UNASSIGNED: Systematic Review and Meta-Analysis.
UNASSIGNED: There has been an increasing trend in maxillofacial injuries associated with combat trauma. Within the maxillofacial complex, the mandible is the most likely structure to be damaged during combat. The structural deficits as a result can be reconstructed with many options. These include vascularised bone grafts (VBGs), non-vascularised bone grafts (NVBGs), alloplastic implants, reconstruction bars and distraction osteogenesis. This study aimed to determine the common modality and efficacy of mandibular reconstruction in combat trauma-related defects.
UNASSIGNED: A literature search was conducted on Pubmed, Prospero, Dynamed, DARE, EMBASE, COCHRANE and BMJ databases.
UNASSIGNED: A total of six articles met the inclusion criteria identifying 165 patients requiring mandibular reconstruction. Non-vascularised iliac bone graft (n = 137) was the most common method followed by ileac crest bone chips harvest using Dacron urethran osteomesh tray (n = 24) and frontoparietal grafts (n = 4). Meta-analysis of five out of six trials demonstrated an overall success rate of 85% (95% CI 79-90; I2 = 59%). A total of 13% (n = 22) of reconstructions failed either completely or partially and 21% (n = 34) of patients suffered postoperative complications.
UNASSIGNED: NVBGs are a practical, cost-effective and favourable method of war zone management of mandibular defects with success rates comparable to those reported in the civilian literature. However, general trauma principles take precedence to rule out life-threatening injuries. Due consideration of patient factors, surgical factors, and available resources are required in the first-line management of combat-related mandibular defects.

Facial transplantations have become a clinical reality as the last reconstructive option in severely disfigured patients. To date, clinical outcomes remain unclear. The purpose of this paper was to analyse the outcomes in facial transplantation (FT) and determine the risks and benefits of FT based on short- and long-term outcomes. An electronic literature search was performed across PubMed, EMBASE and the Cochrane Central Register for Controlled Trials (CENTRAL) databases to capture all the relevant records relating to outcomes in FTs from 2005 to 2021. Articles for inclusion were decided upon pre-defined inclusion and exclusion criteria. A total of 48 FTs has been performed to date. A total of 90 studies met the eligibility criteria and were included in the outcome analysis. Studies were analysed based on each of the 48 cases and outcomes categorised into short-term (<36 months) and long-term (>36 months) outcomes. Primary outcomes included patient and graft survival and secondary outcomes included functional, surgical revision events, immunological, medical complications, aesthetics, psychosocial and quality of life. Mortality rate, infection and malignancy incidence remain high, and patients should be fully informed of the potential life-threatening complications. FTs improve outcomes such as quality of life and psychosocial recovery in the short- and long-term. Outcomes remain under-reported in peer-review journals.

Facial fractures cause postoperative morbidity, including edema, pain, and trismus. Elastic therapeutic tapes are used for optimizing recovery. Background: The aim of the present systematic review and meta-analysis was to evaluate the effectiveness of elastic tape Kinesio taping (KT) in reducing postoperative morbidity in facial fractures surgeries. Methods: A systematic review was conducted in accordance with the PRISMA guidelines. Searches were conducted in the Cochrane, Medline, Scopus, Embase and Web of Science databases using a pre-established search strategy. Results: A total of 811 studies were retrieved after the duplicates were removed, and only randomized clinical trials were included. Eight trials, involving 319 participants, were deemed eligible. One study solely investigated the effect on edema, while the others analyzed at least two of the variables of interest. Results from two RCTs, where qualitative analysis was applicable, suggest a potential reduction in edema in the KT group compared to the control group on the second (RR -0.55, 95% CI -0.89 to -0.22; p = 0.01; I2 = 0%) and third postoperative days (RR -0.71, 95% CI -1.01 to -0.40; p < 0.00001; I2 = 0%). Conclusions: KT is effective in controlling postoperative edema following surgery for facial fractures. However, the effects on pain and trismus should be explored further in studies with standardized methods.

UNASSIGNED: Case series.
UNASSIGNED: This retrospective review of frontal sinus fractures aims to describe our current experience managing these fractures at an urban level I trauma center.
UNASSIGNED: An institutional database of 2081 patients who presented with maxillofacial fractures on computed tomography face/sinus in 2019 was queried for all patients with traumatic frontal sinus fractures. Demographics, trauma-related history, management approach, and follow-up data were collected and analyzed.
UNASSIGNED: Sixty-three (7.3%) patients had at least one fracture involving the frontal sinus. The most common etiologies were assaults, falls, and motor vehicle accidents. Surgical repair was performed in 26.8% of patients with frontal sinus fractures, and the other 73.2% were observed. Fractures that were displaced, comminuted, obstructive of the frontal sinus outflow tract, or associated with a dural tear or cerebrospinal fluid leak were more likely to be operative.
UNASSIGNED: The majority of frontal sinus fractures in this study were treated with observation. Despite advances in transnasal endoscopic approaches, many surgeons still rely on open approaches to repair frontal sinus fractures.

Patients with facial trauma may suffer from injuries such as broken bones, bleeding, swelling, bruising, lacerations, burns, and deformity in the face. Common causes of facial-bone fractures are the results of road accidents, violence, and sports injuries. Surgery is needed if the trauma patient would be deprived of normal functioning or subject to facial deformity based on findings from radiology. Although the image reading by radiologists is useful for evaluating suspected facial fractures, there are certain challenges in human-based diagnostics. Artificial intelligence (AI) is making a quantum leap in radiology, producing significant improvements of reports and workflows. Here, an updated literature review is presented on the impact of AI in facial trauma with a special reference to fracture detection in radiology. The purpose is to gain insights into the current development and demand for future research in facial trauma. This review also discusses limitations to be overcome and current important issues for investigation in order to make AI applications to the trauma more effective and realistic in practical settings. The publications selected for review were based on their clinical significance, journal metrics, and journal indexing.

UNASSIGNED: Pediatric nasal bone fractures presenting as isolated fractures or with concomitant facial injuries are rare and not well documented. Analysis of treatment at an urban, level-one trauma center provides insight into their management.
UNASSIGNED: Data were collected for pediatric nasal bone fractures diagnosed between January 2000 and December 2014. Patients were divided into groups based on presence or absence of isolated nasal bone fractures. Groups were compared using Chi-squared analysis, and a Bonferroni correction was used for a more conservative alpha (a = .004).
UNASSIGNED: Assault was the most common etiology presenting in 46 of 122 pediatric nasal bone fractures. There was no significant difference in surgical versus non-surgical management of isolated and non-isolated nasal bone fractures (P = 0.98). Treatment for both was predominantly watchful waiting in 91% to 95% of the cases followed by closed reduction in 3.2% to 3.3%. In the patients with isolated fractures, 11.5% sustained intracranial hemorrhage, compared to 35.6% of multifracture cases (P = .002); 15.0% of isolated fractures sustained a traumatic brain injury, compared to 55.9% of multifracture cases (P = .000003). No significant difference in fatality existed between groups (P = 0.53).
UNASSIGNED: Multi-facial fracture cases were more likely to present with traumatic brain injuries and be admitted to the intensive care unit than isolated nasal bone fractures. Rates of surgical and non-surgical management were not significantly different between the 2 groups. Watchful waiting of pediatric nasal bone fractures was the management approach selected 92% to 95% of the time regardless of the presence or absence of concomitant facial fractures.

UNASSIGNED: Pediatric nasal bone fractures presenting as isolated fractures or with concomitant facial injuries are rare and not well documented. Analysis of treatment at an urban, level-one trauma center provides insight into their management.
UNASSIGNED: Data were collected for pediatric nasal bone fractures diagnosed between January 2000 and December 2014. Patients were divided into groups based on presence or absence of isolated nasal bone fractures. Groups were compared using Chi-squared analysis, and a Bonferroni correction was used for a more conservative alpha (a = .004).
UNASSIGNED: Assault was the most common etiology presenting in 46 of 122 pediatric nasal bone fractures. There was no significant difference in surgical versus non-surgical management of isolated and non-isolated nasal bone fractures (P = 0.98). Treatment for both was predominantly watchful waiting in 91% to 95% of the cases followed by closed reduction in 3.2% to 3.3%. In the patients with isolated fractures, 11.5% sustained intracranial hemorrhage, compared to 35.6% of multifracture cases (P = .002); 15.0% of isolated fractures sustained a traumatic brain injury, compared to 55.9% of multifracture cases (P = .000003). No significant difference in fatality existed between groups (P = 0.53).
UNASSIGNED: Multi-facial fracture cases were more likely to present with traumatic brain injuries and be admitted to the intensive care unit than isolated nasal bone fractures. Rates of surgical and non-surgical management were not significantly different between the 2 groups. Watchful waiting of pediatric nasal bone fractures was the management approach selected 92% to 95% of the time regardless of the presence or absence of concomitant facial fractures.

UNASSIGNED: Sports injuries are a growing concern which requires immediate attention. Dental injuries are the most common type of orofacial injuries sustained during sports activities.
UNASSIGNED: This study aims to review the prevalence of sports-related facial trauma in India, to identify the most common types of oro-facial injury incurred due to sports, and to assess the level of awareness regarding preventive measures used in sports.
UNASSIGNED: The present review was performed in accordance with preferred reporting items for systematic reviews and meta-analyses guidelines. All articles published from 2005 to 2019 on sports-related facial trauma were analyzed. PubMed, Google Scholar, and Cochrane reviews databases were searched using primary keywords.
UNASSIGNED: A total of 24 articles published in the period of 2005-2019 were included. The prevalence of sports-related facial trauma was found to be the highest in the study conducted by Selva et al., in 2018, at a rate of 75%, whereas it was found to be minimal in the study conducted by Bali et al. in 2013. While the awareness of mouthguards was reported the highest in a study conducted by Ramagoni et al., in 2007.
UNASSIGNED: This study shows that there is a definite need to improve the awareness as well as the usage of protective gear, from the level of schooling, where children are introduced to sports. Prevention of sports-related facial trauma is essential to avoid the serious and lifelong consequences which could be the aftermath of such injuries.

UNASSIGNED: Pneumomediastinum (PM) secondary to oromaxillofacial trauma (OMF) is a rare but well-described complication/pathologic finding. The aim of this study was twofold: first, to report our experience in treatment of maxillofacial trauma patients with PM, and second, to review the literature regarding the clinical features, severity, course, and management of the aforementioned complication.
UNASSIGNED: We retrospectively reviewed the medical records and charts of patients who suffered from maxillofacial trauma and treated in our hospital between September 1, 2013 and September 31, 2017. The inclusion criteria were patients with radiologically confirmed PM. In addition, the electronic databases PubMed, Scopus, and Science Direct were queried for articles reporting PM cases secondary to OMF injuries and published in English, French, and German language.
UNASSIGNED: Three cases of PM out of 3,514 cases of craniomaxillofacial trauma were found; there were 3 male patients who presented in our emergency department with the chief complaint of cervicofacial swelling. Literature search isolated 58 selected articles and 63 cases were assessed in total; posttraumatic repeated blowing of nose was proved as most frequent triggering factor among them. Furthermore, the outcomes of review showed that thoracic pain, respiratory distress, and swallowing difficulties were not frequently reported in patients with ME due to facial trauma.
UNASSIGNED: Both our experience and the results of systematic literature review indicated that patients with PM due to OMF injuries present mild clinical course. If properly managed, this specific pathologic condition may have no further complications or relative comorbidities. The exact etiology and mechanism of PM in the context of maxillofacial injuries always needs to be identified. Radiographic, laboratory, and endoscopic examinations should be applied to rule out the more serious and frequently diagnosed aerodigestive, thoracic, and abdominal causes of PM.

UNASSIGNED: Retrospective cohort study.
UNASSIGNED: The emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in late December 2019 has spread globally resulting in a pandemic of respiratory illness. The purpose of this study is to understand the impact of the first 6 months of the COVID-19 pandemic on the epidemiology of maxillofacial trauma at an urban trauma center.
UNASSIGNED: The study sample was derived from the population of patients who presented for evaluation and management of maxillofacial injuries at TriStar Skyline Medical Center in Nashville, Tennessee beginning March 1, 2020 and ending August 31, 2020, compared to the same period in 2019. Descriptive and bivariate statistics were calculated for study variables in each cohort with significance set at P < .05.
UNASSIGNED: The number of subjects in the 2020 cohort (n = 212) was 4.2% higher than the 2019 cohort (n = 203). Volume decreased 24.5% during the initial phase of the pandemic with a 36.1% increase in volume occurring during the reopening phase (P = .003). Volume related to interpersonal decreased 52.4% during the initial phase of the pandemic with a rebound increase of 30% during reopening (P = .005).
UNASSIGNED: The first case of COVID-19 presented in Nashville, Tennessee in early March 2020. Over the next 6 months, periods of lockdown and reopening transpired. The volume of maxillofacial trauma decreased during the initial 3-months of the pandemic and rebounded to volumes greater than the year prior.