颌面部外伤并发颈椎骨折的临床分析(附30例病例)

本文总结颌面部外伤并发颈椎骨折 30例 ,面部损伤与颈椎骨折部位 ,类型有一定相关关系 ,在诊治复杂颌面外伤患者时应警惕颈椎骨折漏诊发生 ,颌面部外伤合并颈椎骨折处理原则应优先考虑颈椎骨折治疗的需要 ,术中需特别注意保持患者正确体位及呼吸道通畅问题。     

口腔颌面部创伤

实验性骨质疏松症对下颌骨骨折愈合的影响；颧骨复合体骨折临床治疗探讨；526例下颌骨髁状突骨折临床病例回顾性研究；上颌骨骨折合并泪道损伤的早期处理及意义；重症颌面部损伤患者的首（急）诊护理；下颌骨髁突骨折治疗的Meta分析；颌面创伤3958例临床回顾；69例老年患者颌面部骨折的临床分析；颌骨骨折合并颅脑损伤的处理；颌面部外伤患者早期的个性及心理调查。[编者按]     

颌面部外伤并发颈椎骨折的临床分析

本文总结颌部外伤并发颈椎骨折３０例，面部损伤与颈椎骨折部位，类型有一定相关关系，在诊治复杂颌面外伤患者时应警惕骨折漏诊发生，颌面部餐伤合并颈椎骨折处理原则应优先考虑颈椎骨折治疗的需要，术中需特别注意保持患者正确体位通畅问题。     

颌面部创伤伴颈髓损伤患者的临床观察与治疗体会

目的：总结颌面部创伤合并颈髓损伤患者的临床观察和治疗经验，重视此类患者的早期诊断。方法：回顾性分析15例颌面部创伤伴颈髓损伤患者的临床资料.结果：保守治疗7例，无院内死亡；手术治疗8例,3例死亡．原因均为呼吸衰竭。结论：不要忽视颌面部创伤病人颈椎的检查和保护。一旦合并颈髓损伤，愈后较差．治疗要重视早期诊断及全身的病理、生理变化。     

眼眶骨折138例CT影像分析

目的:对眼眶骨折进行CT检查分析,以提高临床诊断水平。方法:对颌面部外伤伴眼眶骨折的138例患者的145只眼CT检查结果进行研究分析。结果:眼眶骨折以眶内壁、眶外壁骨折最多见,且以多壁骨折为主。145只眼中发生单壁骨折51例(35.17%),双壁骨折48例(33.10%),三壁骨折31例(21.38%),四壁骨折15例(10.35%)。结论:颌面部外伤大多存在复杂的眼眶骨折,应将CT列为常规检查方法。     

颅脑损伤合并口腔颌面部损伤及漏诊分析

口腔颌面部居头颅的下三分之二 ,颅脑损伤时亦常波及口腔颌面部。我院 1 996～ 1 999年收治的各类颅脑损伤 1 68例 ,其中合并口腔颌面部损伤 56例占三分之一 ,初诊漏诊 6例 (约 1 0 % )。临床资料表 1　口腔颌部损伤的性别年龄分布性别 10岁以下 10～ 2 0 2 1～3031～5 0(岁 )合计男 3 82 7 7 45女 2 6 3 11合计 3 10 33 10 5 6表 2　口腔颌面部损伤的诊断和原因诊断例数原因例数软组织挫裂伤 40交通事故 30上下颌骨、颧骨骨折 4劳动致伤 11上颌骨骨折 3打架斗殴 10下颌骨骨折 4跌　伤 3牙折及牙龈撕裂伤 3爆炸伤 2爆炸伤合并下颌骨骨折 2讨…     

冠状位切口在颧骨骨折三维重建中的临床应用

颧骨由于其在颌面部的特殊解剖位置和结构 ,比较容易因外力而导致面部的复合骨折 ,临床上发病率较高 ,常常影响面部外形 ,导致张口受限 ,使患者的生活质量下降。近年来 ,随着交通事故和暴力事件的增多 ,颌面部外伤的发生率也逐渐增加 ,其中颧骨、颧弓骨折占较高的比例。Edward Ellis等对此进行过统计分析 ,在其抽取的颌面部外伤样本中 ,43.9%的病例有颧骨骨折 ,471 1例颌面部外伤中1 0 67个患者中至少有一处颧骨骨折。1　临床资料我科收治 9例颧骨骨折 ,手术方法均采用头皮冠状切口 ,其中男性 5例 ,女性 4例 ,年龄在 2 5～58,平均年龄 36;…     

口腔颌面部损伤病人麻醉诱导气管插管方式的比较

口腔颌面部重度损伤病人往往气管插管操作困难。故选择合适的麻醉诱导插管方式至关重要。本文就我院 91年以来 48例口腔颌面部重度损伤患者手术时不同麻醉诱导插管方式分析报告如下。1　临床资料1 .1　一般资料　本组 48例 ,男性 41例 ,女 7例 ,年龄 1 1～ 68岁 ,损伤类型 :上颌骨多发骨折 5例 ,2例合并颅脑损伤 ;下颌骨多发骨折 1 8例 ;上下颌骨骨折 7例 ;面部多处刀砍伤合并颧骨骨折或上颌骨骨折 3例 ;颌面部爆炸伤 5例 ;颧骨骨折合并上颌骨骨折 4例 ;上颌贯通伤 4例 ;下颌贯通伤 2例。1 .2　麻醉处理　 48例均行气管内插管静复或静吸全麻…     

严重颌面部外伤救治体会(附49例报道)

颌面部是人体暴露部位 ,易引起外伤 ,严重的颌面部损伤 ,常伴有其他器官的损伤 ,抢救时必须迅速而及时地判断伤者的伤情 ,及时有效的抢救患者的生命 ,是外伤早期处理时最重要的目的 ,可以大大降低死亡率[1] 。现将 49例报告如下。1　临床资料　　男性 3 2例 ,女性 1 7例 ,年龄 6～ 5 8岁 ,平均年龄 3 0岁。致伤原因 :车祸 3 2例 ,摔伤 3例 ,打伤 6例 ,炸伤 2例 ,刀斧伤 5例 ,电锯伤 1例。开放性骨折 45例 ,闭合性骨折 4例。上颌骨骨折 1 7例 ,颧骨骨折 1 2例 ,鼻骨骨折 1 5例 ,髁状突骨折 8例 ,颅底骨折 9例。两处以上骨折 3 6例 ,3处以上骨…     

颌面部骨折108例临床分析

颌面部骨折是头面部外伤的常见病之一,在急诊病症中占有一定的比例,颌面骨折的治疗研究是口腔颌面部损伤的重要课题,现将我科收治的颌面部骨折的病人108例总结报导如下。 一、临床资料 1.资料来源:本组均系我院急诊和住院病人,病历记载完整。     

Cervical spine fractures associated with maxillofacial trauma: an 11-year review

Although cervical spine injury is rarely associated with maxillofacial trauma, it should be suspected when injuries above the clavicle occur, as suggested in the Advanced Trauma Life Support Manual. A retrospective study of 2482 patients with maxillofacial trauma, who were admitted to the Maxillofacial Surgical Division of Turin University between 1996 and 2006, conducted to identify concomitant fractures of the cervical spine and establish a treatment protocol. Twenty-one patients (0.8%), consisting of 17 males and four females ranging in age from 15 to 70 years, had amyelic cervical spine fractures. In 90% of the cases, the cervical spine injury was caused by a road accident. Cervical spine injuries were diagnosed using lateral x-rays in three cases and with computed tomography in the remaining patients. Although an association has been reported between mandibular fracture and cervical spine injury, we did not observe a preferential association between injuries of the upper third of the face and spinal injury. Cervical spine immobilization should never be removed until cervical spine injury has been excluded using a lateral x-ray of the cervical spine. In males with significant blunt craniomaxillofacial trauma caused by high-energy impact accidents such as car and motorcycle accidents, computed tomography is the radiologic examination of first choice to exclude cervical spine injuries. Lastly, the presence of a cervical spine injury did not result in modified or delayed treatment of maxillofacial fractures, with the exception of one patient who had a fracture of the odontoid process.     

Cervical spine fractures and maxillofacial trauma

Cervical spine fractures are a serious complication of maxillofacial trauma because of the high potential for mortality and neurologic morbidity. This study reviewed 563 patients with facial fractures treated by the Division of Oral and Maxillofacial Surgery at a level I trauma center and identified 11 concomitant cervical spine fractures (2.0%). These patients were almost exclusively male (91%), white (100%), between 20 and 35 years of age (64%), involved in a motor vehicle accident (91%), with a concomitant mandibular fracture (91%). The examination, diagnosis, and management of patients with cervical spine injuries are discussed.     

Prevalence of cervical spine injuries in patients with facial trauma

OBJECTIVE: Injuries to the spine may accompany facial trauma. By using a large computerized database the goal of this case control study was to assess the association between facial and cervical spine injuries among patients sustaining facial trauma. STUDY DESIGN: During a period of 4 years (1995 to 1998) 3083 patients, 10 years or older, with facial injuries were admitted to the University Hospital of Innsbruck's Department of Oral and Maxillofacial Surgery for facial trauma. Records were analyzed for cause of injury, age and gender distribution, frequency and type of injury, and frequency of cervical spine injuries in relation to facial trauma and concomitant injuries. Two hundred six (6.7%) of these patients had experienced a concomitant cervical spine injury (case group). All other patients (2877) were assigned to the control group of facial trauma only. RESULTS: Facial trauma patients with concomitant cervical spine injuries were significantly older (mean age, 42 vs 34 years); no difference existed for the female/male ratio of 30:70. Sports trauma was the main cause of facial trauma in the control group (37.4%), yet traffic accidents accounted for 43.7% of combined facial and cervical spine injuries in the case group. Central mid face fractures dominated in the case group and lateral mid face fractures in the control group. In the case group cervical spine fractures and dislocations occurred in 19.2%. None of them showed evidence of paralysis. Concomitant brain injuries occurred in 21.6% of the case group and 8.8% of the control group. For patients sustaining facial trauma, logistic regression analysis revealed reduced risks for additional cervical spine injuries in younger patients, female patients, absence of brain injury, and in patients with facial soft tissue lesions alone (58.2%) or dental trauma alone (77.5%). CONCLUSION: The results of this study underline the importance of proper clinical and computed tomographic evaluation in cases of facial fractures for recognition of additional cervical spine trauma. Detection of cervical spine trauma can be missed, especially when pain or symptoms from other parts of the body dominate. The typical patient with concomitant neck and facial trauma is male, 40 years old, and usually involved in a traffic accident.     

Cervical spine fractures associated with maxillofacial trauma: A 3-year-long study in the Greek population

Background

Maxillofacial fractures have been recognized as high risk trauma for concomitant cervical spine or spinal cord injury.

增强CT在口腔颌面颈部多间隙感染中的应用评价

目的：总结口腔颌面颈部多间隙感染在增强CT上的影像学特点,并评估其对诊断和治疗的应用价值。方法：收集2005年12月-2011年12月口腔颌面颈部多间隙感染并行增强CT检查的连续病例227例．对其发病原因、CT表现、累及间隙、治疗结果、随访CT表现进行回顾分析。结果：病因多为牙源性和腺源性,分别有167例和33例;CT主要表现为脓肿、气体积聚和蜂窝织炎;下颌下间隙累及频率最高,为145例,其次为咬肌间隙（73例）、翼颌间隙（50例）和舌下间隙（48例）;出现呼吸道梗阻15例,下行性纵隔炎11例;214例患者治愈,8例失访,5例死亡。结论：增强CT应作为口腔颌面颈部多间隙感染首选的影像学检查．可为术前诊断、指导治疗及判断预后提供有效信息。     

Cervical Spine Injuries and Maxillofacial Trauma: A Systematic Review

ObjectivesIdentify specific maxillofacial trauma patterns associated with cervical spine injuries.MethodsThe protocol was developed according to (PRISMA-P) and was admitted to PROSPERO under accreditation code #CRD42020177816. Furthermore, the reporting of the present SR was conducted based on the PRISMA checklist.ResultsOf the 1,407,750 patients recorded, a total of 115,997 patients (12.13%) had MFF with an associated CSI with a gender proportion (M:F) of 3.63:1 respectively. Motor vehicle accident was the most common cause of the combined Maxillofacial Trauma (MFT) and CSI. The most common CSI location was at the C2, followed by the C5 cervical spines. The most common location of a maxillofacial fracture resulting in a CSI was the mandible.ConclusionThe incidence of the association of CSIs with MFT has been low (12.13%). Nevertheless, in cases of an isolated mandibular trauma due to a severe blow presenting with a low Glasgow Coma Scale, maxillofacial surgeons should be at a high alert of an associated CSI.     

分诊制下326例口腔颅颌面创伤急诊住院患者临床分析

目的： 总结分诊制下口腔颅颌面创伤急诊救治经验。方法： 回顾分析2020年9月—2021年8月间上海交通大学医学院附属第九人民医院南部院区口腔颅颌面创伤患者急诊接诊救治情况。期间共接诊36 599例患者,急诊留观处理1 683例,住院治疗326例。收集住院患者入院前处理情况,包括基础生命支持（急诊止血、液体复苏、损伤控制手术）、伤情、高级生命支持、多学科联合救治及转归情况等。采用SPSS 13.0软件包对数据进行统计学分析。结果： 326例急诊入院患者中,男253例,女73例,男女比例3.47∶1;年龄20~73岁,平均（41.64±15.34）岁。最常见原因为道路交通伤（169例）,其中电瓶车事故伤138例,占81.63%;其次为生活意外伤（89例）,其中跌伤65例,占73.01%;工伤33例,其中坠落伤14例,占42.42%;其他损伤35例。83例进行初级生命支持（心电监护、液体复苏,清创止血）,其中输血30例,气管插管或切开7例,石膏或支具外固定9例。65例实施损害控制性手术。235例直接收住口腔颅颌面科,54例根据创伤情况收入相应专科,37例收入EICU继续高级生命支持。所有患者均成功救治,326例患者经急诊或延期手术得到确切治疗,4例出院后做二期修复。结论： 采取急救辅助下的专科诊治是有效解决分诊制下日益增多口腔颅颌面创伤救治需求的有效措施。由急诊科牵头,强调以生命救治、器官功能保护和重建、社会回归为中心,在各个专科之间开展协作,是口腔颅颌面多发伤救治成功的关键。     

伴全身多系统创伤颌面伤患者的综合救治

目的:研究伴发身体其他部位创伤的颌面伤患者综合救治中专科确定性手术时机和适应证。方法:回顾性统计4所大型综合医院口腔科病房近20年收治的4 869例口腔颌面部创伤患者的临床资料,分析伴发身体其他部位创伤状况和专科手术时机。结果:4 869例患者中,面骨骨折3 364例,软组织伤1 505例。伴发其他部位创伤1 524例(占31.3%),其中颅脑伤570例(37.4%),肢体伤545例(35.8%),胸部伤170例(11.2%),眼创伤151例(9.9%),脊柱伤54例(3.3%),腹部伤34例(2.2%)。74%的颅脑伴发伤患者伤后4周内、76.2%的眼伴发伤患者伤后7d内进行了面骨骨折手术治疗。而肢体、脊柱、胸腹部伴发伤患者,面骨骨折手术均有不同程度延误。结论:伴发多系统创伤的颌面伤患者的救治需要多学科间的合作,在患者呼吸系统、循环系统等全身状况稳定的情况下,大部分颌面多发伤患者可以同期或早期进行专科处理。     

严重多发伤合并颌面部坏死性筋膜炎3例

目的：探讨严重多发伤后合并颌面部坏死性筋膜炎的临床特征及治疗方法。方法：回顾近10年诊治的严重多发伤后合并颌面部坏死性筋膜炎3例临床资料，结合文献复习，讨论其发病原因、临床表现和诊治方法。结果：2例获得良好疗效，1例病例死亡。结论：对严重多发伤后合并颌面部的坏死性筋膜炎应引起足够重视，及时有效地外科处理，联合应用抗生素和防治并发症是治疗成功的关键；颌面部皮肤缺损创面，要适时用皮片移植修复。