UNASSIGNED: Maxillofacial injuries in children and adolescents always present a challenge due to the peculiar facial anatomy in children. This study aimed to determine the characteristics and pattern of traumatic maxillofacial injuries in children and adolescents reported to outpatient departments of two tertiary care health centers.
UNASSIGNED: Present study had a retrospective design, and the hospital records of all children and adolescent patients aged between 0 and 18 years, who had undergone maxillofacial fractures and were admitted for the same to two tertiary care health centers between January 2012 and May 2022 were reviewed.
UNASSIGNED: 77 patients suffered maxillofacial trauma with 115 fractures. The leading cause of maxillofacial trauma in the study was found to be road traffic accidents (RTA) followed by falls and sports-related injuries. Maxillofacial trauma was observed more in boys than girls, with an M: F ratio of 3.8:1. Out of 77 patients in the present study, more than half (51.9%) suffered maxillofacial trauma involving the lower one-third of the face, followed by the middle third (45.5%) and upper third (2.6%). A total of 11 patients (14.2%) were treated within 24 hr of sustaining injury. The majority of the patients, (n = 68; 88.3%) underwent open reduction and rigid internal fixation (ORIF), while 9 patients (11.7%) underwent closed reduction.
UNASSIGNED: Pediatric maxillofacial trauma was mainly attributed to road traffic accidents. Lower one-third of faces were more commonly affected and an increasing trend of maxillofacial trauma was observed with age.

BACKGROUND Submental intubation, a technique often considered a good alternative for managing the airway in challenging maxillofacial surgical scenarios, plays a pivotal role in providing accessibility to the surgical site and ensuring airway safety, particularly in cases involving facial fractures. This innovative approach not only grants surgeons adequate access to the operative field but also mitigates potential complications associated with traditional intubation methods, making it a valuable tool in dealing with complex facial trauma cases. CASE REPORT A 37-year-old man arrived at the Emergency Department (ED) with a severe facial injury caused from a traumatic incident involving a falling concrete wall, resulting in severe facial injuries that included multiple lacerations and abrasions on his face and body. The patient presented with multiple facial and body lacerations and abrasions, necessitating prompt medical intervention. The ED team swiftly treated the facial lacerations, controlled the bleeding, stabilized the patient, and proceeded to secure the airway through orotracheal intubation. Following stabilization, the patient was transferred to the operation theater (OT) for further management of his extensive pan-facial fractures under general anesthesia, utilizing the submental intubation technique for airway management. CONCLUSIONS Despite its limited use, submental intubation is a good option for some maxillofacial surgeries, offering a less intrusive approach to airway management and presenting an alternative pathway to the conventional endotracheal intubation technique. Its ability to streamline procedures, enhance patient outcomes, and reduce complications underscores the importance of considering submental intubation as a valuable tool in dealing with complex maxillofacial cases.

BACKGROUND: Maxillofacial injuries, due to their diverse etiological causes, are often considered a component of multi-trauma and constitute a significant portion of trauma. This study aims to elucidate the incidence of maxillofacial traumas, particularly among military personnel, various clinical courses, and characteristics, thereby contributing to the literature.
METHODS: Forensic reports, primarily related to military personnel and organized between 2011 and 2016 at the Forensic Medicine Department of Gülhane Medical Faculty, Health Sciences University, were retrospectively examined. The study involved a detailed analysis of cases with maxillofacial injuries resulting from trauma, focusing on aspects such as age, gender, the origin of the trauma, degree of injury, the presence of bone and dental fractures, and the occurrence of psychiatric disorders as a result of the trauma.
RESULTS: This study demonstrated that maxillofacial traumas predominantly occurred in young male individuals, particularly among military personnel. The most common etiological factor identified was interpersonal violence. The majority of injuries were soft tissue damages, with the nasal bone being the most frequently fractured area. Injuries to the head and upper extremities were also detected in some of the cases, showing that multiple injuries are common in such cases. Post-traumatic psychological disorders developed in some cases, with anxiety disorders being the most commonly observed.
CONCLUSIONS: It has been determined that maxillofacial injuries can affect multiple body regions, necessitating a multidisciplinary approach. This study underscores the importance of developing comprehensive strategies and policies for understanding and managing maxillofacial traumas, providing a fundamental reference for future studies in this field.

The safety of children\'s living environment is affected by several factors. Safer living environments have been offered as one explanation to decreases in children\'s fractures. Earlier studies provide evidence of a decreasing trend in children\'s fractures in the past decades. The objective of this study was to investigate demographic and clinical features of paediatric maxillofacial fractures during three time periods. A retrospective cross-sectional single-centre study was designed. The study included 474 patients aged ≤ 15 years admitted to Helsinki University Hospital in Finland with maxillofacial fractures during 1980-1989, 1993-2002 and 2013-2018. Maxillofacial fractures increased by 25% during the study period. The increase was greater in boys (28%) than in girls (19%), and significant in age groups 0-5 years (71%) and 13-15 years (32%). Exclusively mandibular fractures decreased by 20%, while exclusively midfacial fractures increased more than four-fold and exclusively upper-third fractures five-fold. Being hit by object and falls from height increased more than two-fold. A temporary increase in assaults and decrease in bicycle accidents in the middle period of the study was observed. During the three decades, paediatric maxillofacial fractures have increased and both fracture type and underlying aetiology have changed. These findings reflect improvements in diagnostics, traffic safety, regulations and technology. The role of factors such as interpersonal violence and economic fluctuation on the incidence of childhood maxillofacial fractures is discussed.

In India, 21.20% of annual road traffic accidents (RTA) result in maxillofacial injuries, with most victims being young adults aged 18-45 years. Such RTAs cause personal losses to individuals and families and adversely impact the country\'s health system facilities. These losses result from the expenses for medical care, lost wages for individuals who are rendered unable to work, and lost productivity for family members who must miss work or school in order to care for the injured. Most nations lose 3% of their gross domestic product to road accidents. RTA injuries, often associated with severe morbidity, cause functional impairments and have immense psychological impact. Rehabilitating these patients and their future treatment needs constitute an economic burden to themselves and their families, more so in a developing country like India, where a majority of the population cannot afford the treatment costs and lack health insurance coverage. These injuries therefore, as defined by the International Classification of Functioning, Disability and Health 2001, fall within the ambit of impairment and disability. However, Indian law does not identify maxillofacial injuries and the ensuing trauma as disabilities. Addressing this could be an important step towards improvement in the care and compensation provided to survivors of such life changing accidents.

This article delves into the profound impact of various types of disasters, examining some specific contexts. It provides insights into the unique challenges posed by different disasters, ultimately highlighting the invaluable role of maxillofacial surgery in addressing the critical healthcare needs of affected populations. A comprehensive review of the literature was conducted to analyze the role of maxillofacial surgery in disaster management. Relevant studies were examined to gather evidence supporting the criticality of maxillofacial surgeons in disaster response. Continuous training, coordination, and international collaboration among maxillofacial surgeons were reported as key factors in enhancing preparedness and improving post-disaster recovery. Sharing experiences, implementing best practices, and staying updated with advancements in the field seemed crucial for maximizing the impact of maxillofacial surgery in disaster medicine. By prioritizing the inclusion of maxillofacial surgeons in disaster response teams, lives can be saved, functional outcomes can be improved, and hope can be restored in affected communities. Understanding the intricacies and patterns associated with various types of disasters can be crucial details for successful rescue operations.

In addition to the clinical burden of trauma, the financial burden is an important aspect of care globally, especially for patients in low- and middle-income countries. The current retrospective review was done of data from January 2015 to December 2020 related to patients of oral maxillofacial trauma management in a tertiary care setting. Analysis of variance was used to determine the mean difference in the cost incurred depending upon the type of trauma and the number of bone plates used in fracture management. Pearson correlation was applied to explore any correlation involving patient age, aetiology and type of fracture, number of bone plates employed and the length of stay in the hospital. No statistically significant differences were noted in the cost among the different groups. The cost of care was significantly (p<0.001) correlated to the length of stay. Other variables, such as the type of fractures and the number of plates, had no significant impact (p>0.05).

OBJECTIVE: The removal of small foreign bodies embedded within the deep soft tissues of the maxillofacial region is a complex and challenging task for maxillofacial surgeons. The purpose of this study was to explore the efficacy of the combination of intraoperative CT and surgical navigation for the removal of small foreign objects in the maxillofacial region.
METHODS: A serial case study was conducted involving all consecutive patients who underwent surgical removal of small foreign bodies in the maxillofacial region. The combination of intraoperative CT and a surgical navigation system was used at a single medical institution from January 2018 to December 2022. Comprehensive data, including patient demographics, characteristics of the foreign bodies, previous surgical interventions, duration of the surgical procedure, and removal success rate were collected for this study. Relevant data were recorded into Microsoft Excel sheet and analyzed using SPSS version 22.0.
RESULTS: Nine patients (6 males and 3 females) were included in this study, with an average age of 37 years. Each patient had previously undergone an unsuccessful removal attempt utilizing conventional surgical methods based on preoperative CT imaging or C-arm guidance at a local healthcare facility. Four patients also experienced unsuccessful attempts with preoperative CT image-based navigation systems. However, by employing the combined approach of intraoperative CT and surgical navigation, the foreign bodies were successfully removed in all 9 patients. The mean duration of the surgical procedure was 59 min, and the average size of the foreign bodies was approximately 26 mm³. Postoperative follow-up exceeding 6 months revealed no complications.
CONCLUSIONS: The combined use of a surgical navigation system and intraoperative CT represents a potent and effective strategy for the precise localization and subsequent removal of small foreign bodies from the soft tissue structures of the maxillofacial region. This integrative approach appears to increase the success rate of surgical interventions in such cases.

OBJECTIVE: This study aims to analyze the clinical epidemiology, diagnostic and treatment characteristics of minor patients with maxillofacial fracture and provide a reference for the prevention and treatment.
METHODS: The clinical data of minor patients with maxillofacial fracture in Departmentof Traumatic and Plastic Surgery, West China Hospital of Stomatology, Sichuan University, from January 1, 2015 to December 31, 2020 were retrospectively studied and statistically analyzed in terms of age, gender, etiology, anatomic sites and treatment modalities.
RESULTS: The mean age of the patients was (10.65±5.15) years, and the male-to-female ratio was 1.91∶1. High fall was the primary cause of maxillofacial fractures in minors aged 0-6 years. Traffic accident injuries were the main cause of maxillofacial fractures in minors aged 7-12 and 13-17 years. About 65.13% of the midface and 83.08% non-condylar fractures were mainly treated by surgery, and condylar fractures were treated conservatively in 74.73% and by surgical treatment in 25.27%.
CONCLUSIONS: The etiology of maxillofacial fractures in minors differs at different ages, so prevention strategies should be adjusted according to age. Surgical treatment has become the preferred treatment modality for midface and non-condylar fractures. Conservative treatment is still the main treatment method for condylar fractures, but the proportion of surgical treatment increases.
目的: 分析近年来未成年人颌面部骨折的临床流行病学和诊治特点，为其防治提供参考依据。方法: 回顾性研究2015年1月1日—2020年12月31日四川大学华西口腔医院创伤整形外科的未成年颌面部骨折患者的临床资料，统计分析其年龄、性别、致病因素、骨折部位、治疗方式和效果。结果: 患者平均年龄为（10.65±5.15）岁，男女比为1.91∶1。高坠伤是0~6岁患者的首要致伤原因，对7~12岁和13~17岁患者，交通事故伤则成为首要致伤原因。面中部骨折和面下部非髁突骨折手术治疗占比为65.13%和83.08%，髁突骨折保守治疗占比74.73%，手术治疗占比25.27%。结论: 不同年龄阶段的未成年人颌面部骨折致伤原因存在差异，因此需要根据未成年人所处的年龄阶段调整其预防策略。手术治疗是面中部骨折和面下部非髁突骨折的主要治疗方式，髁突骨折仍以保守治疗为主要治疗方式，但手术治疗占比呈增长趋势。.

BACKGROUND: The percentage of elderly trauma patients under anticoagulation and antiplatelet agents has been rising lately. As newer agents are introduced, each comes with its own advantages and precautions. Our study covered elderly patients admitted to the ED with maxillofacial trauma while on anticoagulation (AC) or antiplatelet therapy (APT). We aimed to investigate the demographic characteristics, causes, and types of maxillofacial trauma, along with concomitant injuries, duration of hospitalisation, haemorrhagic complications, and the overall costs of care in the emergency department (ED).
METHODS: Data were gathered from the ED of Bern University Hospital. In this retrospective analysis, patients over 65 of age were included, who presented at our ED with maxillofacial trauma between 2013 and 2019 while undergoing treatment with therapeutic AC/APT.
RESULTS: The study involved 188 patients with a median age of 81 years (IQR: 81 [74; 87]), of whom 55.3% (n=104) were male. More than half (54.8%, n=103) were aged 80 years or older. Cardiovascular diseases were present in 69.7% (n=131) of the patients, with the most common indications for AC/APT use being previous thromboembolic events (41.5%, n=78) and atrial fibrillation (25.5%, n=48). The predominant cause of facial injury was falls, accounting for 83.5% (n=157) of cases, followed by bicycle accidents (6.9%, n=13) and road-traffic accidents (5.3%, n=10). The most common primary injuries were fractures of the orbital floor and/or medial/lateral wall (60.1%, n=113), zygomatic bone (30.3%, n=57), followed by isolated orbital floor fractures (23.4%, n=44) and nasal bone fractures (19.1%, n=36). Fractures of the mandible occurred in 14.9% (n=28). Facial hematomas occurred in 68.6% of patients (129 cases), primarily in the midface area. Relevant facial bleeding complications were intracerebral haemorrhage being the most frequent (28.2%, n=53), followed by epistaxis (12.2%, n=23) and retrobulbar/intraorbital hematoma (9%, n=17). Sixteen patients (8.5%) experienced heavy bleeding that required emergency treatment. The in-hospital mortality rate was 2.1% (4 cases).
CONCLUSIONS: This study indicates that falls are the leading cause of maxillofacial trauma in the elderly, with the most common diagnoses being orbital, zygomatic, and nasal fractures. Haemorrhagic complications primarily involve facial hematomas, especially in the middle third of the face, with intracerebral haemorrhage being the second most frequent. Surgical intervention for bleeding was required in 8.5% of cases. Given the aging population, it is essential to improve prevention strategies and update safety protocols, particularly for patients on anticoagulant/antiplatelet therapy (AC/APT). This can ensure rapid diagnostic imaging and prompt treatment in emergencies.