Clinical manifestations of nasoethmoid-central midface and lateral mid midface trauma: an analytical study
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20233213Keywords:
Fractures, Naso ethmoid, Central midface, Lateral midfaceAbstract
Background: Patients with facial trauma were analyzed to determine the clinical presentation of fractures of the naso-ethmoid, mid and lateral face.
Methods: 61 patients in the trauma unit of Dayanand Medical College were prospectively analyzed during a period of two years (August 2013 to August 2015).
Results: Road traffic accidents were the major cause of fractures (72.13%) followed by assaults (14.75%) and falls (8.19%). The age group commonly affected was 21-30 years (54.09%) followed by 31-40 years (13.11%). Facial fractures were more in males, the females being 5 times less at risk. Epistaxis, swelling, tenderness, nasal obstruction, external nasal deformity and crepitus were noted in almost all patients. Ecchymosis, telecanthus and CSF rhinorrhea were noted in 90.9%, 72.7%, and 18.18% respectively. 90% presented with circumorbital ecchymosis, facial edema and anterior open bite. Other symptoms were epistaxis (81%), infraorbital nerve anesthesia and surgical emphysema (47.6%) and lengthening of face (42.8%). The commonest presentation was circumorbital ecchymosis (95.5%), subconjuctival hemorrhage (85.7%), flattening of cheek and step deformity at the infraorbital margin (81%). Facial edema was seen in 76% and trismus in 42.9%.
Conclusions: Common symptoms and signs of nasoethmoid fractures included epistaxis, swelling and tenderness, nasal obstruction, external nasal deformity and crepitus in all patients, circumorbital ecchymosis in 90% and telecanthus in 73%.
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References
Olayemi AB, Adeniyi AO, Samuel U, Emeka OA. Pattern, severity, and management of cranio-maxillofacial soft-tissue injuries in Port Harcourt, Nigeria. J Emerg Trauma Shock. 2013;6(4):235.
Hwang K, You SH. Analysis of facial bone fractures: An 11-year study of 2,094 patients. Indian J Plastic Surg. 2010;43(1):42-8.
Rahman SA, Chandrasala S. When to suspect head injury or cervical spine injury in maxillofacial trauma?. Dent Res J. 2014;11(3):336.
Akadiri OA. Naso-Orbito-Ethmoid Fractures: Perspective and Practices of Nigerian Surgeons. Ann Ibadan Postgrad Med. 2012;10(2):40-7.
Bank P, Brown A. Fractures of the facial skeleton. Wright. Oxford, Boston Banks PA (1998) Pragmatic approach to the management of condylar fractures Int J Oral Maxillofac Surg. 2001;27:244-6.
Sargent LA. Nasoethmoid orbital fractures: diagnosis and treatment. Plastic Reconstruct Surg. 2007;120(7): 16S-31.
Sargent LA, Rogers GF. Nasoethmoid orbital fractures: diagnosis and management. J Craniomaxillofac Trauma. 1999;5(1):19-27.
Daly BD, Russell JL, Davidson MJ, Lamb JT. Thin section computed tomography in the evaluation of naso-ethmoidal trauma. Clinical Radiol. 1990;41(4): 272-5.
Scarfe WC. Imaging of maxillofacial trauma: evolutions and emerging revolutions. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2005; 100(2):S75-96.
Tung TC, Tseng WS, Chen CT, Lai JP, Chen YR. Acute life-threatening injuries in facial fracture patients: a review of 1,025 patients. J Trauma Acute Care Surg. 2000; 49(3):420-4.
Rana M, Gellrich NC, Ghassemi A, Gerressen M, Riediger D, Modabber A. Three-dimensional evaluation of postoperative swelling after third molar surgery using 2 different cooling therapy methods: a randomized observer-blind prospective study. J Oral Maxillofac Surg. 2011; 69(8):2092-8.
Modabber A, Peters F, Kniha K, Goloborodko E, Ghassemi A, Lethaus B, et al. Evaluation of the accuracy of a mobile and a stationary system for three-dimensional facial scanning. J Craniomaxillofac Surg. 2016;44(10):1719-24.
Kanala S, Gudipalli S, Perumalla P, Jagalanki K, Polamarasetty PV, Guntaka S, et al. Aetiology, prevalence, fracture site and management of maxillofacial trauma. Ann Royal Coll Surg Eng. 2021; 103(1):18-22.
Louis M, Agrawal N, Truong TA. Midface fractures II. In: Seminars in plastic surgery. USA: Thieme Medical Publishers; 2017:31(2):94-9.
Park KP, Lim SU, Kim JH, Chun WB, Shin DW, Kim JY, et al. Fracture patterns in the maxillofacial region: a four-year retrospective study. J Korean Assoc Oral Maxillofac Surg. 2015;41(6):306.
Litschel R, Suárez GA. Management of zygomatic fractures: bone and arch. Facial Plastic Surg. 2015; 31(4):368-75.