ABSTRACT
Introducción: Correspondiendo a una patología frecuente en la especialidad de cabeza, cuello y máxilo-facial, consecuencia de traumatismos severos, es importante determinar las características de las fracturas del tercio medio facial, para su manejo. Objetivo: Determinar la presentación de las fracturas del tercio medio facial por edad, sexo, agente causal. Diseño: Estudio observacional descriptivo. Lugar: Servicio de Cirugía de Cabeza, Cuello y Máxilo-Facial del Hospital Nacional Dos de Mayo, Lima, Perú. Participantes: Pacientes con fractura del tercio medio facial. Intervenciones: Recolección de datos registrados en las historias clínicas, entre junio 1999 y mayo 2009. Principales medidas de resultados: Edad, sexo, agente causal y clasificación. Resultados: De 471 pacientes, 83% fue de sexo masculino, 72,5% tenía entre 21 y 40 años de edad, 48% fue por accidentes de tránsito y 25% por robos; 83% correspondió solamente a fracturas del tercio medio y 88% a trazo unilateral. Conclusiones: Las fracturas del tercio medio facial son las más frecuentes de la región facial; el diagnóstico clínico depende de la estructura afectada. Se debe actuar oportunamente para evitar secuelas y complicaciones.
Introduction: Facial middle third fractures resulting from severe trauma are frequent pathology attended by Surgery Head, Neck and Maxillofacial specialists; to determine its characteristics is important for treatment. Objectives: To determine the presentation of facial middle third fractures by age, sex, causal agent. Design: Observational descriptive study. Setting: Head, Neck and Maxillofacial Surgery Service, Dos de Mayo National Hospital, Lima, Peru. Participants: Patients with facial middle third fracture. Interventions: Collection of data from medical records June 1999 through May 2009. Main outcome measures: Age, sex, causing agent and classification. Results: From 471 patients, 83% were male, 72.5% between 21 and 40 years of age; 48% resulted from traffic accidents and 25% from robberies; 83% were middle third fractures only, and 88% unilateral stroke. Conclusions: Facial middle third fractures are the most common fractures of the facial region; clinical diagnosis depends on the affected structure. Prompt treatment is necessary to prevent sequelae and complications.
ABSTRACT
Objective To explore the location of the centre of resistance for the maxillary complex in cleft lip and palate by the use of finite element analysis. Methods Combining spiral CT scanning technology with the three-dimensional finite element method, a three-dimensional FEM model of LeFort Ⅰ , Ⅱ , and Ⅲ complex and soft tissue in cleft lip and palate was developed for analysis. Anteriorly and inferiorly directed forces of 9.8N were applied at five different levels parallel to the functional occlusal plane and four different levels perpendicular to the functional occlusal plane, respectively.For each loading condition, horizontal and vertical displacements of different anatomic points in the complex and on the maxillary dentition were analysed. Location of the centre of resistance in different osteotomy complex were studied. Results The resistant center of the LeFort Ⅱ complex in cleft lip and palate was located on intersection between basis nasi and medium of apertura piriforms vertically,apex of the canine and posterior point of the first bicuspid horizontally. The resistant center of the LeFort Ⅲ complex in cleft lip and palate was located on intersection between anterior of the nasion and medium of apertura piriforms vertically, posterior point of the first molar and first bicuspid horizontally. Conclusion Knowledge of the resistant center of different osteotomy complex could establish a basis for biomechanical studies of craniofacial complex distraction osteogenesis in cleft lip and palate.
ABSTRACT
BACKGROUND: The coronal incision is versatile surgical approach to upper and middle region of the facial skeletal including the zygomatic arch. The advantages of coronal approach are minimal injury of facial tissue including facial nerve and satisfactory cosmetic result by hidden scar at hair. But wide exposure of scalp, its disadvantages are operation time and massive blood loss. METHODS: Thirty patients undergoing elective surgery were divided 3 groups. Group I used only coronal approach, group II used coronal with subciliary approach and group III used coronal with subciliary and intraoral approach. And then retrospected of the preoperative, postoperative red blood cell count, hemoglobin(Hb), hematocrit, transfused red blood cell units and platelet cell units, and the amount of infused crystalloids and colloids, and postoperative hemovac count was estimated. RESULTS: 1. Red blood cell count were decreased in all groups at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II but increased group III of postoperative third day. 2. Hemoglobin and hematocrit were decreased in all group at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II., but increased group III postoperative third day. 3. Platelet was decreased in all group at immediated postoperation, and decreased in group II, III but increased in group I of postoperative first day and decreased in group I but increased group II, III of postoperative third day. 4. Mean postoperative hemovac mean drainage group I of first day is 48.63+/-21.12ml and second day is 23.92+/-19.53ml and third day is 7.82+/-5.32ml and group II of first day 60.45+/-22.65ml and second day is 22.14+/-13.21ml and third day is 7.32+/-6.25ml. III group of first day 58.16+/-10.13ml and second day is 21.27+/-11.72ml and third day is 7.13+/-4.90ml. 5. Infusion of group I is mean PRC 1.08+/-0.91 pint, FFP 1.03+/-0.75 pint, crystalloid 2562.23+/-1345.53ml and group II is mean PRC 1.05+/-0.89 pint, FFP 1.71+/-0.78, crystalloid 2650.47+/-1096.36ml and group III is mean PRC 1.79+/-1.45 pint, crystalloid 3295.43+/-1472.432ml.