背景:在处理受创伤的患者时,至关重要的是要优先确保他们的气道。然而,对面部严重受伤的人进行插管可能会造成困难,因为它们的上呼吸道狭窄和改变的形状可能会阻碍它们张开嘴的能力。鉴于此,这项研究的目的是通过利用计算机断层扫描(CT)扫描来评估面部创伤引起的上呼吸道的体积和形态改变。
方法:这是一项以单一为中心的回顾性分析研究。这项研究包括麦地那国王法哈德医院收治的创伤性面部损伤患者的CT扫描,沙特阿拉伯。研究变量包括年龄,性别,体重指数(BMI),骨折的骨头,气道对称性,和气道体积。使用3D切片器软件(切片器社区,美国),通过CT扫描构建咽部气道的三维模型,以评估对称性和容积.IBMSPSSStatisticsforWindows,版本23(2013年发布;IBMCorp.,Armonk,纽约,美国)用于分析数据。
结果:在筛选的扫描中,136例创伤性面部损伤患者被纳入研究。年龄从4岁到91岁,平均值为28.26(±14.9)。下颌骨和颧骨骨折是最常见的,71例(52.2%)和69例(50.7%),分别。111例(81.6%)咽部气道对称,25例(18.4%)不对称。下颌骨骨折的骨折侧与气道不对称之间存在显着关联(p值=0.03)。移位的下颌骨骨折中的总气道体积显示出统计学上的显着减少(p值=0.019)。骨折部位与气道不对称无统计学联系,除了骨不对称性和联合骨折,p值分别为0.038和0.041。
结论:研究结果表明,在大多数面部骨折中,咽气道通常不会受损;然而,双侧移位的下颌骨骨折有可能减少咽气道体积,特别是在涉及联合和肩胛骨区域的骨折中。
BACKGROUND: When dealing with traumatized patients, it is crucial to prioritize securing their airway. However, intubating someone who has sustained significant facial injuries can pose difficulties, as the narrow and altered shape of their upper airway may impede their ability to open their mouth. In light of this, the purpose of this
study is to evaluate the volumetric and morphological alterations to the upper airway resulting from facial trauma by utilizing computed tomography (CT) scans.
METHODS: This is a single-centered retrospective analytical
study. This
study included CT scans of patients with traumatic facial injuries admitted to King Fahad Hospital in Madinah, Saudi Arabia.
Study variables included age, gender, body mass index (BMI), fractured bones, airway symmetry, and airway volume. Using the 3D Slicer software (Slicer Community, USA), a three-dimensional model of the pharyngeal airway was constructed from the CT scan to evaluate symmetry and volume. IBM SPSS Statistics for Windows, version 23 (released 2013; IBM Corp., Armonk, New York, United States) was used to analyze data.
RESULTS: Among the screened scans, 136 cases with traumatic facial injuries were included in the study. Age ranged from four to 91 years, with a mean of 28.26 (±14.9). Mandibular and zygomatic fractures were the most common, with 71 (52.2%) and 69 (50.7%) cases, respectively. The pharyngeal airway was symmetric in 111 (81.6%) cases and not symmetric in the other 25 (18.4%) cases. A significant association was found between the side of the fracture and airway asymmetry in mandibular fractures (p-value = 0.03). The total airway volume in the displaced mandibular fractures showed a statistically significant decrease (p-value = 0.019). The fracture sites were not statistically linked to airway asymmetry except for parasymphyseal and symphyseal fractures, with a p-value of 0.038 and 0.041, respectively.
CONCLUSIONS: The
study findings suggest that the pharyngeal airway is not usually compromised in most facial bone fractures; however, bilateral displaced mandibular fractures have the potential to diminish the pharyngeal airway volume, especially in fractures involving the symphysis and parasymphysis area.