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.
BACKGROUNDAnaesthetic management of patients with oromaxillofacial surgeries poses quite a few challenges to both anaesthesiologist and operating surgeons. This is because the corrective procedure demands fixation of fractures, repair of soft tissue injuries and maintaining occlusion all without compromising the cosmetic aspect. Though securing the airway takes the precedence, it is of paramount importance that it should not interfere with the surgical techniques.
METHODSSeventy one patients of maxillofacial injuries, operated over a period of five years between February 2011 and December 2015 in Indira Gandhi Medical College Hospital at Puducherry were reviewed. All patients were reviewed in relation to age, type of injury, etiology, bones involved and method of airway management.
RESULTSThe major etiology of injuries were road traffic accidents (79%). Majority of patients were young in the age group of 21-40 years (55%). Fracture mandible (46%) was the most common injury. Airway secured by nasotracheal route with direct visualization of vocal cords was the most common (90%), followed by submental route (10%).
CONCLUSIONThis analysis showed in maxillofacial procedures, trauma is the leading cause in this part of India also. Male preponderance, maximum injuries are seen in third and fourth decade of life and other findings that are correlating well with other studies. Nasotracheal intubation is the method of choice in securing the airway during the maxillofacial procedures. Submental intubation can be considered as a viable option when nasotracheal intubation is not possible due to the involvement of base of the skull or midfacial fractures.
Peripheral ossifying fibroma (POF) is an inflammatory reactive hyperplasia of gingiva. It occurs frequently in anterior maxilla with a higher predilection for females. It presents as sessile mucosal nodule and more common in second decade of life. It has been suggested as a separate clinical entity rather than a transitional form of pyogenic granuloma. Diagnosis is often challenging as the clinical presentation of POF mimicks other reactive lesions of gingiva. Due to its high recurrence rate of 8.9% to 20%, prompt diagnosis is important. Here, we report a case of 15 year old girl with pedunculated lesion in gingival and clinically diagnosed as traumatic fibroma.
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