Introduction: The treatment of panfacial fractures is complex and constitutes a challenge for the maxillofacial surgeon, who, despite therapeutic progress, frequently suffers functional and aesthetic sequelae. This st...Introduction: The treatment of panfacial fractures is complex and constitutes a challenge for the maxillofacial surgeon, who, despite therapeutic progress, frequently suffers functional and aesthetic sequelae. This study aimed to describe the treatment and evaluate the functional and aesthetic sequelae of panfacial fractures in the stomatology and maxillofacial surgery department of the Treichville University Hospital. Materials and Methods: We conducted a retrospective study over a 6 years in the stomatology and maxillofacial surgery department of Treichville University Hospital. Forty-two patients with panfacial fractures were included in the study. Results: Forty-two patients were registered. The average time to osteosynthesis was 12.4 days. Nasotracheal intubation was used most often (88%), and in the majority of cases, mixed osteosynthesis combining a screwed plate and steel wire was performed (64.29%). The “Bottom-up and Outside-in” surgical sequence was the most commonly used (64.29%). All patients had at least one functional and/or cosmetic sequela after treatment. Functional sequelae were dominated by occlusal problems and aesthetic sequelae by nasal deformities. Discussion: Panfacial fractures are characterised by their complexity, presenting maxillo-facial surgeons with a therapeutic and evolutionary challenge. The quality of the initial, often multidisciplinary, management of panfacial fractures is an essential factor in both functional and aesthetic prognosis. Conclusion: The treatment of panfacial fractures, even if well managed, is sometimes a source of sequelae, requiring often complex secondary management.展开更多
This editorial commentary critically examines the systematic review by Miotti et al,which discusses the evolving trends in upper lid blepharoplasty towards a conservative,volume-preserving approach.The review emphasiz...This editorial commentary critically examines the systematic review by Miotti et al,which discusses the evolving trends in upper lid blepharoplasty towards a conservative,volume-preserving approach.The review emphasizes the shift from traditional tissue resection to techniques that maintain anatomical integrity,paralleling broader trends in panfacial rejuvenation.Miotti et al delve into the nuances of fat pad management,advocating for conservation over reduction to sustain natural contours and improve long-term aesthetic outcomes.This perspective is supported by comparative studies and empirical data,such as those from Massry and Alghoul et al,highlighting the benefits of conservative approaches in terms of patient satisfaction and aesthetic longevity.The review also stresses the importance of surgeon discretion in adapting procedures to diverse patient demographics,particularly in addressing distinct features such as the Asian upper eyelid.However,it identifies a significant gap in long-term comparative research,underscoring the need for future studies to substantiate the safety and efficacy of these minimalist techniques.Overall,Miotti et al.'s work contributes profoundly to the discourse on personalized,conservative cosmetic surgery,urging ongoing research to refine and validate surgical best practices in upper eyelid blepharoplasty.展开更多
Purpose: The aim of this retrospective study was to analyze the characteristics of panfacial fractures and evaluate treatment results at the Maxillofacial, Stomatology and plastic surgery department at the AVICENNE mi...Purpose: The aim of this retrospective study was to analyze the characteristics of panfacial fractures and evaluate treatment results at the Maxillofacial, Stomatology and plastic surgery department at the AVICENNE military hospital over a period of 5 years. Patients and Methods: Forty eight patients with panfacial fractures were treated in Maxillofacial, stomatology and plastic surgery department of the AVICENNE Military Teaching Hospital between 2012 and 2017. The criteria for inclusion in the study were patients who had fractures of at least three of the four axial segments of the facial skeleton: frontal, upper midface, lower midface, and mandible. Results: 48 patients with panfacial fractures had a total of 116 subtypes of facial bone fractures. A total of seventeen (14.6%) LeFort II fractures in 16 (33.4%) patients were recorded, fifteen LeFort I fractures were recorded in 3 (6.2%) cases;seven (6%) LeFort III fractures were recorded in 5 (10.4%) cases, thirteen (11.2%) fractures of the NOF complex were recorded in 6 (12.5%) patients;sixteen (33.4%) patients had thirty eight (32.7%) fractures involving the mandible. Ten (8.6%) NOM (naso-orbito-maxilla) complex fractures occurred in 9 (18.7%) cases. 5 (10.4%) patients had a total of five (4.3%) CNEMFO (naso-ethmoido-maxillo-fronto-orbital) complex fractures. Our case series included five Comminuted premaxillary fractures and six Intermaxillary disjunctions. All 48 cases had facial deformities and thirty six had malocclusions. The treatment plan to reduce and fix the facial bone fractures was sequenced “Bottom up, Outside in”. Postoperative complications were reported, there were 5 cases whose malocclusions, 4 cases of zygomatic non-union or partial defects, 13 had enophthalmos and hypoglobus. Seven had scars from the trauma, 2 had lower eyelid ectropion, and 2 had temporal muscle atrophy. Conclusion: Panfacial fractures seem to be complex and difficult to treat, but with an organized and flexible approach, appropriate reduction of fractures is accomplishable, yet post-surgical complications mainly caused by soft tissue problems, including lacerations and asymmetries, can’t be easily avoided.展开更多
文摘Introduction: The treatment of panfacial fractures is complex and constitutes a challenge for the maxillofacial surgeon, who, despite therapeutic progress, frequently suffers functional and aesthetic sequelae. This study aimed to describe the treatment and evaluate the functional and aesthetic sequelae of panfacial fractures in the stomatology and maxillofacial surgery department of the Treichville University Hospital. Materials and Methods: We conducted a retrospective study over a 6 years in the stomatology and maxillofacial surgery department of Treichville University Hospital. Forty-two patients with panfacial fractures were included in the study. Results: Forty-two patients were registered. The average time to osteosynthesis was 12.4 days. Nasotracheal intubation was used most often (88%), and in the majority of cases, mixed osteosynthesis combining a screwed plate and steel wire was performed (64.29%). The “Bottom-up and Outside-in” surgical sequence was the most commonly used (64.29%). All patients had at least one functional and/or cosmetic sequela after treatment. Functional sequelae were dominated by occlusal problems and aesthetic sequelae by nasal deformities. Discussion: Panfacial fractures are characterised by their complexity, presenting maxillo-facial surgeons with a therapeutic and evolutionary challenge. The quality of the initial, often multidisciplinary, management of panfacial fractures is an essential factor in both functional and aesthetic prognosis. Conclusion: The treatment of panfacial fractures, even if well managed, is sometimes a source of sequelae, requiring often complex secondary management.
文摘This editorial commentary critically examines the systematic review by Miotti et al,which discusses the evolving trends in upper lid blepharoplasty towards a conservative,volume-preserving approach.The review emphasizes the shift from traditional tissue resection to techniques that maintain anatomical integrity,paralleling broader trends in panfacial rejuvenation.Miotti et al delve into the nuances of fat pad management,advocating for conservation over reduction to sustain natural contours and improve long-term aesthetic outcomes.This perspective is supported by comparative studies and empirical data,such as those from Massry and Alghoul et al,highlighting the benefits of conservative approaches in terms of patient satisfaction and aesthetic longevity.The review also stresses the importance of surgeon discretion in adapting procedures to diverse patient demographics,particularly in addressing distinct features such as the Asian upper eyelid.However,it identifies a significant gap in long-term comparative research,underscoring the need for future studies to substantiate the safety and efficacy of these minimalist techniques.Overall,Miotti et al.'s work contributes profoundly to the discourse on personalized,conservative cosmetic surgery,urging ongoing research to refine and validate surgical best practices in upper eyelid blepharoplasty.
文摘Purpose: The aim of this retrospective study was to analyze the characteristics of panfacial fractures and evaluate treatment results at the Maxillofacial, Stomatology and plastic surgery department at the AVICENNE military hospital over a period of 5 years. Patients and Methods: Forty eight patients with panfacial fractures were treated in Maxillofacial, stomatology and plastic surgery department of the AVICENNE Military Teaching Hospital between 2012 and 2017. The criteria for inclusion in the study were patients who had fractures of at least three of the four axial segments of the facial skeleton: frontal, upper midface, lower midface, and mandible. Results: 48 patients with panfacial fractures had a total of 116 subtypes of facial bone fractures. A total of seventeen (14.6%) LeFort II fractures in 16 (33.4%) patients were recorded, fifteen LeFort I fractures were recorded in 3 (6.2%) cases;seven (6%) LeFort III fractures were recorded in 5 (10.4%) cases, thirteen (11.2%) fractures of the NOF complex were recorded in 6 (12.5%) patients;sixteen (33.4%) patients had thirty eight (32.7%) fractures involving the mandible. Ten (8.6%) NOM (naso-orbito-maxilla) complex fractures occurred in 9 (18.7%) cases. 5 (10.4%) patients had a total of five (4.3%) CNEMFO (naso-ethmoido-maxillo-fronto-orbital) complex fractures. Our case series included five Comminuted premaxillary fractures and six Intermaxillary disjunctions. All 48 cases had facial deformities and thirty six had malocclusions. The treatment plan to reduce and fix the facial bone fractures was sequenced “Bottom up, Outside in”. Postoperative complications were reported, there were 5 cases whose malocclusions, 4 cases of zygomatic non-union or partial defects, 13 had enophthalmos and hypoglobus. Seven had scars from the trauma, 2 had lower eyelid ectropion, and 2 had temporal muscle atrophy. Conclusion: Panfacial fractures seem to be complex and difficult to treat, but with an organized and flexible approach, appropriate reduction of fractures is accomplishable, yet post-surgical complications mainly caused by soft tissue problems, including lacerations and asymmetries, can’t be easily avoided.
