Six-year analysis of traumatic injuries of the craniomaxillofacial area: relation between maxillofacial and traumatic brain injuries
DOI:
https://doi.org/10.33295/1992-576X-2021-1-56Keywords:
Glasgow coma scale, fracture, Le Fort, traumatic brain injuryAbstract
Summary. Craniofacial trauma is one of the most difficult types of injuries. There is disagreement among various authors about the relationship between maxillofacial trauma (MFT) and traumatic brain injury (TBI).
Purpose. Retrospectively evaluate the epidemiology of traumatic injuries of the craniomaxillofacial area and determine whether there is a relationship between different isolated or combined fractures of the facial bones and brain damage.
Materials and methods. The case histories of three groups of patients with isolated fractures of the mandible (I group), isolated fractures of the midface zone (II group) and combined fractures of all areas of the face (III group), who were hospitalized in the period from 2012 to 2017, were analyzed. The main epidemiological indicators were determined. The analysis of indicators of severity of MFT and TBI is carried out. Correlation analysis of indicators, analysis using the Kruskal- Wallis test and Steel-Dwass test for pairwise comparisons was performed.
Results. Were treated519 patients. 457 men (88 %) and 62 women (12 %). The main causes of injuries were assaults (40 %). Correlation analysis did not reveal the dependence of MFT and TBI. The difference in severity of isolated fractures of the mandible and midface bones was statistically significant, and there is a statistical significance between the severity of TBI in case of isolated fractures of midface bones and panfacial fractures (p < 0.05).
Conclusions. The severity of maxillofacial trauma in the case of panfacial fractures is on average 3 times higher than in the case of isolated fractures of the lower jaw or midface bones. The severity of TBI is largely consistent with concussion in all groups, but in the group with panfacial fractures, the median rate is lower comparing to other groups.
Downloads
References
Bogusiak K, Arkuszewski P. Characteristics and epidemiology of zygomaticomaxillary complex fractures // J. Craniofac. Surg. – 2010, Jul; 21 (4): 1018–23. doi: 10.1097/scs.0b013e3181e62e47. PMID: 20677370.
Haug RH, Prather J, Indresano AT. An epidemiologic survey of facial fractures and concomitant injuries // J. Oral. Maxillofac. Surg. – 1990, Sep; 48 (9): 926–32. doi: 10.1016/0278-2391(90)90004-l. PMID: 2395044.
Haug RH, Adams JM, Conforti PJ, Likavec MJ. Cranial fractures associated with facial fractures: a review of mechanism, type, and severity of injury // J. Oral. Maxillofac. Surg. – 1994, Jul; 52 (7): 729–33. doi: 10.1016/0278-2391(94)90488-x. PMID: 8006737.
Scherer M., Sullivan W.G., Smith D.J. Jr., Phillips L.G., Robson M.C. An analysis of 1,423 facial fractures in 788 patients at an urban trauma center // J. Trauma. – 1989, Mar.; 29 (3): 388–90. doi: 10.1097/00005373-198903000-00020. PMID: 2648018.
Boffano P., Roccia F., Zavattero E., Dediol E., Uglešić V., Kovačič Ž., Vesnaver A., Konstantinović V.S., Petrović M., Stephens J., Kanzaria A., Bhatti N., Holmes S., Pechalova P.F., Bakardjiev A.G., Malanchuk V.A., Kopchak A.V., Galteland P., Mjшen E., Skjelbred P., Koudougou C., Mouallem G., Corre P., Lшes S., Lekven N., Laverick S., Gordon P., Tamme T., Akermann S., Karagozoglu K.H., Kommers S.C., Forouzanfar T. European Maxillofacial Trauma (EURMAT) project: a multicentre and prospective study // J. Craniomaxillofac. Surg. – 2015, Jan.; 43 (1): 62–70. doi: 10.1016/j.jcms.2014.10.011. Epub 2014 Oct 22. PMID: 25457465.
Salentijn E.G., Peerdeman S.M., Boffano P., van den Bergh B., Forouzanfar T. A ten-year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam: incidence and aetiology // J. Craniomaxillofac. Surg. – 2014, Sep.; 42 (6): 705–10. doi: 10.1016/j.jcms.2013.12.008. Epub 2014 Feb 13. PMID: 24703508.
Katzen JT, Jarrahy R, Eby JB, Mathiasen RA, Margulies DR, Shahinian HK. Craniofacial and skull base trauma // J. Trauma. – 2003, May; 54 (5): 1026–34. doi: 10.1097/01.TA.0000066180.14666.8B. PMID: 12777923.
Bagheri SC, Dierks EJ, Kademani D, Holmgren E, Bell RB, Hommer L, Potter BE. Application of a facial injury severity scale in craniomaxillofacial trauma // J. Oral Maxillofac. Surg. – 2006, Mar.; 64 (3): 408–14. doi: 10.1016/j.joms.2005.11.013. PMID: 16487802.
Pappachan B, Alexander M. Correlating facial fractures and cranial injuries // J. Oral Maxillofac. Surg. – 2006, Jul; 64 (7): 1023–9. doi: 10.1016/j.joms.2006.03.021. PMID: 16781334.
You N, Choi MS, Roh TH, Jeong D, Kim SH. Severe Facial Fracture is Related to Severe Traumatic Brain Injury // World Neurosurg. – 2018, Mar.; 111: e47–e52. doi: 10.1016/j.wneu.2017.11.166. Epub 2017 Dec 7. PMID: 29225134.
Plaisier BR, Punjabi AP, Super DM, Haug RH. The relationship between facial fractures and death from neurologic injury // J. Oral Maxillofac. Surg. – 2000, Jul; 58 (7): 708–12; discussion 712-3. doi: 10.1053/joms.2000.7250. PMID: 10883684.
Mehta R., GP trainee, Chinthapalli K., consultant neurologist. Glasgow coma scale explained // BMJ. – 2019, May 2; 365: l1296. doi: 10.1136/bmj.l1296. PMID: 31048343.
Kanda Y. Investigation of the freely available easy-to-use software «EZR» for medical statistics // Bone Marrow Transplant. – 2013; 48: 452–458.
Keenan HT, Brundage SI, Thompson DC, Maier RV, Rivara FP. Does the face protect the brain? A case-control study of traumatic brain injury and facial fractures // Arch Surg. – 1999, Jan; 134 (1): 14–7. doi: 10.1001/archsurg.134.1.14. PMID: 9927123.
Lee KF, Wagner LK, Lee YE, Su JH, Lee SR. The impact-absorbing effects of facial fractures in closed-head injuries. An analysis of 210 patients // J. Neurosurg. – 1987, Apr; 66 (4): 542–7. doi: 10.3171/jns.1987.66.4.0542. PMID: 3559719.
Davidoff G, Jakubowski M, Thomas D, Alpert M. The spectrum of closed-head injuries in facial trauma victims: incidence and impact // Ann. Emerg. Med. – 1988, Jan.; 17 (1): 6–9. doi: 10.1016/s0196-0644(88)80492-x. PMID: 3337417.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 LLC «Expert LTD»
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
