مجله جهانی جراحی پلاستیک
مجله جهانی جراحی پلاستیک
دوشنبه 10 آذر 1404
[Archive]
چکیده: (627 مشاهده)
Background: Maxillofacial trauma presents unique airway management challenges due to anatomical disruptions, soft tissue compromise, edema, hemorrhage, and emesis. While isolated mandibular fractures are typically non-emergent, specific fracture patterns can precipitate airway obstruction secondary to bony fragment displacement. There is a paucity of data on airway changes after unilateral mandibular fractures. This prompted us to conduct the present study.
Methods: This prospective, quasi-experimental study enrolled patients with isolated unilateral mandibular fractures requiring surgical reduction between December 2023 and December 2024. Airway changes were assessed via lateral cephalometric analysis pre-operatively and at a 3-month post-operative interval. Specifically, the distances of the posterior nasal spine (PSP), the intersection of the inferior border of the mandible with the posterior tongue (PTO), and the highest point of the epiglottis (E) from the PRL reference line (a vertical line connecting the Porion (PO) to the Frankfort plane) were measured and compared on pre- and post-operative cephalometric radiographs. Descriptive and bivariate statistics were employed, with statistical significance defined as P < 0.05.
Results: Twenty eight patients, including 18 males and 10 females with a mean age of 34.4± 14.1 years, were investigated. Post-treatment, the average airway space increased slightly at all measured points: PSP (23.6 mm to 23.8 mm, P=0.222), PTO (22.0 mm to 22.1 mm, P=0.366), and E (12.6 mm to 12.9 mm, P=0.590).
Conclusion: Although slight increases in airway space were observed post-treatment at all measured points (PSP, PTO, and E), none of these changes were statistically significant.
Methods: This prospective, quasi-experimental study enrolled patients with isolated unilateral mandibular fractures requiring surgical reduction between December 2023 and December 2024. Airway changes were assessed via lateral cephalometric analysis pre-operatively and at a 3-month post-operative interval. Specifically, the distances of the posterior nasal spine (PSP), the intersection of the inferior border of the mandible with the posterior tongue (PTO), and the highest point of the epiglottis (E) from the PRL reference line (a vertical line connecting the Porion (PO) to the Frankfort plane) were measured and compared on pre- and post-operative cephalometric radiographs. Descriptive and bivariate statistics were employed, with statistical significance defined as P < 0.05.
Results: Twenty eight patients, including 18 males and 10 females with a mean age of 34.4± 14.1 years, were investigated. Post-treatment, the average airway space increased slightly at all measured points: PSP (23.6 mm to 23.8 mm, P=0.222), PTO (22.0 mm to 22.1 mm, P=0.366), and E (12.6 mm to 12.9 mm, P=0.590).
Conclusion: Although slight increases in airway space were observed post-treatment at all measured points (PSP, PTO, and E), none of these changes were statistically significant.
فهرست منابع
1. Goh EZ, Beech N, Johnson NR. Traumatic maxillofacial and brain injuries: a systematic review. Int J Oral Maxillofac Surg 2021 Aug;50(8):1027-33. [DOI:10.1016/j.ijom.2020.12.003]
2. AlGhamdi S, Alasmari FS, Alarjani MB, et al. Association between maxillofacial fractures and brain injuries in trauma patients: a cross-sectional study in the Kingdom of Saudi Arabia. Pan Afr Med J 2022;43:193. [DOI:10.11604/pamj.2022.43.193.36283]
3. Tselnik M, Pogrel MA. Assessment of the pharyngeal airway space after mandibular setback surgery. J Oral Maxillofac Surg 2000 Mar;58(3):282-5; discussion 5-7. [DOI:10.1016/S0278-2391(00)90053-3]
4. Galvagno SM, Jr., Nahmias JT, Young DA. Advanced Trauma Life Support(®) Update 2019: Management and Applications for Adults and Special Populations. Anesthesiol Clin 2019 Mar;37(1):13-32. [DOI:10.1016/j.anclin.2018.09.009]
5. Assiri ZA, Salma REG, Almajid EA, Alfadhel AK. Retrospective radiological evaluation to study the prevalence and pattern of maxillofacial fracture among Military personal at Prince Sultan Military Medical City [PSMMC], Riyadh: An institutional study. Saudi Dent J 2020 Jul;32(5):242-9. [DOI:10.1016/j.sdentj.2019.09.005]
6. Alassaf MS, Khan HK, Habib OA, Aboalkhair AE, Albeshir HA, Samman MM. Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study. Cureus 2023 Oct;15(10):e47081. [DOI:10.7759/cureus.47081]
7. Papadiochos I, Goutzanis L, Petsinis V. Flail Mandible and Immediate Airway Management: Traumatic Detachment of Mandibular Lingual Cortex Results in Obstructive Dyspnea and Severe Odynophagia. J Craniofac Surg 2017 Jul;28(5):1311-4. [DOI:10.1097/SCS.0000000000003706]
8. Farzan R, Farzan A, Farzan A, Karimpour M, Tolouie M. A 6-Year Epidemiological Study of Mandibular Fractures in Traumatic Patients in North of Iran: Review of 463 Patients. World J Plast Surg 2021 Jan;10(1):71-7. [DOI:10.29252/wjps.10.1.71]
9. Barak M, Bahouth H, Leiser Y, Abu El-Naaj I. Airway Management of the Patient with Maxillofacial Trauma: Review of the Literature and Suggested Clinical Approach. Biomed Res Int 2015;2015:724032. [DOI:10.1155/2015/724032]
10. Le TT, Oleck NC, Khan W, et al. Implications of Facial Fracture in Airway Management of the Adult Population: What Is the Most Effective Management Strategy? Ann Plast Surg 2019 Apr;82(4S Suppl 3):S179-s84. [DOI:10.1097/SAP.0000000000001883]
11. Famurewa BA, Oginni FO, Aregbesola SB, Erhabor GE. Pulmonary functions of patients with isolated mandibular fractures: a preliminary report. J Korean Assoc Oral Maxillofac Surg 2020 Feb;46(1):36-40. [DOI:10.5125/jkaoms.2020.46.1.36]
12. Samman M, Ahmed SW, Beshir H, Almohammadi T, Patil SR. Incidence and Pattern of Mandible Fractures in the Madinah Region: A Retrospective Study. J Nat Sci Biol Med 2018 Jan-Jun;9(1):59-64. [DOI:10.4103/jnsbm.JNSBM_60_17]
13. Bormann KH, Wild S, Gellrich NC, et al. Five-year retrospective study of mandibular fractures in Freiburg, Germany: incidence, etiology, treatment, and complications. J Oral Maxillofac Surg 2009 Jun;67(6):1251-5. [DOI:10.1016/j.joms.2008.09.022]
14. Alqahtani F, Bishawi K, Jaber M. Analysis of the pattern of maxillofacial injuries in Saudi Arabia: A systematic review. Saudi Dent J 2020 Feb;32(2):61-7. [DOI:10.1016/j.sdentj.2019.08.008]
15. Tung TC, Tseng WS, Chen CT, Lai JP, Chen YR. Acute life-threatening injuries in facial fracture patients: a review of 1,025 patients. J Trauma 2000 Sep;49(3):420-4. [DOI:10.1097/00005373-200009000-00006]
16. Pyfer BJ, Cason RW, Mundy L, Powers DB, Erdmann D. Acute Airway Compromise After Isolated Mandibular Subcondyle Fracture in a Patient With a Hemi-Mandible: A Case Report. Craniomaxillofacial Trauma & Reconstruction Open 2021 2021/01/01;6:24727512211035254. [DOI:10.1177/24727512211035254]
17. Chen LJ, Zhao MC, Pan XF, Wei YQ, Wang DY. X-cephalometric study of different parts of the upper airway space and changes in hyoid position following mandibular fractures. West Indian Med J 2013 Sep;62(7):642-8. [DOI:10.7727/wimj.2013.028]
18. Hochban W, Schürmann R, Brandenburg U, Conradt R. Mandibular setback for surgical correction of mandibular hyperplasia--does it provoke sleep-related breathing disorders? Int J Oral Maxillofac Surg 1996 Oct;25(5):333-8. [DOI:10.1016/S0901-5027(06)80024-X]
19. Schilbred Eriksen E, Gulati S, Moen K, Wisth PJ, Løes S. Apnea-Hypopnea Index in Healthy Class III Patients Treated With Intraoral Vertical Ramus Osteotomy: A Prospective Cohort Study. J Oral Maxillofac Surg 2019 Mar;77(3):582-90. [DOI:10.1016/j.joms.2018.07.017]
20. Demetriades N, Chang DJ, Laskarides C, Papageorge M. Effects of mandibular retropositioning, with or without maxillary advancement, on the oro-naso-pharyngeal airway and development of sleep-related breathing disorders. J Oral Maxillofac Surg 2010 Oct;68(10):2431-6. [DOI:10.1016/j.joms.2010.02.033]
21. Kitagawara K, Kobayashi T, Goto H, Yokobayashi T, Kitamura N, Saito C. Effects of mandibular setback surgery on oropharyngeal airway and arterial oxygen saturation. Int J Oral Maxillofac Surg 2008 Apr;37(4):328-33. [DOI:10.1016/j.ijom.2007.12.005]
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