Medical City, Gazi Alhariri Hospital, Baghdad, Iraq
| | - Mohammed Kamel
- Department Oral and Maxillofacial Surgery, Medical City, Gazi Alhariri Hospital, Baghdad, Iraq
| | - Sahand Samieirad
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Sajjad Abdur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Tabishur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Timothy Aladelusi
- Department Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Kirsten Carlaw
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, Australia
| | - Peter Aquilina
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, Australia
| | - Euan Rae
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Sean Laverick
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Maximilian Goetzinger
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Gian Battista Bottini
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
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Garzino Demo P, Bojino A, Roccia F, Malandrino MC, Cocis S, Ramieri G. Different Presentation and Outcomes in the Surgical Treatment of Advanced MRONJ in Oncological and Nononcological Patients Taking or Not Corticosteroid Therapy. Biomed Res Int 2021; 2021:7855497. [PMID: 38523862 PMCID: PMC10960651 DOI: 10.1155/2021/7855497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/02/2021] [Indexed: 03/26/2024]
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect caused by antiangiogenic antiresorptive drugs used to treat various oncological and non oncological diseases. The clinical and radiological characteristics of MRONJ depend on the type of causative drug, the time of administration, and its dosage. Proven systemic risk factors like anemia, uncontrolled diabetes, corticosteroid therapy, and chemotherapy in neoplastic diseases (e.g., high doses of methotrexate up to 30 mg daily) significantly increase the chances of acquiring MRONJ. The risk factors themselves can affect treatment outcomes. Although the main scientific societies have recently disseminated good practice rules on the patient's prevention, diagnosis, and management, there are still no guidelines on shared therapeutic strategies. In general, if conservative treatment fails, surgical treatment is considered, including local debridement, osteoplasty, and marginal or segmental osteotomy. In literature, cohorts of heterogeneous patients with MRONJ have been analyzed for a long time, resulting in a lack of uniformity of information and difficulties interpreting the data. According to the American Association of Oral and Maxillofacial Surgeons criteria, this retrospective study evaluates the surgical treatment outcomes of 64 patients with stage II-III MRONJ, evaluated at the Department of Maxillofacial Surgery of the University of Turin (Italy). The first objective of this retrospective study is to evaluate treatment results for stages II-III in all cases; the second objective is to evaluate the same results by dividing the sample into different cohorts of patients: first, based on the underlying pathology, i.e., oncological and non oncological, and secondly, based on the drug or combination of drugs they took.
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Affiliation(s)
- Paolo Garzino Demo
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Italy
| | - Alessandro Bojino
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Italy
| | - Maria Chiara Malandrino
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Italy
| | - Stefan Cocis
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Italy
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Italy
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11
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Segura-Pallerès I, Roccia F, Cocis S, Atin CB, Ganasouli D, Bakardjiev A, Jelovac D, Goetzinger M. Surgical Management of Bilateral Mandibular Angle Fractures With a Third Molar in Line of Fracture: A European Multicenter Survey. J Oral Maxillofac Surg 2020; 79:201.e1-201.e5. [PMID: 33011164 DOI: 10.1016/j.joms.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/20/2020] [Accepted: 09/01/2020] [Indexed: 11/15/2022]
Abstract
PURPOSE The aim of this survey was to investigate the surgical management of bilateral mandibular angle fracture (BMAF) in Europe. METHODS Data were collected from 2008 to 2018 on patients ≥ 16 years of age who underwent open reduction internal fixation (ORIF) for BMAF with a third molar in the fracture line. The study was conducted at 6 European trauma centers. The following data were recorded: sex, age, cause of the fracture, type of fracture (nondisplaced, displaced, comminuted), type of approach (intraoral, transbuccal, or extraoral), thickness of the plate (≤1.4 mm or ≥1.5 mm), number of plates, cause of plate removal, and third molar extraction status. RESULTS 25 patients with BMAF (24 males, 1 female, 17 to 83 years old [mean: 28.2 years]) were collected. The main cause of BMAF was assault, and the main surgical approach was intraoral. The most common types of BMAF were displaced + undisplaced (11 patients), displaced + displaced (7 patients), undisplaced + undisplaced (6 patients), and comminuted + comminuted (1 patient). Osteosynthesis was performed with 2 ≤1.4 mm plates on 1 angular fracture and 1 ≤1.4 mm plate on the other fracture in 11 patients, 1 ≤1.4 mm plate on both angular fractures in 6 patients, 1 ≥1.5 mm plate on both fractures in 5 patients, and 2 ≤1.4 mm plates on both fractures in the remaining 3 patients. Out of 25 patients with BMAF, 7 third molars were extracted during ORIF. Among these patients, angular fracture fixation was performed in 3 cases with 1 ≥1.5 mm plate and in 4 patients with 2 ≤1.4 mm plates. CONCLUSIONS This retrospective multicenter survey indicates a trend of treating with open reduction and rigid internal fixation at least 1 angular fracture of BMAF and those cases requiring extraction of the third molar in the line of fracture.
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Affiliation(s)
- Ignasi Segura-Pallerès
- Resident of Dpt. Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy.
| | - Fabio Roccia
- Assistant Professor of the Dpt. Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - Stefan Cocis
- Resident of Dpt. Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - Coro Bescos Atin
- Department Head of the Dpt. of Oral and Maxillofacial Surgery, University Hospital of Vall D'Hebron, Barcelona, Spain
| | - Dimitra Ganasouli
- Assistant Professor of Dpt. of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greek
| | - Angel Bakardjiev
- Professor of the Department Maxillofacial Surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Drago Jelovac
- Assistant Professor of Clinic of Maxillofacial Surgery, School of dentistry, University of Belgrade, Serbia
| | - Maximilian Goetzinger
- Assistant Professor Dpt. of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
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Volpe F, Grieco F, Falco EC, Roccia F, Garzino Demo P. Aggressive angiolymphoid hyperplasia with eosinophilia of the tongue: A case report and review of the literature. Oral and Maxillofacial Surgery Cases 2020. [DOI: 10.1016/j.omsc.2020.100179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Bojino A, Roccia F, Giaccone E, Cocis S. Comprehensive analyses of maxillofacial fractures due to non-professional sports activities in Italy. Dent Traumatol 2020; 36:632-640. [PMID: 32790896 DOI: 10.1111/edt.12586] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND/AIM Sports activities have become increasingly popular among amateurs and this has led to an increase in maxillofacial fractures. The aim of this study was to investigate the management of amateur sport-related maxillofacial fractures and appropriate preventive measures. METHODS A trauma database was used to analyze 3231 patients with maxillofacial fractures admitted to the Maxillofacial Surgery Division of Città della Salute e della Scienza Hospital, Turin, Italy, from January 2001 to December 2019. Only patients with non-professional sports-related maxillofacial fractures were included. The following data were collected: age, gender, type of sport, mechanisms of injury, sites of fracture, Facial Injury Severity Scale, associated injuries, month of trauma, time to treatment, treatment, length of stay, and interval before return to sport. RESULTS There were 432 patients, 378 males and 54 females, with a mean age of 29.2 (5-76 years). Sport-related maxillofacial fractures' relative percent ranged from 11.1% in 2001 to 17.5% in 2019. Soccer was the most common cause of sport-related maxillofacial fractures (54.2%), and impact with a player/opponent was the main mechanism of injury (72%). An intentional violent act (player hit by a fist) was the cause of fracture in 8.5% of the soccer-related injuries. Fractures of the middle third of the face occurred in 61.2% of patients. Maxillofacial fractures were treated within 24 h in 25% of patients. There were 343 out of 412 patients who received open reduction and internal fixation (mean length of hospital stay: 3.7 days). There was no contraindication to resuming sport activities at 30/40 days after treatment, except for combat sports. CONCLUSIONS This study provided further evidence of a relative increase in sports-related maxillofacial fractures. Soccer is related to the majority of sport maxillofacial fractures. Adherence to the rules is necessary to limit violent acts that cause such injuries. In non-professional players, resumption of the full activity is allowed after 40 days for non-combat sports.
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Affiliation(s)
- Alessandro Bojino
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Torino, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e delle Scienze Hospital, Turin, Italy
| | - Elena Giaccone
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Torino, Italy
| | - Stefan Cocis
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Torino, Italy
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Gerbino G, Cocis S, Roccia F, Novelli G, Canzi G, Sozzi D. Management of atrophic mandibular fractures: An Italian multicentric retrospective study. J Craniomaxillofac Surg 2018; 46:2176-2181. [DOI: 10.1016/j.jcms.2018.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/28/2018] [Accepted: 09/20/2018] [Indexed: 10/28/2022] Open
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Gerbino G, Zavattero E, Roccia F, Benech R, Bianchi F, Ramieri G. Intraoperative navigation: is it a useful tool only in traumatology? Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Boffano P, Kommers SC, Roccia F, Forouzanfar T. Mandibular trauma treatment: a comparison of two protocols. Med Oral Patol Oral Cir Bucal 2015; 20:e218-23. [PMID: 25475782 PMCID: PMC4393986 DOI: 10.4317/medoral.20263] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/01/2014] [Indexed: 11/23/2022] Open
Abstract
Objectives: The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years.
Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two centers in Turin, Italy and in Amsterdam, the Netherlands for ten years. Only patients who were admitted for mandibular fractures were considered for this study.
Results: Between 2001 and 2010, a total of 752 patients were admitted at Turin hospital with a total of 1167 mandibular fractures not associated with further maxillofacial fractures, whereas 245 patients were admitted at Amsterdam hospital with a total of 434 mandibular fractures. At Amsterdam center, a total of 457 plates (1.5 - 2.7 mm) were used for the 434 mandibular fracture lines, whereas at Turin center 1232 plates (1.5 – 2.5 mm) were used for the management of the 1167 mandibular fracture lines. At Turin center, 190 patients were treated primarily with IMF, whereas 35 patients were treated with such treatment option at Amsterdam center.
Conclusions: Current protocols for the management of mandibular fractures are quite efficient. It is difficult to obtain a uniform protocol, because of the difference of course of each occurring fracture and because of surgeons’ experiences and preferences. Several techniques can still be used for each peculiar fracture of the mandible.
Key words:Mandibular fracture, facial trauma, maxillofacial, treatment, multicentre, database.
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Affiliation(s)
- Paolo Boffano
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry, Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, The Netherlands,
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Boffano P, Roccia F, Zavattero E, Dediol E, Uglešić V, Kovačič Ž, Vesnaver A, Konstantinović VS, Petrović M, Stephens J, Kanzaria A, Bhatti N, Holmes S, Pechalova PF, Bakardjiev AG, Malanchuk VA, Kopchak AV, Galteland P, Mjøen E, Skjelbred P, Koudougou C, Mouallem G, Corre P, Løes S, Lekven N, Laverick S, Gordon P, Tamme T, Akermann S, Karagozoglu KH, Kommers SC, Forouzanfar T. European Maxillofacial Trauma (EURMAT) project: A multicentre and prospective study. J Craniomaxillofac Surg 2015; 43:62-70. [DOI: 10.1016/j.jcms.2014.10.011] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/15/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022] Open
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Roccia F, Boffano P, Bianchi FA, Zavattero E. Maxillofacial Fractures due to Falls: does Fall Modality Determine the Pattern of Injury? J Oral Maxillofac Res 2014; 5:e5. [PMID: 25635212 PMCID: PMC4306323 DOI: 10.5037/jomr.2014.5405] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 06/17/2014] [Indexed: 11/16/2022]
Abstract
Objectives In several epidemiological studies of maxillofacial trauma, falls were one of the most frequent causes of facial injury. The aim of this study is to analyse the patterns of fall-related maxillofacial injuries based on the height of the fall. Material and Methods Using a systematic computer-assisted database of patients hospitalised with maxillofacial fractures, only those with fall-related injuries were considered. The falls were divided into four groups: falls from slipping, tripping or stumbling (STSF), loss of consciousness (LOCF), stairs (SAF), and height (HF). Data on the age, gender, fracture site, Facial Injury Severity Scale (FISS), facial lacerations, associated lesions, type of treatment, and length of hospital stay were also analysed. Results This study included 557 patients (338 males, 219 females; average age 51.5 years [range 4 - 99 years]). In the over 60 age group, females were more prevalent in STSF than males. According to aetiology, STSF was the most frequent cause of maxillofacial fractures (315 patients; 56.5%) followed by LOCF (157; 28.2%), HF (55; 9.9%), and SAF (30; 5.4%). The middle third of the face was affected most frequently. After LOCF, however, the inferior third was prevalently involved. The majority of associated fractures, as well as the most severe injuries and greatest rate of facial lacerations, occurred secondary to HF. Conclusions This study showed that fracture severity and site are influenced not only by patient age, but also by the nature of the fall.
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Affiliation(s)
- Fabio Roccia
- Surgical Science Department, San Giovanni Battista Hospital, University of Turin, Turin Italy
| | - Paolo Boffano
- Surgical Science Department, San Giovanni Battista Hospital, University of Turin, Turin Italy
| | - Francesca A Bianchi
- Surgical Science Department, San Giovanni Battista Hospital, University of Turin, Turin Italy
| | - Emanuele Zavattero
- Surgical Science Department, San Giovanni Battista Hospital, University of Turin, Turin Italy
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Boffano P, Roccia F, Zavattero E, Dediol E, Uglešić V, Kovačič Ž, Vesnaver A, Konstantinović VS, Petrović M, Stephens J, Kanzaria A, Bhatti N, Holmes S, Pechalova PF, Bakardjiev AG, Malanchuk VA, Kopchak AV, Galteland P, Mjøen E, Skjelbred P, Grimaud F, Fauvel F, Longis J, Corre P, Løes S, Lekven N, Laverick S, Gordon P, Tamme T, Akermann S, Karagozoglu KH, Kommers SC, Meijer B, Forouzanfar T. European Maxillofacial Trauma (EURMAT) in children: a multicenter and prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:499-504. [PMID: 25660086 DOI: 10.1016/j.oooo.2014.12.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/01/2014] [Accepted: 12/12/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study is to present and discuss the results of a European multicentre prospective study about pediatric maxillofacial trauma epidemiology during a year. STUDY DESIGN The following data were recorded: gender, age, etiology, site of fracture, date of injury. Of the 3396 patients with maxillofacial fractures admitted within the study period, 114 (3.3%) were children aged 15 years and younger, with a male/female ratio of 2.6:1. Mean age was 10.9 years. Most patients (63%) were aged 11-15 years. RESULTS The most frequent cause of injury was fall (36 patients). Sport injuries and assaults were almost limited to the oldest group, whereas falls were more uniformly distributed in the 3 groups. The most frequently observed fracture involved the mandible with 47 fractures. In particular, 18 condylar fractures were recorded, followed by 12 body fractures. CONCLUSIONS Falls can be acknowledged as the most important cause of facial trauma during the first years of life. The high incidence of sport accidents after 10 years may be a reason to increase the use of mouthguards and other protective equipment. Finally, the mandible (and in particular the condyle) was confirmed as the most frequent fracture site.
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Affiliation(s)
- Paolo Boffano
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
| | - Fabio Roccia
- Department of Maxillofacial Surgery, University of Turin, Turin, Italy
| | | | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Vedran Uglešić
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Žiga Kovačič
- Maxillofacial Department, UKC Ljubljana, Ljubljana, Slovenia
| | - Aleš Vesnaver
- Maxillofacial Department, UKC Ljubljana, Ljubljana, Slovenia
| | | | - Milan Petrović
- Clinic of Maxillofacial Surgery, School of Dentistry, University of Belgrade, Belgrade, Serbia
| | - Jonny Stephens
- Department of Oral and Maxillofacial Surgery, Royal London Hospital, Barts Health NHS, London, UK
| | - Amar Kanzaria
- Department of Oral and Maxillofacial Surgery, Royal London Hospital, Barts Health NHS, London, UK
| | - Nabeel Bhatti
- Department of Oral and Maxillofacial Surgery, Royal London Hospital, Barts Health NHS, London, UK
| | - Simon Holmes
- Department of Oral and Maxillofacial Surgery, Royal London Hospital, Barts Health NHS, London, UK
| | - Petia F Pechalova
- Department of Maxillofacial Surgery, Medical University, Plovdiv, Bulgaria
| | - Angel G Bakardjiev
- Department of Maxillofacial Surgery, Medical University, Plovdiv, Bulgaria
| | - Vladislav A Malanchuk
- Department for Oral and Maxillofacial Surgery, Bogomolets National Medical University, Kiev, Ukraine
| | - Andrey V Kopchak
- Department for Oral and Maxillofacial Surgery, Bogomolets National Medical University, Kiev, Ukraine
| | - Pål Galteland
- Department of Maxillofacial Surgery, Oslo University Hospital, Oslo, Norway
| | - Even Mjøen
- Department of Maxillofacial Surgery, Oslo University Hospital, Oslo, Norway
| | - Per Skjelbred
- Department of Maxillofacial Surgery, Oslo University Hospital, Oslo, Norway
| | - Fanny Grimaud
- Service de Stomatologie et Chirurgie Maxillo-faciale, Chu de Nantes, France
| | - Fabien Fauvel
- Service de Stomatologie et Chirurgie Maxillo-faciale, Chu de Nantes, France
| | - Julie Longis
- Service de Stomatologie et Chirurgie Maxillo-faciale, Chu de Nantes, France
| | - Pierre Corre
- Service de Stomatologie et Chirurgie Maxillo-faciale, Chu de Nantes, France
| | - Sigbjørn Løes
- Department of Maxillofacial Surgery, University of Bergen, Bergen, Norway
| | - Njål Lekven
- Department of Maxillofacial Surgery, University of Bergen, Bergen, Norway
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, NHS Tayside, University of Dundee, Dundee, UK
| | - Peter Gordon
- Department of Oral and Maxillofacial Surgery, NHS Tayside, University of Dundee, Dundee, UK
| | - Tiia Tamme
- Department of Maxillofacial surgery, Stomatology Clinic, Tartu University, Tartu, Estonia
| | - Stephanie Akermann
- Department of Maxillofacial surgery, Stomatology Clinic, Tartu University, Tartu, Estonia
| | - K Hakki Karagozoglu
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Sofie C Kommers
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Brigitte Meijer
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Boffano P, Roccia F, Gallesio C, Karagozoglu K, Forouzanfar T. Inferior alveolar nerve injuries associated with mandibular fractures at risk: a two-center retrospective study. Craniomaxillofac Trauma Reconstr 2014; 7:280-3. [PMID: 25383147 DOI: 10.1055/s-0034-1375169] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 07/13/2013] [Indexed: 10/25/2022] Open
Abstract
The aim of the study was to investigate the incidence of the inferior alveolar nerve (IAN) injury in mandibular fractures. This study is based on two databases that have continuously recorded patients hospitalized with maxillofacial fractures in two departments-Department of Maxillofacial Surgery, Vrije Universiteit University Medical Center, Amsterdam, the Netherlands, and Division of Maxillofacial Surgery, San Giovanni Battista Hospital, Turin, Italy. Demographic, anatomic, and etiology variables were considered for each patient and statistically assessed in relation to the neurosensory IAN impairment. Statistically significant associations were found between IAN injury and fracture displacement (p = 0.03), isolated mandibular fractures (p = 0.01), and angle fractures (p = 0.004). A statistically significant association was also found between IAN injury and assaults (p = 0.03). Displaced isolated mandibular angle fractures could be considered at risk for increased incidence of IAN injury. Assaults seem to be the most important etiological factor that is responsible for IAN lesions.
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Affiliation(s)
- Paolo Boffano
- Division of Maxillofacial Surgery, Head and Neck Department, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Head and Neck Department, University of Turin, Turin, Italy
| | - Cesare Gallesio
- Division of Maxillofacial Surgery, Head and Neck Department, University of Turin, Turin, Italy
| | - K Karagozoglu
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Vrije Universiteit University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Vrije Universiteit University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
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Boffano P, Kommers SC, Roccia F, Gallesio C, Forouzanfar T. Fractures of the mandibular coronoid process: a two centres study. J Craniomaxillofac Surg 2014; 42:1352-5. [PMID: 24787084 DOI: 10.1016/j.jcms.2014.03.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 01/25/2014] [Accepted: 03/25/2014] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to assess the characteristics of patients with coronoid fractures treated in two European centres over 10 years and to briefly review the literature. This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures and surgically treated in two European centres between 2001 and 2010. During the 10 years, 1818 patients and 523 patients with maxillofacial fractures were admitted to the two centres respectively: 21 patients (16 males, 5 females) were admitted with 21 coronoid fractures and 28 associated maxillofacial fractures. A mean age of 42.1 years was observed. The fractures were mainly the result of motor vehicle accidents, followed by assaults and falls. The most frequently observed associated maxillofacial fracture was a zygomatic fracture (13 fractures). In both centres, mandibular coronoid fractures are treated unless a severe dislocation of the fractured coronoid is observed or a functional mandibular impairment is encountered. Conservative treatment can be used, together with the open reduction and internal fixation of associated fractures. The crucial point is to prevent ankylosis, which may be prevented by correct and early postoperative physiotherapy and mandibular function.
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Affiliation(s)
- Paolo Boffano
- Department of Oral and Maxillofacial Surgery/Pathology (Head: Professor Tymour Forouzanfar), VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Sofie C Kommers
- Department of Oral and Maxillofacial Surgery/Pathology (Head: Professor Tymour Forouzanfar), VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy
| | - Cesare Gallesio
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Pathology (Head: Professor Tymour Forouzanfar), VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
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Boffano P, Zavattero E, Roccia F, Ramieri G. Open surgical management of an asymptomatic giant frontal sinus osteoma. Craniomaxillofac Trauma Reconstr 2014; 7:51-4. [PMID: 24624257 DOI: 10.1055/s-0033-1364200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 02/23/2013] [Indexed: 10/25/2022] Open
Abstract
Osteomas are benign, slow-growing tumors that arise most frequently in the craniomaxillofacial region, and in particular in correspondence of the nose and paranasal sinuses. Osteomas may be asymptomatic for a long time until they cause deformation of the bone or compress adjacent structures. The treatment of osteomas of the frontal sinus may involve endoscopic approach or open approach. Although endoscopic treatment is the most common approach for frontal sinus osteomas, a coronal approach combined with the use of titanium mesh may still constitute a valuable option for the reconstruction of the anterior wall of the frontal sinus. This intervention is extremely important and delicate because the restoration of the integrity of the frontal sinus is crucial for its function. The purpose of this article is to present a case of frontal sinus osteoma that was treated by a coronal approach and a titanium mesh to restore frontal sinus contour.
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Affiliation(s)
- Paolo Boffano
- Division of Maxillofacial Surgery, Head and Neck Department, University of Turin, Turin, Italy
| | - Emanuele Zavattero
- Division of Maxillofacial Surgery, Head and Neck Department, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Head and Neck Department, University of Turin, Turin, Italy
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Head and Neck Department, University of Turin, Turin, Italy
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Roccia F, Boffano P, Bianchi FA, Ramieri G. An 11-year review of dental injuries associated with maxillofacial fractures in Turin, Italy. Oral Maxillofac Surg 2013; 17:269-274. [PMID: 23138750 DOI: 10.1007/s10006-012-0371-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 10/22/2012] [Indexed: 06/01/2023]
Abstract
INTRODUCTION The aim of the study was to analyze the incidence, characteristics, and correlations between maxillofacial fractures and dental injuries in patients who were treated at a first-level trauma center in a metropolitan center in northwest Italy in the last 11 years. MATERIAL AND METHODS Between January 1, 2001 and December 31, 2011, 2,110 patients with maxillofacial fractures were admitted. Only dentulous patients with complete clinical records who presented with associated dental injuries were included in this study. Data on the age, gender, mechanism of injury, damaged tooth, type of dental injury, site of facial fractures, and concomitant injuries were recorded. RESULTS On the whole, 267 patients (13.1%), mainly males aged 20-29 years, presented with 759 dental injuries associated with maxillofacial fractures, especially following motor vehicle accidents. The maxillary teeth, most often the anterior elements with decreasing involvement from the incisors to the molars, were the teeth most frequently damaged overall. The main types of dental trauma in patients with maxillofacial fractures were luxations and dental fractures. DISCUSSION Our findings show that patients with mandibular fractures were statistically and significantly associated with dental injury, and the teeth in the upper jaw were the most frequently injured teeth, exhibiting mainly luxations and crown fractures. Confirmation of the predominant impact site in patients with dental injuries associated with maxillofacial fractures comes from the 177 lacerations noted in the chin and lip regions in 267 patients.
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Affiliation(s)
- Fabio Roccia
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Corso A.M. Dogliotti 14, 10126, Torino, Italy,
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Roccia F, Campolo B, Gallelli L. Sleep and pulmonary intensive care: Insomnia and the paradox of. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Roccia F, Boffano P, Bianchi FA, Gerbino G. Maxillofacial injuries due to work-related accidents in the North West of Italy. Oral Maxillofac Surg 2013; 17:181-186. [PMID: 22868983 DOI: 10.1007/s10006-012-0336-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 07/16/2012] [Indexed: 06/01/2023]
Abstract
INTRODUCTION The aim of this study was to assess the incidence and patterns of work-related maxillofacial injuries, identifying worker categories with a high risk of injury. MATERIAL AND METHODS From a systematic computer-assisted database that has continuously recorded patients hospitalized with maxillofacial fractures, only patients with work-related injuries were considered. Occupation, mechanism of injury, and demographic and clinical data were analyzed. RESULTS Work-related facial injuries represented the fifth most common cause of injury, with a percentage of 6.3 %. Maxillofacial fractures were most often seen in construction workers (37.9 %). The middle third was involved in 67 % of the cases; the mandible was the most frequently injured site. CONCLUSIONS Work-related maxillofacial trauma is rare, but it is often complex and challenging as Facial Injury Severity Scale values show. In agreement with the few published reports, construction workers, together with farm and forestry workers, are at the highest risk of injuries, mainly because of struck by a thrown, projected, or falling object.
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Affiliation(s)
- Fabio Roccia
- Division of Maxillofacial Surgery, Head & Neck Department, San Giovanni Battista Hospital, University of Turin, Corso A.M. Dogliotti 14, 10126, Torino, Italy.
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Boffano P, Roccia F, Gallesio C, Karagozoglu KH, Forouzanfar T. Bicycle-related maxillofacial injuries: a double-center study. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:275-80. [DOI: 10.1016/j.oooo.2013.03.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 02/24/2013] [Accepted: 03/06/2013] [Indexed: 10/26/2022]
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Boffano P, Roccia F, Gallesio C, Berrone S. Pathological mandibular fractures: a review of the literature of the last two decades. Dent Traumatol 2013; 29:185-96. [PMID: 23294978 DOI: 10.1111/edt.12028] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2012] [Indexed: 12/17/2022]
Abstract
Pathological mandibular fractures are rare, accounting for fewer than 2% of all fractures of the mandible. They could be defined as fractures that occur in regions where bone has been weakened by an underlying pathological process. Pathological fractures usually may follow surgical interventions such as third molar removal or implant placement, result from regions of osteomyelitis, osteoradionecrosis, and bisphosphonate-related osteonecrosis of the jaw, occur because of idiopathic reasons or be facilitated by cystic lesions, benign, malignant, or metastatic tumors. Pathological mandibular fractures may be challenging to treat because of their different etiology and peculiar local and general conditions, often requiring a more rigid fixation. In patients with poor medical conditions, simpler and more limited options may be preferred.
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Affiliation(s)
- Paolo Boffano
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
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Gallelli L, Gioffrè V, Vero G, Gallelli A, Roccia F, Naty S, Pelaia G, Capano A, Loiacono A, De Sarro G, Maselli R. Clarithromycin in the Treatment of Legionella pneumophila Pneumonia Associated with Multiorgan Failure in a Previously Healthy Patient. Clin Drug Investig 2012; 25:485-90. [PMID: 17532691 DOI: 10.2165/00044011-200525070-00008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- L Gallelli
- Department of Experimental and Clinical Medicine, Chair of Pharmacology, Clinical Pharmacology and Pharmacovigilance Unit, University ‘Magna Graecia’ of Catanzaro, Regional Pharmacovigilance Center, ‘Mater Domini’ University Hospital, Catanzaro, Italy
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Boffano P, Roccia F, Zavattero E, Gallesio C, Cassarino E, Campisi P, Berrone S. The surgical management of a leiomyosarcoma of the submandibular gland in a 95-year-old patient. ACTA ACUST UNITED AC 2011; 112:e34-8. [PMID: 21856190 DOI: 10.1016/j.tripleo.2011.04.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2011] [Accepted: 04/19/2011] [Indexed: 11/19/2022]
Affiliation(s)
- Paolo Boffano
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, Turin, Italy.
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Boffano P, Roccia F, Campisi P, Zavattero E, Gallesio C, Bosco GF. Epidermoid cyst of the temporal region. ACTA ACUST UNITED AC 2011; 112:e113-6. [DOI: 10.1016/j.tripleo.2011.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2011] [Revised: 05/29/2011] [Accepted: 06/06/2011] [Indexed: 10/17/2022]
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Roccia F, Boffano P, Guglielmi V, Forni P, Cassarino E, Nadalin J, Fea A, Gerbino G. Role of the maxillofacial surgeon in the management of severe ocular injuries after maxillofacial fractures. J Emerg Trauma Shock 2011; 4:188-93. [PMID: 21769204 PMCID: PMC3132357 DOI: 10.4103/0974-2700.82204] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 07/19/2010] [Indexed: 11/16/2022] Open
Abstract
Aim: This study was designed to evaluate the incidence of severe ocular injuries associated to maxillofacial fractures and report their management in the Emergency Department. Patients and Methods: Among the 1779 patients admitted for maxillofacial fractures, those with partial or total loss of vision at the time of emergency consultation were included in the study. Data collected from the patients’ medical records included age, gender, mechanism of injury, location and type of facial fractures, type of ocular injuries and cause of blindness, methods of treatment, and days of hospitalization. Results: Forty patients (2.2%), 32 men and 8 women, ranging from 17 to 85 years of age, presented with severely reduced vision or blindness associated to fractures of the facial middle third with involvement of one or more orbital walls, mainly caused by motor vehicle and work accidents. In 18 patients, severe ocular injuries were determined by direct lesion of the globe, in 14 by direct or indirect traumatic optic neuropathy and in 8 by a retrobulbar hematoma. Direct lesion of the eyeball was treated by prompt repair or enucleation of the globe, though no or little recovery of vision was obtained. Ophthalmologic and/or maxillofacial treatment of the anterior compartment lesions of the eye allowed a partial or total recovery of the vision. A partial or total recovery of the vision was observed in almost all the patients with indirect traumatic optic neuropathy after administration of steroids according to NASCIS II protocol. Likewise, an evident improvement of the vision was obtained by immediate drainage of retrobulbar hematoma. Conclusions: Early diagnosis of the nature of the ophthalmic injury and treatment are important, and involvement of the ophthalmologist is mandatory.
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Affiliation(s)
- Fabio Roccia
- Head & Neck Department, Division of Maxillofacial Surgery, San Giovanni Battista Hospital, Turin, Italy
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Boffano P, Boffano M, Gallesio C, Roccia F, Cignetti R, Piana R. Rugby athletes’ awareness and compliance in the use of mouthguards in the North West of Italy. Dent Traumatol 2011; 28:210-3. [DOI: 10.1111/j.1600-9657.2011.01067.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Boffano P, Roccia F, Campisi P, Gallesio C. Review of 43 osteomas of the craniomaxillofacial region. J Oral Maxillofac Surg 2011; 70:1093-5. [PMID: 21820784 DOI: 10.1016/j.joms.2011.05.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 04/21/2011] [Accepted: 05/02/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE To present and discuss the demographic and clinical aspects and the management of 44 cases of osteomas of the craniomaxillofacial region. MATERIALS AND METHODS A retrospective chart review was performed of all cases of osteoma diagnosed from 2000 through 2010. The data collected included age at diagnosis, gender, lesion location, presenting symptoms, type of osteoma, treatment, and outcomes. RESULTS Forty-two patients with 43 osteomas were diagnosed during the study period. Their mean age was 48 years. The male-to-female ratio was 0.4:1. Twenty-one patients were asymptomatic, whereas 10 patients complained about headache and neuralgia, and 11 patients presented with facial asymmetry. Only 21 symptomatic osteomas were surgically removed after histologic diagnosis, whereas for the asymptomatic lesions a careful follow-up was maintained. CONCLUSIONS The slow growth of osteomas allows a conservative attitude toward asymptomatic lesions. Thus, when surgery is performed, it is extremely important to plan a surgical approach that minimizes any damage to the adjacent structures.
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Affiliation(s)
- Paolo Boffano
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
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Boffano P, Roccia F, Pittoni D, Di Dio D, Forni P, Gallesio C. Management of 112 hospitalized patients with spreading odontogenic infections: correlation with DMFT and oral health impact profile 14 indexes. Oral Surg Oral Med Oral Pathol Oral Radiol 2011; 113:207-13. [PMID: 22677738 DOI: 10.1016/j.tripleo.2011.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2010] [Revised: 02/04/2011] [Accepted: 02/08/2011] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study was to report our experience in treating patients affected by spreading odontogenic infections and to discuss their management and outcome. STUDY DESIGN Demographic and clinical information was collected from hospitalized patient records. Decayed, missing, and filled teeth (DMFT) index was calculated for 45 randomly selected patients. Statistical analysis was used to search for associations among multiple variables. RESULTS Statistical analysis of the variance by univariate test found significant associations between a longer hospital stay and patients >30 years old (P < .05) and patients with the presenting symptoms of dysphagia and/or dyspnea (P < .05). Statistical analysis using Fisher exact test found significant associations between patients with a DMFT index >10 and female patients (P < .05), patients >30 years old (P < .005), and a hospital stay >4 days (P < .0005). CONCLUSIONS Rapid resolution of the infection was appreciated when removal of the cause, drainage of the infection, and intravenous antibiotics were performed.
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Affiliation(s)
- Paolo Boffano
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
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Gerbino G, Roccia F, Bianchi FA, Zavattero E. Surgical management of orbital trapdoor fracture in a pediatric population. J Oral Maxillofac Surg 2010; 68:1310-6. [PMID: 20381939 DOI: 10.1016/j.joms.2009.12.037] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 11/27/2009] [Accepted: 12/23/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE Orbital trapdoor fractures are pure orbital floor fractures with herniation and entrapment of the orbital contents, leading to restricted eye movement and diplopia. Trapdoor fractures in children have been discussed widely in published reports; however, the treatment policy and outcome remain controversial, although early treatment has been advocated. Our retrospective study analyzed the long-term results of pediatric patients undergoing surgery for trapdoor fractures to determine the outcome in relation to the type of fracture and the timing and technique of intervention. PATIENTS AND METHODS The present study included 24 patients (age range 6 to 16 years) who underwent surgery for trapdoor fractures from 1998 to 2007. The demographic, etiologic, radiologic, and surgical findings, interval between trauma and surgery, surgical techniques, and complications were recorded. Diplopia, ocular motility, dysesthesia, and scar quality were recorded at follow-up. RESULTS The follow-up duration averaged 36 months. At follow-up, 1 (8.3%) of 12 patients who underwent surgery within 24 hours (urgent treatment) had residual diplopia. In contrast, 3 (37.5%) of 8 patients who underwent surgery 24 to 96 hours (early treatment) and 4 (100%) of 4 who underwent surgery after 96 hours (late treatment) had diplopia. No sensory deficit of the skin or unesthetic eyelid scar was noted. CONCLUSIONS We found a correlation between the outcome and the timing of surgery for trapdoor fractures in the pediatric population. The success rate was significantly better when the fractures were treated within 24 hours of the injury. The results of the present study have strengthened the assertion that trapdoor orbital fractures pose a true surgical emergency.
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Affiliation(s)
- Giovanni Gerbino
- Division of Maxillofacial Surgery, Department of Head and Neck Surgery, San Giovanni Battista Hospital, University of Turin, Turin, Italy
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Roccia F, Campolo B. 038 SLEEP MEDICINE AND WEANING FROM TRACHEOSTOMY: HELMET, A NEW FRONTLINE IN INTENSIVE MEDICINE CARE. Sleep Med 2009. [DOI: 10.1016/s1389-9457(09)70040-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tosco P, Tanteri G, Iaquinta C, Fasolis M, Roccia F, Sid Berrone, Garzino-Demo P. Surgical treatment and reconstruction for central giant cell granuloma of the jaws: A review of 18 cases. J Craniomaxillofac Surg 2009; 37:380-7. [DOI: 10.1016/j.jcms.2009.04.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 03/22/2009] [Accepted: 04/03/2009] [Indexed: 12/26/2022] Open
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Pecorari G, Roccia F, Nadalin J, Giordano C, Garzaro M. Combined endovascular and surgical treatment of carotid body tumor in a patient with thoracic situs solitus. Head Neck 2009; 30:1523-6. [PMID: 18302255 DOI: 10.1002/hed.20806] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chemodectomas of the head and neck are tumors that originate from the neural crest. The authors report a case of carotid body tumor with chronic hypoxia secondary to congenital cyanogenic cardiac malformation, radiologically and surgically treated. METHODS AND RESULTS A 37-year-old woman presented 1-year history of a slow-growing right lateral-cervical swelling. Radiologic examination led to a suspicion of carotid body tumor. Her history revealed thoracic situs solitus and a complex congenital heart disease. She was hospitalized for a selective angiography of the cervical vessels. Twenty-four hours later, the tumor was completely removed under local anesthesia. One year later, there were no signs of recurrence, and the patient showed a correct hemodynamic compensation. CONCLUSIONS The choice of surgical resection with selective preoperative embolization, which induced the obliteration of the feeder vessels, devascularizing the tumor and avoiding significant intraoperative bleeding, was successful.
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Affiliation(s)
- Giancarlo Pecorari
- First ENT Section, Department of Clinical Physiopathology, University of Turin, Turin, Italy
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Affiliation(s)
- Fabio Roccia
- Divisions of Maxillofacial Surgery, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
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Roccia F, Pecorari GC, Oliaro A, Passet E, Rossi P, Nadalin J, Garzino-Demo P, Berrone S. Ten Years of Descending Necrotizing Mediastinitis: Management of 23 Cases. J Oral Maxillofac Surg 2007; 65:1716-24. [PMID: 17719388 DOI: 10.1016/j.joms.2006.10.060] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2006] [Revised: 10/02/2006] [Accepted: 10/28/2006] [Indexed: 11/29/2022]
Abstract
PURPOSE Through a 10-year retrospective study, we report our experience in the management of descending necrotizing mediastinitis (DNM), a rare and often lethal complication of odontogenic and oropharyngeal infections. PATIENTS AND METHODS We reassessed 23 patients between the ages of 16 and 69 years (mean, 49 years) seen between 1996 and 2005, with DNM secondary to odontogenic abscess or phlegmon in 9 cases or secondary to peritonsillar abscess in 14 cases. In this study, 48% of the patients had immune system disorders, mainly diabetes mellitus (6 patients). The diagnosis of DNM was confirmed by cervicothoracic computed tomography. RESULTS Eight patients underwent a bilateral collar cervicotomy, and 15 underwent a combined cervicothoracic approach. Five, 2, 1, and 1 patients underwent surgery 2, 3, 4, and 5 times, respectively. Seven patients died as a result of septic shock and multiorgan failure, for a mortality rate of 30.4%. Four of those who died had a compromised immune system. CONCLUSION The relatively high mortality rate seen in this study shows that, in addition to early diagnosis and aggressive treatment, it is important to give greater attention to and be more medically and surgically aggressive in the management of patients whose immune system is compromised in any way.
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Affiliation(s)
- Fabio Roccia
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
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Affiliation(s)
- Fabio Roccia
- Division of Maxillofacial Surgery, San Giovanni Battista Hospital, Turin, Italy.
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Gallelli L, Gallelli A, Vero G, Roccia F, Pelaia G, De Sarro G, Maselli R. Acute Renal Failure Probably Induced by Prulifloxacin in an Elderly Woman. Clin Drug Investig 2006; 26:49-53. [PMID: 17163235 DOI: 10.2165/00044011-200626010-00007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- L Gallelli
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Experimental and Clinical Medicine, Faculty of Medicine and Surgery University Magna Graecia of Catanzaro, Mater Domini University Hospital, Catanzaro, Italy.
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Abstract
Interest in the psychiatric consequences of trauma and the subsequent surgical intervention has been increasing steadily; therefore, the authors assessed the prevalence of acute symptoms of stress in patients who experienced a craniomaxillofacial injury. Fifty patients between the ages of 18 and 65 years were evaluated and assigned a score using the Injury Severity Scale (ISS). Within 48 hours of surgery (T0) and at 3 months after surgery (T1), the authors administered the Davidson Trauma Scale (DTS) to assess post-traumatic symptoms, Spielberger's State-Trait Anxiety Inventory (STAI) to assess symptoms of anxiety, and Zung's Self-rating Depression Scale (SDS) to assess depressive symptoms. Of the subjects, 44% (22 patients at T0) had acute symptoms of stress, and 26% (13 patients at T1) had post-traumatic stress symptoms. The statistical association between demographic variables was significant only for gender, especially for women. There was a significant correlation between the psychopathologic variables and trauma-specific symptoms at both T0 and T1; the same was true for the ISS at T0. Eight of the 13 patients with positive DTS results at 3 months had aesthetic and functional sequelae that might have served as reminders of the traumatic event. It is not only necessary to restitutio ad integrum the anatomy and function, but also to provide psychiatric support for patients experiencing psychiatric symptoms caused by traumatic events.
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Affiliation(s)
- Fabio Roccia
- Division of Maxillofacial Surgery and Department of Neuroscience, Psychiatric Section, S. Giovanni Battista Hospital, Turin, Italy.
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Abstract
PURPOSE The authors report the 2-year experience of use of the PATATRAC telemedicine system in managing maxillofacial trauma. MATERIALS AND METHODS Thirty-five regional hospitals on-line with PATATRAC in the period from January 2002-January 2004 have sent 18 consultations (11 men and 7 women) to the Maxillofacial Surgery Division of San Giovanni Battista Hospital in Turin for telemedicine evaluation of patients with maxillofacial trauma. RESULTS Only 50% of the consultations (9 patients) sent via PATATRAC indicated maxillofacial treatment, and only one case resulted in immediate transfer. Of the remaining 8 transfers, 2 patients were transferred after treatment of associated lesions in the receiving hospital, and the other 6 patients were transferred as scheduled based on the availability of beds in the specialist center. CONCLUSIONS The results obtained, despite the poor number of telemedicine maxillofacial consultations, have mainly proved the usefulness of PATATRAC in drastically reducing expensive and unnecessary transfers of maxillofacial patients, without indications for either immediate or deferred treatment, thus also avoiding discomfort to the patient with other injuries.
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Affiliation(s)
- Fabio Roccia
- Division of Maxillofacial Surgery, S. Giovanni Battista Hospital, Turin, Italy.
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Roccia F, Tavolaccini A, Dell'Acqua A, Fasolis M. An audit of mandibular fractures treated by intermaxillary fixation using intraoral cortical bone screws. J Craniomaxillofac Surg 2005; 33:251-4. [PMID: 15978822 DOI: 10.1016/j.jcms.2005.02.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2004] [Accepted: 02/22/2005] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION During the last 10 years, intermaxillary fixation using intraoral cortical bone screws has been introduced for the treatment of mandibular fractures. The aim of this work was to evaluate the indications and possible complications of this method. MATERIALS AND METHODS Sixty-two patients with mandibular fractures, treated by intermaxillary fixation using these screws, were evaluated by preoperative and postoperative panoramic radiographs. Clinical testing was carried out for vitality and abnormal mobility of teeth adjacent to the site of screw insertions. To evaluate the efficacy of this method, different factors were considered such as possible iatrogenic dental injuries, loss, breakage or screw cover by oral mucosa and postoperative occlusion. RESULTS The most important complication was iatrogenic damage to dental roots (1.5%), 4.9% of the screws were covered by oral mucosa and 1.9% were lost, while none were broken. Malocclusion was observed in one patient (1.6%) and lack of consolidation of a displaced fracture of the mandibular body in another patient. CONCLUSIONS Use of intraoral cortical bone screws for intermaxillary fixation is a valid alternative to arch bars in the treatment of mandibular fractures. Iatrogenic injury to dental roots is the most important problem of this procedure, but can be minimized by an experienced surgeon.
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Affiliation(s)
- Fabio Roccia
- Division of Maxillofacial Surgery, S. Giovanni Battista Hospital, Turin, Italy.
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Abstract
In the maxillofacial region, subcutaneous emphysema, which occurs after fractures of the pneumatic paranasal sinuses, is a common finding in a maxillofacial surgeon's daily practice. Pneumomediastinum secondary to these fractures is a less frequent event, however, without thoracic or abdominal injuries. The authors report a case of severe subcutaneous emphysema and pneumomediastinum that occurred after fractures of the nasal bones and medial orbital wall. The etiology, diagnosis, and treatment modalities of mediastinal emphysema are discussed.
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Affiliation(s)
- Fabio Roccia
- Division of Maxillofacial Surgery, S. Giovanni Battista Hospital, University of Torino, Torino, Italy.
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Gerbino G, Roccia F, Benech A, Caldarelli C. Analysis of 158 frontal sinus fractures: current surgical management and complications. J Craniomaxillofac Surg 2000; 28:133-9. [PMID: 10964548 DOI: 10.1054/jcms.2000.0134] [Citation(s) in RCA: 129] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A retrospective analysis is presented of 158 patients who sustained frontal sinus fractures and were subsequently treated in the Division of Maxillofacial Surgery, University of Turin, from 1987 to 1998. The fractures were subdivided according to involvement of anterior and posterior walls, and of the nasofrontal duct. While treatment involving only the anterior wall is well standardized and without complications, management of anterior plus posterior wall fractures or involving the nasofrontal duct is still controversial. In dislocated posterior wall fractures, cranialization and obliteration of the remaining dead space and of the nasofrontal ducts using bone grafts, combined with the use of a pericranium flap, allow separation of the nasal cavity from the anterior cranial fossa, preventing ascending infections and thus reducing the rate of complications. When the fracture involves the nasofrontal duct with the posterior wall substantially intact, it is better to re-establish patency of the nasofrontal duct with a drainage tube and preserve the function of the sinus. A protocol used in the management of each group of fractures, clinical and radiological results, timing of operation, surgical procedures, outcomes, and long-term complications are all discussed.
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Affiliation(s)
- G Gerbino
- Division of Maxillofacial Surgery, S. Giovanni Battista Hospital, University of Turin, Italy
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Gallelli A, Pelaia G, Calderazzo M, Roccia F, Vero G, Gallelli G, Triggiani E, Tranfa CM. Transudative right pleural effusion due to compression of the brachiocephalic vein caused by an intrathoracic goitre. Monaldi Arch Chest Dis 2000; 55:210-1. [PMID: 10948668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
The case presented in this report is of a female patient who suffered recurrent transudative right pleural effusions, due to a giant benign intrathoracic goitre. The latter caused compression of the brachiocephalic vein, which is a very rare cause of pleural fluid accumulation. Magnetic resonance imaging played a crucial diagnostic role.
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Affiliation(s)
- A Gallelli
- Dept of Respiratory Medicine, University of Catanzaro, Italy
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Abstract
Maxillofacial fractures and associated lesions following airbag deployment were studied in six patients who suffered frontal or fronto-lateral car crashes. Installation of airbags in motor vehicles has reduced the morbidity and the mortality following motor vehicle accidents, but the appearance of new types of trauma directly related to airbag deployment raise questions about the potential danger of these devices when used improperly. The results of this limited study suggest that airbag injuries can be aggravated if: (1) seat belts are not worn; and (2) if the driver's chest is too close to the steering wheel as can easily happen with small people (in our study, two women). There needs to be a way of disconnecting the system.
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Affiliation(s)
- F Roccia
- Division of Maxillofacial Surgery, University of Turin, Italy
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