• 대한두개안면성형외과학회지
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• 제23권6호
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• pp.262-268
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• 2022

Background: To compare the sensory change and recovery of infraorbital area associated with zygomaticomaxillary and orbital floor fractures and their recoveries and investigate the factors that affect them. Methods: We retrospectively reviewed 652 patients diagnosed with zygomaticomaxillary (n= 430) or orbital floor (n= 222) fractures in a single center between January 2016 and January 2021. Patient data, including age, sex, medical history, injury mechanism, Knight and North classification (in zygomaticomaxillary fracture cases), injury indication for surgery (in orbital floor cases), combined injury, sensory change, and recovery period, were reviewed. The chi-square test was used for statistical analysis. Results: Orbital floor fractures occurred more frequently in younger patients than zygomaticomaxillary fractures (p< 0.001). High-energy injuries were more likely to be associated with zygomaticomaxillary fractures (p< 0.001), whereas low-energy injuries were more likely to be associated with orbital floor fractures (p< 0.001). The sensory changes associated with orbital floor and zygomaticomaxillary fractures were not significantly different (p= 0.773). Sensory recovery was more rapid and better after orbital floor than after zygomaticomaxillary fractures; however, the difference was not significantly different. Additionally, the low-energy group showed a higher incidence of sensory changes than the high-energy group, but the difference was not statistically significant (p= 0.512). Permanent sensory changes were more frequent in the high-energy group, the difference was statistically significant (p= 0.043). Conclusion: The study found no significant difference in the incidence of sensory changes associated with orbital floor and zygomaticomaxillary fractures. In case of orbital floor fractures and high-energy injuries, the risk of permanent sensory impairment should be considered.

• Journal of Korean Neurosurgical Society
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• 제50권1호
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• pp.17-22
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• 2011

Objective : In the present study, authors retrospectively reviewed the clinical outcomes of halo-vest immobilization (HVI) versus surgical fixation in patients with odontoid fracture after either non-surgical treatment (HVI) or with surgical fixation. Methods : From April 1997 to December 2008, we treated a total of 60 patients with upper cervical spine injuries. This study included 31 (51.7%) patients (22 men, 9 women; mean age, 39.3 years) with types II and III odontoid process fractures. The average follow-up was 25.1 months. We reviewed digital radiographs and analyzed images according to type of injury and treatment outcomes, following conservative treatment with HVI and surgical management with screw fixation. Results : There were a total of 31 cases of types II and III odontoid process fractures (21 odontoid type II fractures, 10 type III fractures). Fifteen patients underwent HVI (10 type II fractures, 5 type III fractures). Nine (60%) out of 15 patients who underwent HVI experienced successful healing of odontoid fractures. The mean period for bone healing was 20.2 weeks. Sixteen patients underwent surgery including anterior screw fixation (6 cases), posterior C1-2 screw fixation (8), and transarticular screw fixation (2) for healing the odontoid fractures (11 type II fractures, 5 type III fractures). Fifteen (93.8%) out of 16 patients who underwent surgery achieved healing of cervical fractures. The average bone healing time was 17.6 weeks. Conclusion : The overall healing rate was 60% after HVI and 93.8% with surgical management. Patients treated with surgery showed a higher fusion rate and shorter bony healing time than patients who received HVI. However, prospective studies are needed in the future to define better optimal treatment and cost-effective perspective for the treatment of odontoid fractures.

• Archives of Plastic Surgery
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• 제39권3호
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• pp.204-208
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• 2012

Background : Isolated pure blowout fractures are clinically important because they are the main cause of serious complications such as diplopia and limitation of extraocular movement. Many reports have described the incidence of blowout fractures associated with diplopia and limitation of extraocular movement; however, no studies have statistically analyzed this relationship. The purpose of this study was to demonstrate the correlation between the location of isolated pure blowout fractures and orbital symptoms such as diplopia and limitation of extraocular movement. Methods : We enrolled a total of 354 patients who had been diagnosed with isolated pure blowout fractures, based on computed tomography, from June 2008 to November 2011. Medical records were reviewed, and the prevalence of extraocular movement limitations and diplopia were determined. Results : There were 14 patients with extraocular movement limitation and 58 patients complained of diplopia. Extraocular movement limitation was associated with the following findings, in decreasing order of frequency: floor fracture (7.1%), extended fracture (3.6%), and medial wall (1.7%). However, there was no significant difference among the types of fractures (P=0.60). Diplopia was more commonly associated with floor fractures (21.4%) and extended type fractures (23.6%) than medial wall fractures (10.4%). The difference was statistically significant (Bonferroni-corrected chi-squared test P<0.016). Conclusions : Data indicate that extended type fractures and orbital floor fractures tend to cause diplopia more commonly than medial wall fractures. However, extraocular movement limitation was not found to be dependent on the location of the orbital wall fracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권5호
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• pp.530-534
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• 2007

Nasal fractures are the most common type of facial fractures. Nowdays computed tomography is found to be very helpful in diagnosing nasal fracture, especially in findings the nasal septal fractures. From August 2004 to July 2005, 36 cases of nasal fracture were admited and reviewed to oral and maxillofacial surgery of Ulsan University Hospital, not including other facial bone fracture. Out of 223 cases of facial bone fractures, we treated 47 cases of nasal fractures. We reviewed and examined the 36 patients of nasal fractures 2months postoperative. The results were 28cases of male and 8cases of female. The highest age frequency was in the fourth decades group. The most frequent causes of injury were falling down and fist trauma. The 25(69%) patients were found to have septal fractures, after computed tomography findings. The treatment methods of nasal fracture were closed reduction(13cases), open reduction(20cases), ORIF(1case), non operation(2cases). Complications of nasal deformity were found in 2patients. Septoplasty was performed on 21 patients. Septal fractures in combination with nasal fracture are usually unrecognized and untreated at the time of injury, usually ended in nasal deformities. It is important to find out the exact type of nasal fractures. We will report the results of treatment of nasal fractures with a literature review.

• 대한두개안면성형외과학회지
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• 제23권1호
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• pp.29-33
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• 2022

Background: There have been many reports of nasal bone fractures in adults, but there are few clinical reports of them in adolescents, although adolescence is the main growth period of the nasal bone. In addition, previous studies have tended to classify and describe child and adolescent nasal fractures in the same category. The aim of this study was to identify the clinical aspects of nasal fractures in adolescents, and to evaluate the characteristics of nasal fractures in the growth period. Methods: Our institution's database was reviewed to extract data on adolescent patients between the age of 13 to 18 who had isolated nasal bone fractures from March 2012 to February 2020. The study excluded patients with other facial fractures, previous facial fractures, or congenital deformities. Results: This study included 243 boys and 26 girls. Interpersonal violence and sports-related accidents accounted for 85 and 79 cases, respectively. There were 128 frontal impact injuries and 132 lateral impact injuries, and 97 patients had accompanying septal fractures. An accompanying septal fracture was present in 36.06% of all patients, but in 51.20% of those who underwent surgery. Conclusion: The prevalence of adolescent nasal fractures was significantly higher in boys, to a greater extent than observed for pediatric or adult fractures. The main causes of fractures were interpersonal violence and sports-related accidents. An explanation for these results is that adolescent boys are more prone to have violent accidents or companionship with active sports than other age or sex groups, leading to substantially more fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권3호
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• pp.207-213
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• 1998

Purpose : This study attempted to relate the incidence of fractures at the mandibular angle with the presence and state of eruption of lower third molars, and to find out the real risk factors for angle fractures in the states of lower third molars. Materials and Methods : Medical records and radiographs of 395 patients with mandibular fractures were retrospectively reviewed. The presence and states of third molars were assessed for each patients and related to the occurrence of angle and other mandibular fractures. Results : Of 395 patients with mandibular fractures, 142 had angle fractures. The incidence of angle fractures was found to be significantly greater when partial erupted lower third molars were present and it had a definite role for risk factors for angle fractures. But there were no clear relationship between the incidence of angle fracrtures and states of without, fully erupted lower third molars. Furthermore, the states of patial and unerupted lower third molar had an effect on bony segment displacement. Conclusions : This study provides clinical evidence to suggest that patial erupted third molar teeth weaken the mandibular angle both quantitatively and qualitatively.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권6호
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• pp.302-308
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• 2019

Fractures of the styloid process of the temporal bone may occur with or without an obvious relation to trauma. The incidence of either isolated styloid process fracture or in combination with mandibular fractures is rare, and such occurrences are often misdiagnosed or neglected. A fractured styloid when displaced may impinge on adjacent vital structures, leading to neurological or vascular symptoms that vary according to the anatomical structure compressed. Styloid process fractures associated with atlas/C1 fractures have also been rarely reported in the literature. In this review of literature, the majority of patients was treated conservatively, as few demonstrated the necessity of surgical intervention. There is a definitive need for a protocol to recognize and classify styloid fractures to plan for further treatment. The aim of this review was to achieve a comprehensive understanding of all types of styloid fractures, determine the clinical severity of symptoms, and to consider management and prognosis. In addition, a new classification of cervico-stylo-mandibular fractures is proposed based on important evidence in the literature regarding clinical and radiographic factors that might influence the treatment and prognosis of such fractures.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.150-158
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• 2006

Purpose: There are two theories about the relationships between facial fractures and cranial injuries. One is that facial bones act as a protective cushion for the brain, and the other is that facial fractures are the marker for increased risk of cranial injury. They have been debated on for many years. The purpose of this study is to identify the relationship between facial fractures and cranial injuries. Methods: A retrospective study was performed on 242 patients with facial fractures. The data were analyzed based on the medical records of the patients: age, gender, cause of injury, Injury Severity Score (ISS), alcohol intake, type of facial fractures, and type of cranial injury. The patients were divided into two groups: facial fractures with cranial injury and facial fractures without cranial injury. We compared the general characteristics between the two groups and evaluated the relationship between each type of facial fracture and each type of cranial injury. Results: Among the 242 patients with facial bone fractures, 96 (39.7%) patients had a combination of facial fractures and cranial injuries. Gender predilection was demonstrated to favor males: the ratio was 3:1. The mean age was $36.51{\pm}19.63$. As to the injury mechanism, traffic accidents (in car, out of car, motorcycle) were statistically significant in the group of facial fractures with cranial injury (p=0.038, p=0.000, p=0.003). The ISS was significant, but alcohol intake was not significant. No significant relationship between facial fractures and skull fractures was found. Only maxilla fractures, zygoma fractures, and cerebral concussion had a significant difference in cranial injury (p=0.039, p=0.025). Conclusion: There is a no correlation between facial fractures and skull fractures, which suggests that the cushion effect is the predominent relationship between facial fractures and cranial injuries.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.21-31
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• 1989

This is a series of continuing research on facial bone fractures of Koreans worked by Dept. of Oral and Maxillofacial surgery, Dental College of Yonsei University, Seoul, Korea, since 1972. The study was based on a series of 630 patients with facial bone fractures treated as in-patient at Yonsei Medical Center, Yonsei University, during the period of Jan., 1982 through Dec., 1987. The results obtained are as follows: 1. The ratio of Men to Women was 4.3 : 1, and admissions for facial bone fractures have been increased year after 1984. 2. The age frequency was highest in the third decade(38.3%), and fourth, second, fifth decade in orders. 3. The traffic accident was the most frequent cause of facial bone fractures (51.3%). 4. The most common location of facial bone fractures was the Mandible(35.3%), and Zygoma complex(29.8%), Nasal bone(15.0%), Maxilla(11.0%) were next in order of frequency. 5. In 291 patients of Mandible fractures, 226(77.7%) had fractures only in Mandible and 65(22.3%) had another facial bone fractures. The most frequent fracture site of Mandible was the Symphysis(43.0%) and Angle(22.4%), and Simple fracture was the most frequent in type of fracture(66.9%). Intermaxillary fixatin & Open reduction was major method of treatment(36.9%). 6. In 394 patients of Midface fractures 323)82.0%) had fractures only in Midface and 71(18.0%) had another facial bone fractures. The most frequent site of Midface fractures was zygoma complex & zygomatic arch(42.7%), and Simple fracture was the most common type of fractures. Observation(Maxilla :44.2%, Zygoma :51.0%) and Open Reduction(Maxilla :20.0%. Zygoma :23.5%) were the major method of treatment. 7. The frequency of Nasal bone fracture was about 1/5 of Midface fractures, and Closed Reduction(45.2%) was the major method of treatment. 8. The complication was reported in only 16 patients, and Malunion was the major complication. 9. Head(44.4%), Lower extrimities(14.5%) and Eye(12.3%) were injured commonly with facial bone fractures. 10. The elapsed time from injury to hospital was within 24 hours in 73.8% of patients, however 15.5% of patients arrived the hospital 72 hours after injury.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.41-49
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• 1989

This is a retrospective study on facial bone fractures of Koreans. This study was based on a series of 110 patients who had been treated for facial bone fractures as in-patient at Guro Hospital, School of Medicine, Korea University for the period of September, 1984. to August, 1988. The results were obtained as follows : 1. 2nd decade(42.7%) was the highest age group in incidence, and age range was 2 years to 72 years, and the ration of Male/Female was 3.7 : 1. 2. Falling was most frequent cause of facial bone fractures(40.9%) 3. The frequent location of facial bone fractures were mandibule(67.1%), zygoma & zygomatic arch(11.7%), maxilla(10.9%), and others in order. 4. In mandibular fractures, one site fractures showed 30.1% and two site fractures showed 58.8% and triple site fractures showed 11.1%. The most frequent site of mandibular fracture was symphysis(32.7%) 5. The most frequent month of facial bone fracture was September.