A Study on Traumatic Faciomaxillary Fractures Encountered at a Tertiary Care Centre of North-Eastern India

Introduction Faciomaxillary fractures can present either as an isolated injury or as a part of polytrauma. The incidence of faciomaxillary injuries is on the incline with changing lifestyles in developing countries like India; thus posing as a major health burden. We conducted this study to aid in defining strategies to prevent and tackle the same. Materials and Methods A Prospective Observational study was conducted on all the patients admitted for traumatic faciomaxillary fractures in the Department of ENT for a period of three years. Aim of the study was to study the incidence, demography, pattern, management and postoperative complications in traumatic faciomaxillary fractures. Result Out of 499 cases who comprised our study group, the most common fracture encountered was of nasal bone(26.25%) with male predominance (86.37%), mostly scattered in the age group of 18-40 yrs (67.13%). RTA was found to be the most common cause (52.1%). Fractures of lateral third of face and mandible almost always needed an open reduction. Discussion The age and gender distribution pattern as well as the cause of faciomaxillary fractures and complications have been compared with the published reports. The central third of the facial skeleton has been found to be affected most in traumatic fractures, whereas some other studies found fracture of the mandible to be the most common. Open reduction was needed in 44.9% of patients.   Conclusion With increasing incidence of RTAs, there is a need to understand the pattern, review our management techniques and hence be able to provide appropriate and individualized management to those in need of it

Modified Radical Mastoidectomy: Open Mastoid Cavity versus Cavity Obliteration Using Periosteal Temporofascial Flap - A Comparative Study

Introduction  The surgical treatment of Chronic Otitis Media by modified radical mastoidectomy usually results in an open cavity, with chronic discharge, hearing loss of 30 to 40 dB, frequent visits to OPD for debris removal and none the less dizziness on cold air exposure. One way to deal with these issues effectively is to obliterate the mastoid cavity. In our study we used vascularised periosteo-temporofascial swing flap with medicated bone dust to obliterate the mastoid cavity. Material and Methods In this prospective study, 50 patients who suffered from chronic otitis media, active squamous (cholesteatoma) disease, and underwent modified radical mastoidectomy with tympanoplasty procedure were and split between two equally sized groups. Group 1 had patients with open mastoid cavity and Group 2 had obliteration of mastoid cavity using vascularised periosteo-temporofascial swing flap with medicated bone dust. Patients were followed at  3rd week, 6th week, 3rd month and 6th month. Results  Patients with cavity obliteration had better and statistically significant outcomes in term of discharge status of cavity and epithelization at 3 weeks. Patients with obliteration also had positive and statistically significant results in hearing levels and hearing gain at 6 months follow up. Conclusion  Mastoid cavity obliteration with vascularised periosteo-temporofascial swing flap with medicated bone dust is a good and effective method for better post-operative outcomes and curtailing dependency on doctors for cavity care

A Study on Traumatic Faciomaxillary Fractures Encountered at a Tertiary Care Centre of North-Eastern India

Introduction Faciomaxillary fractures can present either as an isolated injury or as a part of polytrauma. The incidence of faciomaxillary injuries is on the incline with changing lifestyles in developing countries like India; thus posing as a major health burden. We conducted this study to aid in defining strategies to prevent and tackle the same. Materials and Methods A Prospective Observational study was conducted on all the patients admitted for traumatic faciomaxillary fractures in the Department of ENT for a period of three years. Aim of the study was to study the incidence, demography, pattern, management and postoperative complications in traumatic faciomaxillary fractures. Result Out of 499 cases who comprised our study group, the most common fracture encountered was of nasal bone(26.25%) with male predominance (86.37%), mostly scattered in the age group of 18-40 yrs (67.13%). RTA was found to be the most common cause (52.1%). Fractures of lateral third of face and mandible almost always needed an open reduction. Discussion The age and gender distribution pattern as well as the cause of faciomaxillary fractures and complications have been compared with the published reports. The central third of the facial skeleton has been found to be affected most in traumatic fractures, whereas some other studies found fracture of the mandible to be the most common. Open reduction was needed in 44.9% of patients.   Conclusion With increasing incidence of RTAs, there is a need to understand the pattern, review our management techniques and hence be able to provide appropriate and individualized management to those in need of it