Craniomaxillofacial Trauma & Reconstruction

49 pages, 1093 KiB

Open AccessAbstract

FACE AHEAD 2022 Abstracts Supplement

by

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 1-49; https://doi.org/10.1177/19433875221091460 - 3 May 2022

Cited by 1 | Viewed by 42

Abstract

Welcome to FACE AHEAD 2022, organized by AO CMF [...] Full article

1 pages, 464 KiB

Open AccessEditorial

Mind the Gap: COVID-19 and Its Differential Effect on the Richer and Poorer Nations

by Rui Fernandes, Sat Parmar and Seenu Susarla

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 3; https://doi.org/10.1177/19433875211067573 - 4 Mar 2022

Cited by 1 | Viewed by 27

Abstract

The gap in wealth between the richer and poorer nations was increasing prior to the Covid pandemic despite some of the extreme poverty rates declining [...] Full article

6 pages, 638 KiB

Open AccessArticle

Complications of the Transmasseteric Anteroparotid Approach for Subcondylar Fractures: A Retrospective Study

by Jared Gilliland, Fabio Ritto and Paul Tiwana

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 66-71; https://doi.org/10.1177/19433875211016923 - 11 May 2021

Cited by 2 | Viewed by 37

Abstract

Study Design: A retrospective analysis of patients with subcondylar fractures treated via a transmasseteric anteroparotid approach by the Oral and Maxillofacial Department at the University of Oklahoma. Objective: The goal of this study was to evaluate complications, morbidity, and safety with the transmasseteric [...] Read more.

Study Design: A retrospective analysis of patients with subcondylar fractures treated via a transmasseteric anteroparotid approach by the Oral and Maxillofacial Department at the University of Oklahoma. Objective: The goal of this study was to evaluate complications, morbidity, and safety with the transmasseteric anteroparotid approach for treatment of subcondylar fractures, and compare it to other findings previously reported in the literature. Methods: A retrospective study was conducted that consisted of 23 surgically treated patients in the past 2 years for subcondylar fractures. Only patients with pre-operative malocclusion and who underwent open reduction with internal fixation with the transmasseteric anteroparotid (TMAP) approach were included. Exclusion criteria included (1) patients treated with closed reduction (2) patients who failed the minimum of 1, 3, and 6-week post-operative visits. The examined parameters were the degree of mouth opening, occlusal relationship, facial nerve function, incidence of salivary fistula and results of imaging studies. Results: 20 of the surgically treated patients met the inclusion criteria. Two patients were excluded due to poor post-operative follow up and 1 was a revision of an attempted closed reduction by an outside surgeon that presented with pre-existing complications. There were no cases of temporary or permanent facial nerve paralysis reported. There were 3 salivary fistulas and 2 sialoceles, which were managed conservatively and resolved within 2 weeks, and 2 cases of inadequate post-surgical maximal incisal opening (<40 mm) were observed. Conclusion: The transmasseteric anteroparotid approach is a safe approach for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications. Full article

8 pages, 5066 KiB

Open AccessArticle

Management of Maxillofacial Gunshot Injuries with Emphasis on Damage Control Surgery During the Yemen Civil War. Review of 173 Victims from a Level 1 Trauma Hospital in Najran, Kingdom of Saudi Arabia

by John S. Daniels, Ibrahim Albakry, Ramat O. Braimah, Mohammed I. Samara, Rabea A. Albalasi and Saleh M. A. Al-Rayshan

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 58-65; https://doi.org/10.1177/19433875211012211 - 30 Apr 2021

Cited by 3 | Viewed by 69

Abstract

Study Design: Studies on the concept of Damage Control Surgery (DCS) in the management of firearm injuries to the oral and maxillofacial region are still scarce, hence the basis for the current study. Objectives: The objectives of the current study is to share [...] Read more.

Study Design: Studies on the concept of Damage Control Surgery (DCS) in the management of firearm injuries to the oral and maxillofacial region are still scarce, hence the basis for the current study. Objectives: The objectives of the current study is to share our experience in the management of maxillofacial gunshot injuries with emphasis on DCS and early definitive surgery. Methods: This was a retrospective study of combatant Yemeni patients with maxillofacial injuries who were transferred across the border fromYemen to Najran, Kingdomof Saudi Arabia. Demographics and etiology of injuries were stored. Paths of entry and exit of the projectiles were also noted. Also recorded were types of gunshot injury and treatment protocols adopted. Data was stored and analyzed using IBM SPSS Statistics forWindows Version 25 (Armonk, NY: IBM Corp). Results: A total of 408 victims, all males, were seen during the study period with 173 (42.4%) males sustaining gunshot injuries to the maxillofacial region. Their ages ranged from 21 to 56 years with mean ± SD (27.5 ± 7.6) years. One hundred and twenty-one (70.0%) victims had extraoral bullet entry, while 53 (30.0%) victims had intraoral entry route. Ocular injuries, consisting of 25 (14.5%) cases of ruptured globe and 6 (3.5%) cases of corneal injuries, were the most commonly associated injuries. A total of 78 (45.1%) hemodynamically unstable victims had DCS as the adopted treatment protocol while early definitive surgery was carried out in 47(27.2%) hemodynamically stable victims. ORIF was the treatment modality used for the fractures in 132 (76.3%) of the victims. Conclusions: We observed that 42.4% of the war victims sustained gunshot injuries. DCS with ORIF was the main treatment protocol adopted in the management of the hemodynamically unstable patients. Full article

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7 pages, 1440 KiB

Open AccessReview

A Literature Review of Rapid Prototyping and Patient Specific Implants for the Treatment of Orbital Fractures

by Danyon O. Graham, Christopher G. T. Lim, Peter Coghlan and Jason Erasmus

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 83-89; https://doi.org/10.1177/19433875211004314 - 14 Apr 2021

Cited by 1 | Viewed by 37

Abstract

Post-traumatic reconstruction of the orbit can pose a challenge due to inherent intraoperative problems. Intra-orbital adipose tissue is difficult to manipulate and retract making visualization of the posterior orbital contents difficult. Rapid prototyping (RP) is a cost-effective method of anatomicalmodel production allowing the [...] Read more.

Post-traumatic reconstruction of the orbit can pose a challenge due to inherent intraoperative problems. Intra-orbital adipose tissue is difficult to manipulate and retract making visualization of the posterior orbital contents difficult. Rapid prototyping (RP) is a cost-effective method of anatomicalmodel production allowing the surgeon to produce a patient specific implant (PSI) which can be pre-surgically adapted to the orbital defect with exact reconstruction. Intraoperative imaging allows immediate assessment of reconstruction at the time of surgery. Utilization and combination of both technologies improves accuracy of reconstruction with orbital implants and reduces cost, surgical time, and the rate of revision surgery. Full article

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7 pages, 749 KiB

Open AccessEditorial

“6 Anatomical Landmarks” Technique for Satisfactory Free-Hand Orbital Reconstruction with Standard Preformed Titanium Mesh

by Gabriele Canzi, Federica Corradi, Giorgio Novelli, Alberto Bozzetti and Davide Sozzi

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 51-57; https://doi.org/10.1177/19433875211007614 - 6 Apr 2021

Viewed by 39

Abstract

Study Design: Retrospective study. Objective: Resolution of clinical signs and symptoms following orbital fractures depends on the accurate restoration of the orbital volume. Computer-Assisted procedures and Patient Specific Implants represent modern solutions, but they require additional resources. A more reproducible option is the [...] Read more.

Study Design: Retrospective study. Objective: Resolution of clinical signs and symptoms following orbital fractures depends on the accurate restoration of the orbital volume. Computer-Assisted procedures and Patient Specific Implants represent modern solutions, but they require additional resources. A more reproducible option is the use of standard preformed titanium meshes, widely available and cheaper; with their use quality of results is proportional to the accuracy with which they are positioned. This work identifies 6 reproducible and constant anatomical landmarks, as an intraoperative guide for the precise positioning of titanium preformed meshes. Methods: 90 patients treated at the Maxillofacial Surgery Department, Niguarda Trauma Center, Milan, for unilateral orbital reconstruction (January 2012 to December 2018), were studied. In all cases reconstruction was performed respecting the 6 proposed anatomical landmarks. The outcomes analyzed are: post-operative CT adherence to the 6 anatomical markers and symmetry achieved respect to controlateral orbit; number/year of re-interventions and duration of surgery; resolution of clinical defects (at least 12-months follow-up); incidence of complications. Results: Satisfactory results were obtained in terms of restoration of orbital size, shape and volume. Clinical defects early recovered with a low incidence of complications and re-interventions. Operating times and radiological accuracy have shown a progressive improvement during years of application of this technique. Conclusions: The proposed “6 anatomical landmarks” is an easy free-hand technique that allows everyone to obtain high levels of reconstructive accuracy and it should be a skill of all surgeons who deal with orbital reconstruction in daily clinical activity. Full article

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5 pages, 704 KiB

Open AccessArticle

Cycling-Related Injuries During COVID-19 Lockdown: A North London Experience

by Shadaab Mumtaz, James Cymerman and Deepak Komath

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 46-50; https://doi.org/10.1177/19433875211007008 - 30 Mar 2021

Cited by 6 | Viewed by 73

Abstract

Objectives: There has been a notable surge in cycling injuries during the COVID-19(SARS-CoV-2 virus) pandemic. Cycling in general increased during lockdown as a leisure & fitness activity along with reduction in the use of public transport for commuting. We investigated the bicycle-related maxillofacial [...] Read more.

Objectives: There has been a notable surge in cycling injuries during the COVID-19(SARS-CoV-2 virus) pandemic. Cycling in general increased during lockdown as a leisure & fitness activity along with reduction in the use of public transport for commuting. We investigated the bicycle-related maxillofacial injuries & associations presenting through our emergency department(ED) which covers more than 1.6 million of London population. Study Design/Methods: A retrospective observational study was undertaken in the Barnet General Hospital (“hub”) which receives all maxillofacial referrals from 6 “spoke” hospitals & other urgent primary/community care practices in North London area between 16 March 2020 & 16 July 2020. All data corresponding to cycling injuries during the lockdown period was analyzed with the aid of trauma database/trust-wide electronic patient records. Results: Twenty-two patients (6.7%) with cycling-related injuries out of a total of 322 patients who attended during the 4 months study period with maxillofacial emergencies were identified. Average age of patient cohort was 35.4 years, mainly consisting of adult males (77%). Seven patients had minor head injury and 1 patient suffered traumatic brain injury. About 59% patients did not wear a protective helmet & 3 patients had heavy alcohol/recreational drug intoxication during the accidents. Four patients needed inpatient admission and treatment under general anesthesia. Conclusions: Based on our humble study, we advocate the need for robust road & personal safety measures with mandatory government legislations, policing of drug intoxication & encouragement of physical & mental health improvement measures during these unprecedented times & beyond. Full article

7 pages, 1254 KiB

Open AccessArticle

The Journey of the Lingual Artery from the Neck to the Oral Cavity: A Cadaveric Study

by Krishan Sarna, Khushboo Jayant Sonigra, Thomas Amuti, Martin Kamau, Wei Cheong Ngeow and Pamela Mandela Idenya

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 39-45; https://doi.org/10.1177/19433875211002058 - 16 Mar 2021

Cited by 7 | Viewed by 39

Abstract

Study Design: Descriptive cross-sectional. Objective: The origin of the lingual artery (LA) has been well studied due to its implication in neck dissection, but the course thereafter to the oral cavity is less described. This cadaveric study traced the journey of the LA [...] Read more.

Study Design: Descriptive cross-sectional. Objective: The origin of the lingual artery (LA) has been well studied due to its implication in neck dissection, but the course thereafter to the oral cavity is less described. This cadaveric study traced the journey of the LA from the external carotid artery to its terminal branches in the tongue. Methods: Following bilateral neck dissections in 35 black Kenyan cadavers, the incidence of Beclard’s, Lesser’s and Pirogoff’s triangles, the types of LA origin with its length, relationship to the hyoglossus muscle and anastomosis with other vessels were documented. Results: Beclard’s triangle was found in 64 dissections (91.42%), Lesser’s in 46 dissections (65.71%) and Pirogoff’s in 39 dissections (55.71%). The LA presented either as a solitary branch (67.15%) or as a branch of either the linguofacial (LFT–24.29%), thyrolingual (TLT–2.72%) or thyrolinguofacial (TLFT–2.86%) trunk. The solitary LA was the longest at 6.93 mm, followed by the TLT branch (6.58 mm), LFT branch (6.12 mm) and TLFT branch (5.65 mm). The majority of solitary LA and LA branches of LFT and TLFT passed through the hyoglossus, while all LA branches of the TLT coursed medial to the muscle. All variants of LA have been found to anastomose with the submental artery (SMA) at frequencies that ranged from 11.10% to 100%. Conclusions: The LA was found in all cadavers and all Beclards’ triangles. There is a significant incidence of LFT and TLFT variants in the Kenyan population. The LA passed either through or medial to the hyoglossus with no lateral relationship being observed. Full article

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5 pages, 545 KiB

Open AccessArticle

Maxillofacial Trauma and COVID-19: A Review of the First 6 Months of the Pandemic

by Steven G. Press

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 34-38; https://doi.org/10.1177/19433875211002050 (registering DOI) - 12 Mar 2021

Cited by 3

Abstract

Study Design: Retrospective cohort study. Objective: 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 [...] Read more.

Study Design: Retrospective cohort study. Objective: 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. Methods: 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 1 March 2020 and ending 31 August 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 < 0.05. Results: 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 = 0.003). Volume related to interpersonal decreased 52.4% during the initial phase of the pandemic with a rebound increase of 30% during reopening (p = 0.005). Conclusion: 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. Full article

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6 pages, 544 KiB

Open AccessArticle

A Nationwide Study of Skiing and Snowboarding-Related Facial Trauma

by Thomas J. Sorenson, Vedant Borad and Warren Schubert

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 28-33; https://doi.org/10.1177/1943387521997237 - 5 Mar 2021

Cited by 9 | Viewed by 54

Abstract

Study Design: Retrospective descriptive observational study. Purpose: Skiing and snowboarding offers valuable opportunities for outdoor physical activity throughout the cold winter months, but these activities can result in substantial personally injury. This study aimed to analyze trends in skiing and snowboarding-related facial trauma [...] Read more.

Study Design: Retrospective descriptive observational study. Purpose: Skiing and snowboarding offers valuable opportunities for outdoor physical activity throughout the cold winter months, but these activities can result in substantial personally injury. This study aimed to analyze trends in skiing and snowboarding-related facial trauma epidemiology. Methods: The National Electronic Injury Surveillance System (NEISS) was queried for facial trauma related to skiing and snowboarding treated in United States (US) emergency departments between 2010 and 2019. These data and weighted estimates were used to analyze patient demographics, injury location, and etiology. Results: A total of 361 skiing or snowboarding-related facial injuries were recorded. Lacerations were most common injury (165/361; 45.7%), and facial fractures occurred in 21.6% (78/261) of patients. The most common facial fracture locations are the nose (38/78; 48.7%), orbit (17/78; 21.8%), and mandible (15/78; 19.2%). Pediatric patients accounted for 52% (187/361) of these injuries and had higher rates of lacerations (51.9% vs 39.1%, p < 0.05) and hospital admission (4.8% vs 1.15%, p < 0.05) than adults. Adults had a higher rate of facial fracture (30% vs 13.9%, p < 0.001) than children. Conclusions: Skiing and snowboarding-related facial trauma is relatively uncommon in the US. In general, these injuries are largely decreasing, but facial fractures still occur not infrequently during these activities. Based on our data, we strongly urge helmet manufacturers to increase the availability of recreational snowsport helmets that include nose, orbit, and mandible protections, which could help to prevent many of these injuries. Full article

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11 pages, 767 KiB

Open AccessReview

Pneumomediastinum as a Complication of Oral and Maxillofacial Injuries: Report of 3 Cases and a 50-Year Systematic Review of Case Reports

by Ioannis (Yiannis) Papadiochos, Stavros-Evangelos Sarivalasis, Meg Chen, Lampros Goutzanis and Aristotelis Kalyvas

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 72-82; https://doi.org/10.1177/1943387521997236 - 4 Mar 2021

Cited by 3 | Viewed by 50

Abstract

Objectives: 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 [...] Read more.

Objectives: 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. Material and methods: We retrospectively reviewed the medical records and charts of patients who suffered from maxillofacial trauma and treated in our hospital between 1 September 2013 and 31 September 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. Results: Three cases of PM out of 3514 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. Conclusions: 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. Full article

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7 pages, 572 KiB

Open AccessArticle

The Association of Helmet Use with the Occurrence of Maxillofacial Injuries Following Bicycle or Scooter Accidents: A Retrospective Cohort Study

by M. M. A. Al Saffar, R. J. C. G. Verdonschot, H. S. Stassen, E. B. Wolvius and A. V. J. Rozeboom

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 21-27; https://doi.org/10.1177/1943387521998199 - 3 Mar 2021

Cited by 2 | Viewed by 27

Abstract

Study Design: Retrospective Cohort Study. Objective: Yearly, bicycle and scooter accidents in the Netherlands amount to 90 thousand emergency department visits. Maxillofacial injuries are common after cycling or scooter accidents. To prevent these injuries, helmet use might be beneficial. However, the effect of [...] Read more.

Study Design: Retrospective Cohort Study. Objective: Yearly, bicycle and scooter accidents in the Netherlands amount to 90 thousand emergency department visits. Maxillofacial injuries are common after cycling or scooter accidents. To prevent these injuries, helmet use might be beneficial. However, the effect of helmet use on maxillofacial injuries remains unclear. The aim of this retrospective study is to assess the effect of helmet use on maxillofacial injuries in patients who had a bicycle or scooter accident. Methods: We collected data from the emergency department of the Erasmus Medical Center in the period from October 2017 to October 2019. Patients that were involved in a bicycle or scooter accident and subsequently received a CT scan of the head were included. We compared the incidence of maxillofacial injuries in helmeted cyclists and scooter users to nonhelmeted users. Descriptive and analytic statistics were computed. Level of statistical significance was set at p < 0.05. Results: Helmet use among scooter users was associated with a significant reduction in maxillofacial fractures (p < 0.001) and soft tissue injuries (p < 0.001). Helmet use among cyclists was not associated with a reduction in maxillofacial fractures (p = 0.17) or soft tissue injuries (p = 0.30). Helmet use was not associated with a reduction in soft tissue injuries of the lower face in both cyclists (p = 0.47) and scooter users (p = 0.24). Conclusions: Helmet use should be considered among cyclists and scooter users to prevent maxillofacial injuries. Especially unhelmeted scooter users might benefit from helmet use as this is associated with a lower incidence of maxillofacial injuries. Full article

9 pages, 1126 KiB

Open AccessArticle

Modified Temporal Incision For the Management of Zygomatic Arch Fractures—A Retrospective Study for 7 Years

by S. Devakumari, Neil Dominic, T. Vijhayapriya, D. S. Dinesh and S. Devameena

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 12-20; https://doi.org/10.1177/1943387521989550 - 27 Jan 2021

Cited by 2 | Viewed by 42

Abstract

Study Design: Retrospective cross-sectional study. Objective: The objective of this retrospective study was to evaluate the clinical outcomes of Modified temporal incision in the management of zygomatic arch fractures (ZAF). Patients and Methods: Records of 34 patients who underwent open reduction for zygomatic [...] Read more.

Study Design: Retrospective cross-sectional study. Objective: The objective of this retrospective study was to evaluate the clinical outcomes of Modified temporal incision in the management of zygomatic arch fractures (ZAF). Patients and Methods: Records of 34 patients who underwent open reduction for zygomatic arch fractures were retrieved and included in the study between 2011 and 2018. These patients were followed up at 4 weeks, 8 weeks and 12 weeks respectively. Clinical parameters such as post-operative infection, hematoma, scarring, degree of mouth opening, palpability of plates, alopecia and weakness of temporal branch of Facial nerve recorded were analyzed for complications of modified temporal incision in the management of ZAF. Results: A thorough analysis of the clinical parameters revealed that at the end of 4 weeks scarring was present in 4 patients and temporal branch of Facial nerve weakness was present in 21 patients. None of the patients had hematoma, infection or palpability of miniplates. At the end of 8 weeks the only complication recorded was weakness of temporal branch of Facial nerve in 21 patients. By 12 weeks, all patients had complete recovery and none of the patient had weakness of temporal branch of Facial nerve. Conclusion: The results obtained proved that the Modified temporal incision can be considered as a reliable method in the management of zygomatic arch fractures. The incision can be adopted with confidence in suitable cases of zygomatic arch fractures without any permanent morbidity. Full article

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5 pages, 742 KiB

Open AccessArticle

New Tunneled Buccal Fat Pad Flap for Palatal Reconstruction

by Giuseppe Consorti, Lisa Catarzi, Marco Messi, Davide Valassina and Paolo Balercia

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 90-94; https://doi.org/10.1177/1943387520988433 - 19 Jan 2021

Cited by 3 | Viewed by 32

Abstract

In the palatal defects due to surgical resection, flap selection is very important for a correct reconstruction. Different methods have been suggested over the time, however the pedicled buccal fat pad is a simple, effective, reliable flap for reconstruction after palate tumor resection. [...] Read more.

In the palatal defects due to surgical resection, flap selection is very important for a correct reconstruction. Different methods have been suggested over the time, however the pedicled buccal fat pad is a simple, effective, reliable flap for reconstruction after palate tumor resection. The aim of the present study is to introduce a new surgical technique for palate reconstruction with pedicled buccal fat pad flap exposing the advantages. The Authors performed this procedure in 17 patients in order to treat medium-sized oncologic surgical defect of palate region in the period between 2016 and 2019. Complete wound healing after only 4 weeks without complication after 12 months follow-up was observed. This is the first cases series described with this new technique. Full article

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8 pages, 976 KiB

Open AccessArticle

Anatomical Variations in the Origin of the Lingual Artery in the Kenyan Population

by Krishan Sarna, Martin Kamau, Khushboo Jayant Sonigra and Thomas Amuti

Craniomaxillofac. Trauma Reconstr. 2022, 15(1), 4-11; https://doi.org/10.1177/1943387520983109 - 6 Jan 2021

Cited by 4 | Viewed by 58

Abstract

Study design: Descriptive cross-sectional study. Objective: To determine the variations in origin of the LA and its relationship to surgical landmarks. Background: The Lingual artery (LA) is a branch of the External Carotid Artery (ECA) that constitutes the principal supply to structures within [...] Read more.

Study design: Descriptive cross-sectional study. Objective: To determine the variations in origin of the LA and its relationship to surgical landmarks. Background: The Lingual artery (LA) is a branch of the External Carotid Artery (ECA) that constitutes the principal supply to structures within the oral cavity and floor of the mouth. Knowledge of its variant anatomy is therefore vital during radiological and surgical procedures performed in the head and neck region since they may predispose it and other branches of the ECA to iatrogenic injury. There is, however, a dearth of regional data on the same. Materials and Methods: A total of 70 LA dissections were performed bilaterally on 35 human cadavers. The borders of the carotid triangle were identified after which the external carotid artery and its branches were exposed. The pattern of origin and the diameter of the LA was noted and distances from its origin to the CB, GCHB and the HN were measured. Similar measurements were carried out for any variant trunks. Data was collected and analyzed using SPSS (IBM version 27). A paired t-test was used to compare side differences. Representative photos of the vessel and its variations were taken. Results: The LA was found to be present in all cadavers dissected and was bilaterally symmetrical in 43% of cases. Four (4) types of branching patterns were encountered in the present study, the most commonly observed being the solitary LA followed by the LFT, TLT and finally the TLFT. The average diameter was least in the solitary pattern and greatest in the TLT. In relation to the CB, the solitary LA originated at a distance of 1.51 + 0.89 cm while the LFT, TLT and TLFT originated at a distance of 1.80 + 0.73 cm, 1.02 + 0.64 cm and 1.25 + 0.01 cm respectively from the CB. The mean distance from the origin of the LA to the GCHB was least in the TLT and greatest in the TLFT. With reference to the hypoglossal nerve, the LA was at an average, 0.82 + 0.15 cm from the HN for the solitary pattern, 1.34 + 0.86 cm for the LFT, 1.34 + 0.90 cm for the TLT and 1.38 + 0.93 cm for the TLFT. Conclusion: The LA in the Kenyan population exhibited a high frequency of variation in comparison to other populations regarding its pattern of origin and relationship to landmarks such as the CB, GCHB and HN. These findings may provide further insight into the understanding of the vascular anatomy to the radiologist and the surgeon to avert complications and improve overall treatment outcome. Full article

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Craniomaxillofac. Trauma Reconstr., Volume 15, Issue 1 (March 2022) – 15 articles

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