OBJECTIVES: The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. MATERIALS AND METHODS: A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. RESULTS: The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. CONCLUSION: This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures.
Adolescent ; Facial Bones ; Facial Injuries ; Female ; Hospitalization ; Human Body ; Humans ; Incidence ; Male ; Malocclusion ; Mandible ; Mandibular Condyle ; Maxillofacial Injuries ; Nasal Bone ; Orbit ; Postoperative Complications ; Retrospective Studies* ; Seoul ; Zygoma

Maxillary and mandibular fractures account for a large proportion of facial bone fractures. The primary objective in reduction of marillary or mandibular fractures is to return the structures to normal position of function and cosmetic contour, i.e. restoration of normal occlusal relations through proper positioning of the teeth and bony structures. Interdental wiring, intermaxillary fixation, rigid internal fixation or external pin fixation are common methods in the management of jaw fractures, varying with the age of the patient, location or extent of fracture. Malocclusion is not an uncommon complication after management of jaw pacture. We managed 16 patients (13 males, 3 females) of mandibular or maxillary fractures with model surgery and occlusal splint from July 1998 to August 1999. The average age of patients was 27.4 years and the average follow-up period was 6 months. We achieved good occlusal relationship without malunion, nonunion, or loss of teeth. Acrylic occlusal splints are rigid, strong, easily adjusted and repaired, translucent, lightweight and tolerated well by the oral mucosa. It is useful in the maintenance of intermaxillary fixation and in maintaining continuity of the maxillary or mandibular dental arch, as well as providing precise dental alignment during healing. Splints are helpful in managing fractures of the symphysis, parasymphyseal region, body and alveolar ridges of the mandible, sagittal fractures of the hard palate, and severely comminuted mandible fractures.
Body Regions ; Dental Arch ; Facial Bones ; Follow-Up Studies ; Humans ; Jaw ; Jaw Fractures ; Male ; Malocclusion ; Mandible ; Mandibular Fractures* ; Maxillary Fractures ; Mouth Mucosa ; Occlusal Splints* ; Palate, Hard ; Splints ; Tooth

PURPOSE: This is to review the complicated jaw fractures that had been referred for revision of the unsatisfactory results, and to provide proper managements for the easily complicated jaw fractures. MATERIALS AND METHODS: Twenty-nine patients who had been revised due to malunion or complicated fractures of facial bones for last 3 years were reviewed. The main problems required for revision, type of fractures complicated, the primary managements to be reclaimed, the specialties to be involved, the management to be reclaimed, time elapsed to seek reoperation, type of revision surgeries, residual complication were analysed with medical records, radiographs and final examinations. RESULTS: The major complaints were malocclusion(79.3%), facial disfigurement(41.3%), TMJ problems (13.7%), neurologic problems(10.3%), non-union(10.3%), and infection(6.8%). Unsatisfactory results were occurred most frequently after improper management of the multiple fractures of the mandible (62.2%), combined fractures of maxilla and mandible (20.6%), fracture of zygomatico-maxillary complex and midpalate (17.2%). The complications to be corrected were widened or collapsed dental arches (79.3%), improperly reduced condyles (41.3%), painful TMJ (34.4%), limited jaw excursion (31.0%), over-reduction of zygoma (13.7%), and nonunion with infection(13.7%). and dysesthesia (10.3%). The primary managements were nendereet by plastic surgeons in 82.7%(24/29) and by oral surgeons in 7.6%(2/29). Main causes of malunion are inadequate ORIF in 76%, unawareness & delay in 17%, and delayed due to systemic cares in 17%. 76% of 29 patients had been in state of intermaxillary fixation for over 4 weeks. Revision were done by means of "refracture and ORIF" in 48.2%(14/29), orthognathic osteotomies with bone grafts in 55.1%(16/29), and camouflage ountering & alloplastic implantations in 37.9%(11/29), TMJ surgeries in 17.2%, micro-neurosurgeries in 11.6%. Residual complications were limited mouth opening in 24.1% (7/29), paresthesia in 13.7%, resorption of reduced condyle in 10.3%. CONCLUSIONS: Failure of initial treatment of jaw fractures is due to improper diagnosis and inadequate treatment with lack of sufficient knowledge of stomatognathic system. It is crucial to judge jaw fracture and patients accurately, moreover, the best way of treatments has to be selected. Consideration of these factors in treatment could minimize the complication of jaw fractures.
Dental Arch ; Diagnosis ; Facial Bones ; Humans ; Jaw Fractures* ; Jaw* ; Mandible ; Maxilla ; Medical Records ; Mouth ; Osteotomy ; Paresthesia ; Reoperation ; Stomatognathic System ; Temporomandibular Joint ; Transplants ; Zygoma

Osseous hemangiomas are uncommon, constituting less than 1% of all osseous tumors. The most frequent sites are the calvaria and the vertebral column. Involvement of the facial bones is rare, and occurs most commonly in the maxilla, mandible, and nasal bones. In nasal cavity, only one case of inferior turbinate involvement has been reported in the English-language literature. We report two cases of osseous hemangioma of the middle turbinate diagnosed by histopathologic confirmation. Because of their infrequent appearance in the nasal cavity, vague symptoms and unknown typical radiologic findings, these tumors can be missed in many cases or may be misinterpreted as other osseous tumors.
Facial Bones ; Hemangioma ; Mandible ; Maxilla ; Nasal Bone ; Nasal Cavity ; Skull ; Spine ; Turbinates

This retrospective study comprised patiens with facial bone fractures in various accidents and treated in the department of Plastic and Reconstructive Surgery, Pildong hospital, Chung Ang university during the past 5 years from January 1994 to December 1998. The medical records of these patients (fractures) were reviewed and analysed in order to gain insight into a clinical pattern and understnad the therapeutic modalities. The following results were obtained: 1. The monthly incidence was highest in August and most common accident time was between 6:00 p.m and midnight. 2. The mean age of patients was 28.3 years, and age range was 3 to 69 years. The most prevalent age group was the third decade of life (42.9%). Males predominated more than female in the ratio of 4.1:1. 3. The most common etiology was assault (29.6%) followed by traffic accidents (28.5%), fall (23.1%), sports (7.9%). 4. 369 facial fractures in 277 patients were classifed. The most common sites were nasal bone, followed by zygoma, mandible, maxilla, orbit. 5. Associated soft tissue injuries were combined in 168 patients (60.6%), and fractures other than facial bone were developed in 61 patients (22%). 6. Treatment of facial bone fracture consisted of open reduction (42.6%), closed reduction (40.1%), and conservative treatment (17.3%). 7. The complication rate was 11.6% and the most common complication was the eye problem.
Accidents, Traffic ; Facial Bones* ; Female ; Humans ; Incidence ; Male ; Mandible ; Maxilla ; Medical Records ; Nasal Bone ; Orbit ; Plastics ; Retrospective Studies ; Soft Tissue Injuries ; Sports ; Zygoma

The traffic accident was one of most common cause for the facial bone fracture. When it involved the midfacial structures, the nasal bone fracture was usually shown. If the reduction was not done in time, it would result in facial deformity. Simple case could be corrected by simple rhinoplasty. However, severe cases would require more invasive technique. We used triangular osteotomy included the nasal bones, the vomer, and the medial wall of maxilla for the correction of post-traumatic nasal deformity and reported the result with the review of literatures.
Accidents, Traffic ; Congenital Abnormalities* ; Facial Bones ; Maxilla ; Nasal Bone ; Osteotomy* ; Rhinoplasty ; Vomer

nasal and zygoma bone are parts of frequently fracturing of facial bones because of anatomically protrusion. Of facial bone fractures, nasal bone is at the high level of incidence rate. But zygoma fracture that anatomical characteristics increase the incidence rate also is occupied considerable part of the facial bone fracture. The outline of face is decided by form of underlying skeletal structure, of that, zygoma plays an important role in. Zygoma is closely attached to surrounding anatomic structure as orbit, maxillary sinus. Aesthetic and functional disturbance are developed by zygoma fracture from trauma, complications, as facial asymmetry, trismus, sensory disturbance, epistaxis, periorbital hemorrhage, diplopia etc, are developed. The patterns of complications following displacement of fractured fragment of zygoma by trauma are slightly different.]]>
Diplopia ; Epistaxis ; Facial Asymmetry ; Facial Bones ; Hemorrhage ; Incidence ; Maxillary Sinus ; Nasal Bone ; Orbit ; Trismus ; Zygoma

PURPOSE: Palatal fracture and mandible fracture result in instability of dental arch. Because they divide the maxillary and mandibular alveolus sagittally and / or transversely and comminute the dentition, they permit rotation of dental alveolar segments and significantly increase the potential for fracture malalignment, complicating fracture treatment. Previous treatment of palatal fracture consisted of palatal splint application and rigid palatal vault stabilization. This procedure result in patient's oral discomfort and removal of palate and screw. Mandible fracture often results in malocclusion due to widening of posterior aspect of dental arch. So we introduce simpler method using intermolar traction wiring, which can protect the widening of dental arch and rotation of dental alveolar segment. METHODS: Arch bar and intermolar traction wiring with wire 1-0, or 2-0 was applied. After exposure of fracture line, neutroclusion was maintained with intermaxillary fixation. And then open reduction & internal fixation on maxillary fracture line, commonly maxillary buttress, alveolar ridge, pyriform aperture except palatal vault or mandibular fracture line. After 1 week, intermolar traction wiring was removed. We checked occlusion and postoperative radiologic finding. RESULTS: From June 2007 to October 2007, 10 patient, who have maxillary fracture with palatal fracture and mandible fracture, underwent open reduction & internal fixation with intermolar traction wiring. All have satisfactory occlusion and there were no complication, like gingiva disease, mouth opening impairment and nonunion. CONCLUSION: The intermolar traction wiring accompany open reduction and internal fixation can be an alternative method for restoration of dental arch in facial bone fracture.
Alveolar Process ; Dental Arch ; Dentition ; Facial Bones ; Gingiva ; Humans ; Malocclusion ; Mandible ; Mandibular Fractures ; Maxillary Fractures ; Mouth Diseases ; Palate ; Splints ; Traction

PURPOSE: The purpose of this study was to evaluate the causes of blow-out fractures, the computed tomography findings, and the associated facial bone fractures in aged patients. METHODS: This study was performed by conducting a chart review. From January 2004 to December 2007, the patients who visited the emergency room of Asan Medical Center and were diagnosed as having a blow-out fracture were included in the study population. Patients 60 years of age or older were grouped as the aged group while patients younger than 60 years of age were grouped as the control group. RESULTS: Between the aged group and the control group, there was a difference in the causes of blow-out fractures. The most common cause of blow-out fracture was a slip down in the aged group and violence in the control group (p<0.05). There were no differences in associated symptoms. Extraocular muscle herniation was the only statistically different computed tomography findings. In associated facial bone fractures, the most common fractures were the zygoma in the aged group and the nasal bone in the control group (p<0.05). CONCLUSION: In patients 60 years of age or older, the most common cause of blow-out fracture was a slip down, and the most common associated facial bone fracture was a zygomatic fracture.
Aged ; Emergencies ; Facial Bones ; Humans ; Muscles ; Nasal Bone ; Orbit ; Orbital Fractures ; Violence ; Zygoma ; Zygomatic Fractures

BACKGROUND: Among facial fractures, nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture take a large portion. Among surgical operations for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture, closed reduction has been generally used but, unlike open reduction, there is a problem in evaluating its accuracy of reduction. METHODS: An assessment was made from October 2011 until April 2013 prospectively on 37 patients. For all the operations, closed reductions were executed in a conventional way and simultaneously using C-Arm to verify the reduction of fractures. Two images of plain radiography, one taken before operation and another one taken one day after the operation, were compared. After obtaining images of plain radiography using C-Arm immediately after the correction upon operation, they were compared with the images of plain radiography taken one day after the operation. RESULTS: The fracture reductions of 26 patients among 27 nasal fracture patients were satisfactory but one patient showed a marginal overcorrection of less than 1 mm. The fracture reductions of 7 patients among 8 zygomatic arch fracture patients were satisfactory but one patient showed a marginal undercorrection of less than 2 mm. All of two mandibular subcondyle fracture patients showed less than 2 mm undercorrection. CONCLUSION: Closed reduction guided by C-Arm for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture was clinically useful because it could make a real-time assessment on fractured areas and add immediate corrections during the operation.
Facial Bones* ; Fluoroscopy* ; Fractures, Closed ; Humans ; Mandible ; Nasal Bone ; Prospective Studies ; Zygoma ; Zygomatic Fractures