Blunt cerebrovascular injury following craniomaxillofacial fractures: A systematic review

Kelts, Gregory; Maturo, Stephen; Couch, Marion E.; Schmalbach, Cecelia E.

doi:10.1002/lary.26186

Cited by 17 publications

(5 citation statements)

References 44 publications

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“…The mean age of the participants with CMF fractures in our study was 23.94 ± 17.40 years, which is similar to the average of 25.75 ± 15.5 years found in another study [17]. Upper facial fractures were the least prevalent type of CMF fractures, a finding corroborated by two other studies to date [18,19].…”

Section: Discussionsupporting

confidence: 90%

“…However, several studies support our findings [2,25,26], while some others do not. A systematic review identified 410 BCVI cases among 90,968 blunt trauma admissions with CMF fractures, constituting an overall incidence of 0.45% [18]. The mean age of BCVI patients in our study was 46.91 ± 17.04 years, similar to that in Weber et al's study (46 ± 19 years) [25].…”

Section: Discussionsupporting

confidence: 83%

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The Relationship Between Cerebrovascular Injuries and Craniomaxillofacial Fractures: Findings From a Tertiary Hospital in Saudi Arabia

Babtain¹,

Alsahly²,

Alkhail³

et al. 2021

Cureus

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Background and objectiveBlunt cerebrovascular injuries (BCVIs) can lead to serious outcomes, particularly because they are difficult to detect in the acute phase. There are studies that have described the association between cerebrovascular injuries and craniomaxillofacial (CMF) fractures; however, no such study has been conducted among a Saudi population. In light of this, we conducted this study to evaluate the correlation between BCVI and CMF fractures among the local population in Saudi Arabia. In addition, the most common types of fractures associated with BCVI were identified. MethodsThis retrospective cohort study was conducted at the King Abdulaziz Medical City, a tertiary hospital in Riyadh, Saudi Arabia. All eligible patients with CMF fractures who were hospitalized at the King Abdulaziz Medical City were included. Consecutive patients were screened; no sampling or randomization was required. Patients with penetrating or avulsive mechanisms of injury were excluded. ResultsOut of a total of 1,560 patients included in the study, 1,537 (98.5%) had CMF fractures, while 23 (1.5%) had BCVIs. None of the patients with CMF fractures had BCVIs. Among the patients with BCVIs, 12 (52.2%) were men and 11 (47.8%) were women. The mean age of these patients was 46.91 ± 17.04 years. Among patients with CMF fractures, 1,071 (69.7%) were men and 466 (30.3%) were women. Their mean age was 23.93 ± 17.36 years. ConclusionThe study did not identify any correlation between BCVI and CMF fractures; however, further studies with larger samples across multiple centers are needed to validate our findings and gain deeper insight into the relationship between BCVI and CMF fractures.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 83%

The Relationship Between Cerebrovascular Injuries and Craniomaxillofacial Fractures: Findings From a Tertiary Hospital in Saudi Arabia

Babtain¹,

Alsahly²,

Alkhail³

et al. 2021

Cureus

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“…As Le Fort fractures often present in patients who have sustained polytrauma, risk factor analysis of this patient population has typically focused on identification of predictors of associated injuries. Indeed, studies have shown that Le Fort fractures confer a significantly increased likelihood of sustaining sight-threatening ocular trauma, 29,30 blunt cerebrovascular injury, 31,32 and cervical spine injury. 33 It is therefore not surprising that a recent, single institution retrospective study by Lucke-Wolde et al 34 proposed an algorithm for management of patients with traumatic brain injury and facial fractures and found that patients with Le Fort II and III fractures were more likely to require neurosurgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Acute Postoperative Complications Following Operative Management of Le Fort Fractures—A NSQIP Study

Matabele

Seitz

Doan

et al. 2023

Journal of Craniofacial Surgery

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Introduction: Le Fort fractures comprise a pattern of complex midfacial fractures that arise secondarily to craniofacial trauma. Although management of these fractures has been detailed within the literature, there is a paucity of research examining postoperative outcomes after surgical repair. The primary aim of this study is to assess patient outcomes after operative management of Le Fort fractures, and examine factors influencing the risk for developing postoperative complications, through utilization of the ACS-NSQIP database. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for cases recorded between 2012 and 2019 with International Classification of Disease (ICD)-9 and ICD-10 codes corresponding to Le Fort fractures. Patient demographics, clinical variables, and postoperative variables were recorded. Logistic regression analysis was conducted to identify independent risk factors for postoperative complications. Results: Identification of cases with appropriate ICD codes, and exclusion of those with missing data, yielded 562 patients for analysis. There were no cases of minor complications and 14 cases of severe complications (3 cases of wound dehiscence, 3 cases of transfusion requirement, 1 case of failure to wean from the ventilator for more than 48 h, 1 pulmonary embolism, and 8 cases of reoperation), corresponding to an overall complication rate of 2.49%. Logistic regression analysis revealed steroid use as an independent predictor of severe postoperative complications (OR = 13.73, 95% CI: 1.08-128.02, P = 0.02). Conclusion:The present study is the first to conduct a risk factor analysis of patients with Le Fort fractures using the ACS-NSQIP national database. The overall postoperative complication rate was 2.49%, with 14 cases of complications recorded in 8 years. Although this may suggest that surgical management of Le Fort fractures is generally well-tolerated, it should be noted that this problem is frequently associated with other severe injuries of the head and neck that may influence patient prognosis. Given this, further analysis would benefit from a larger patient cohort and longer postoperative data as the ACS-NSQIP database only records outcomes within 30 days.

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“…Many diagnostic modalities exist for the diagnosis of DA including ultrasonography, CT, magnetic resonance imaging, and conventional angiography, which is the gold standard in diagnosing arterial dissections. 12 Angiography of a DA classically demonstrates irregular narrowing of the vessel lumen or aneurysmal dilatation. 14 In this case, the conventional angiography revealed narrowing of the extracranial part of the ICA, thus confirming the diagnosis of DA.…”

Section: Discussionmentioning

confidence: 99%

Dissecting Aneurysm of the Internal Carotid Artery as a Complication of Facial Bone Trauma

et al. 2019

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The involvement of the internal carotid artery in dissecting aneurysm is rarely reported in the literature and may occur as a complication of trauma, surgery, and other medical conditions. We report a case of a 22-year-old male who was involved in a motor vehicle accident with associated multiple orthopedic and maxillofacial fractures. During surgical management, the patient was incidentally diagnosed with a dissecting aneurysm involving the right internal carotid artery.

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Blunt cerebrovascular injury following craniomaxillofacial fractures: A systematic review

Abstract: N/A. Laryngoscope, 127:79-86, 2017.

Cited by 17 publications

References 44 publications

The Relationship Between Cerebrovascular Injuries and Craniomaxillofacial Fractures: Findings From a Tertiary Hospital in Saudi Arabia

The Relationship Between Cerebrovascular Injuries and Craniomaxillofacial Fractures: Findings From a Tertiary Hospital in Saudi Arabia

Risk Factors for Acute Postoperative Complications Following Operative Management of Le Fort Fractures—A NSQIP Study

Dissecting Aneurysm of the Internal Carotid Artery as a Complication of Facial Bone Trauma

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