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Abstract
Background. Fractures of the bones of the facial skeleton, in particular the midface area, are one of the most frequent reasons for patients to apply to maxillofacial inpatient care, not only in Ukraine but also abroad. Along with more modern treatment technologies (osteosynthesis using titanium miniplates and minigrid for fixation bone fragments), methods of repositioning of fragments with subsequent tamponade of the maxillary sinus with iodoform tampon and without tamponade and fixation of fragments are used. A certain group of patients is treated conservatively, which is associated with their reluctance to undergo surgery, minimal displacement of fragments or minimal cosmetic and functional impairments.
The purpose of the study. Comparative evaluation of the results of treatment of patients with fractures of the midface area by repositioning the fragments of the zygomatic-orbital complex without fixating the fragments and their subsequent fixation by tamponade of the maxillary sinus with iodoform tampon.
Object and methods of research. The comparison was made of the results of treatment of 70 patients with fractures of the midface area, among which 13 patients were treated by the method of repositioning fragments of the zygomatic-orbital complex (ZOC) without fixation and without maxillary sinus tamponade, 29 patients underwent repositioning of ZOC fragments with subsequent fixation of fragments with iodoform tampon – the tamponade of the maxillary sinus was performed on the affected side. For comparison, the results of conservative treatment of 28 patients with fractures of the midface area were used.
Results. It was found that the reliable (χ2=11.43; p<0.05) majority of patients (64%) sought treatment within 0-3 days after injury. 83-89% of patients who underwent repositioning of the fragments had fresh small-fragment fractures. The reliable (χ2=11.43; p<0.05) majority of them simultaneously had 3-4 sites of bone fractures of the midfacearea, hemosinus of varying degrees and paresthesia in the infraorbital area. In the majority of patients who underwent repositioning of bone fragments with and without tamponade (85% and 93%, respectively), the final displacements ranged from 3.1 to 6 mm. In patients treated conservatively, in most cases (93%) the displacements were greater than 3.1 mm, which remained after treatment.
Conclusion. In the majority of patients treated with the studied methods, in the long term, the displacement of bone fragments remained, which had functional and cosmetic consequences. In all studied groups, a certain cosmetic effect was achieved over time, as evidenced by a reliable (χ2=160.9; p=0.00000) decrease in the indicator by the visual analogue scale .
References
Gassner, R., Tuli, T., Hächl, O., Rudisch, A., & Ulmer, H. (2003). Cranio-maxillofacial trauma: a 10 year review of 9543 cases with 21 067 injuries. Journal of cranio-maxillofacial surgery, 31(1), 51-61. doi: 10.1016/s1010-5182(02)00168-3
Mast, G., Ehrenfeld, M., Cornelius, C. P., Litschel, R., & Tasman, A. J. (2015). Maxillofacial Fractures: Midface and Internal Orbit-Part I: Classification and Assessment. Facial Plastic Surgery, 31(04), 351-356. doi: 10.1055/s-0035-1563692
Li, H., Lu, R. J., Wu, P., Yuan, Y., Yang, S., Zhang, F. F., … Tan, Y. (2021). Numerical simulation and analysis of midfacial impacts and traumatic brain injuries. Annals of translational medicine, 9(6), 459. doi: 10.21037/atm-21-134
Dağaşan, V. Ç., Burdurlu, M. C., & Baysal, E. (2020). Diagnosis and management of midfacial fractures. In C. Evereklioğlu (Ed.), Academic Studies in Health Sciences – II (155-166). Ankara, Turkey: Gece Publishing.
Vrinceanu, D., Banica, B., & Dumitru, M. (2021). Diagnosis and Treatment of Midface Trauma in the Context of Polytrauma: Characteristics during COVID-19 Pandemic Conditions. In G. Tsoulfas (Ed.), Trauma and Emergency Surgery – The Role of Damage Control Surgery. Rijeka, Croatia: IntechOpen. doi:10.5772/intechopen.92862
Nazarevych, M. R., Ohonovskyi, R. Z., Melnychuk, Yu. M., Pohranychna, Kh. R., & Ilnytskyi, Ya. M. (2020). Rezul'taty doslidzhennja stresovyh reakcij u hvoryh iz pojednanoju travmoju seredn'oi' zony oblychchja pislja zastosuvannja kompleksnoi' pisljaoperacijnoi' reabilitacii' [Results of the stress reactions study in patients with combined injuries of the midface area after using of complex postoperative rehabilitation]. Klinichna stomatologija, (2), 43-51. doi: 10.11603/2311-9624.2020.2.11399
Brehlichuk, P. P. (2018). Analitychna ocinka chastoty vynyknennja travmatychnyh urazhen' shhelepno-lycevoi' diljanky v rezul'tati dorozhn'o-transportnyh prygod [Analytical estimation of the maxillo-facial trauma frequency after road traffic accidents]. Sudovo-medychna ekspertyza, (2), 106-112.
Shuminsky, E., & Kopchak, A. (2021). Shestyrichnyj analiz travmatychnyh poshkodzhen' cherepno-shhelepno-lycevoi' diljanky: zv’jazok shelepno-lycevoi' ta cherepno-mozkovoi' travm [Six-year analysis of traumatic injuries of the craniomaxillofacial area: relation between maxillofacial and traumatic brain injuries]. Suchasna stomatologija, (1), 56-60. doi: 10.33295/1992-576x-2021-1-56
Kaura, S., Kaur, P., Bahl, R., Bansal, S., & Sangha, P. (2018). Retrospective study of facial fractures. Annals of maxillofacial surgery, 8(1), 78-82. doi: 10.4103/ams.ams_73_17
Abhinav, R. P., Selvarasu, K., Maheswari, G. U., & Taltia, A. A. (2019). The patterns and etiology of maxillofacial trauma in South India. Annals of maxillofacial surgery, 9(1), 114-117. doi: 10.4103/ams.ams_233_18
Sheth, S., Sharma, A. S., Mehta, S. K., Kachwala, H., Parker, N., & Pandya, D. (2017). Knowledge, attitude, and practices of dental students toward human immunodeficiency virus/acquired immunodeficiency syndrome of AMC Dental College and Hospital, Ahmedabad, Gujarat: A cross-sectional study. Journal of International Oral Health, 9(6), 284-288.
Kühnel, T. S., & Reichert, T. E. (2015). Trauma of the midface. GMS current topics in otorhinolaryngology, head and neck surgery, 14, Doc06. doi: 10.3205/cto000121
Kim, R., Shokri, T., Wang, W., & Ducic, Y. (2021). Facial Protection to Prevent Facial Trauma and Allow for Optimal Protection after Facial Fracture Repair. Facial Plastic Surgery. doi: 10.1055/s-0041-1723006
Marimuthu, M., Andiappan, M., Wahab, A., Muthusekhar, M. R., Balakrishnan, A., & Shanmugam, S. (2018). Canonical Wnt pathway gene expression and their clinical correlation in oral squamous cell carcinoma. Indian Journal of Dental Research, 29(3), 291-297. doi: 10.4103/ijdr.IJDR_375_17
Shamanaeva, L., Diachkova, E., Petruk, P., Polyakov, K., Cherkesov, I., & Ivanov, S. (2020). Titanium Nickelide in Midface Fractures Treatment. Journal of functional biomaterials, 11(3), 52. doi: 10.3390/jfb11030052
Siauw, C., Syamsudin, E., & Ismiarto, Y. D. (2019). Ballooning technique for orbital floor fracture reduction in neglected midfacial fracture: a case report. Journal of Case Reports in Dental Medicine, 1(2), 43-48. doi: 10.20956/jcrdm.v1i2.88
Reiter, M. J., Schwope, R. B., & Theler, J. M. (2017). Postoperative CT of the Midfacial Skeleton After Trauma: Review of Normal Appearances and Common Complications. American Journal of Roentgenology, 209(4), W238-W248. doi: 10.2214/AJR.17.17875
Jo, E. J., Kim, J. H., & Yang, H. J. (2015). Inferior Blow-Out Fracture Reduction Using Two Urinary Balloon Catheters. Archives of craniofacial surgery, 16(3), 114-118. doi: 10.7181/acfs.2015.16.3.114
Hong, S. O., Lee, D. W., Lee, J. W., & Jung, J. H. (2013). Minimal invasive and cost-effective method in reduction of maxillofacial fracture by using a Foley catheter ballooning technique. Journal of Craniofacial Surgery, 24(6), e585-e588. doi: 10.1097/SCS.0b013e31829ad3c3
Dong, Z., Li, Q., Bai, S., & Zhang, L. (2015). Application of 3-dimensional printing technology to Kirschner wire fixation of adolescent condyle fracture. Journal of Oral and Maxillofacial Surgery, 73(10), 1970-6. doi: 10.1016/j.joms.2015.04.005
Nikolaenko, V. P., Astakhov, Y. S., Soloviev, M. M., Khatskevich, G., & Trofimov, I. G. (2015). Zygomaticoorbital Fractures. In V. P. Nikolaenko & Y. S. Astakhov (Eds.), Orbital Fractures: A Physician's Manual (271-301). Berlin: Springer. doi: 10.1007/978-3-662-46208-9_6
Gareb, B., Roossien, C. C., van Bakelen, N. B., Verkerke, G. J., Vissink, A., Bos, R. R., & van Minnen, B. (2020). Comparison of the mechanical properties of biodegradable and titanium osteosynthesis systems used in oral and maxillofacial surgery. Scientific reports, 10(1), 1-18. doi: 10.1038/s41598-020-75299-9
Vujcich, N., & Gebauer, D. (2018). Current and evolving trends in the management of facial fractures. Australian dental journal, 63 Suppl 1, S35-S47. doi: 10.1111/adj.12589
Voloshan, O., Grigorov, S., & Demyanyk, D. (2020). Development and analysis of diagnostic criteria for creation of an automated computer software for predicting the course and individualizing the treatment of patients with odontogenic maxillary sinusitis. Wiadomosci lekarskie, 73(4), 767–772. doi: 10.36740/WLek202004127
de Carvalho, M. F., Vieira, J. N. M., Figueiredo, R., Reher, P., Chrcanovic, B. R., & Chaves, M. (2021). Validity of computed tomography in diagnosing midfacial fractures. International Journal of Oral and Maxillofacial Surgery, 50(4), 471-476. doi: 10.1016/j.ijom.2020.09.002
Singh, A. K., Dhungel, S., & Yadav, M. (2020). Intraoperative ultrasound imaging in the closed reduction of zygomatic arch fracture: Getting it right the first time. Oral and Maxillofacial Surgery Cases, 6(4), 100202. doi: 10.1016/j.omsc.2020.100202
Kim, J., Jung, H. J., & Shim, W. S. (2018). Corrective septorhinoplasty in acute nasal bone fractures. Clinical and experimental otorhinolaryngology, 11(1), 46-51. doi: 10.21053/ceo.2017.00346
Jalil, L. H. (2019). Evaluation of Post-Operative Complications of Subcondylar Fractures Treated with Conservative Method. Journal of University of Babylon for Pure and Applied Sciences, 27(3), 90-102.
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