OBJECTIVEThe treatment of frontobasilar fractures is a demanding aspect of craniofacial fracture management. A sequel of inadequate or improper fracture management presents cosmetic and functional problems which are very difficult to correct. The aim of this manuscript was to examine a group of growing patients treated for frontobasilar fractures and provide clinicians a possible therapeutic option for the treatment of these challenging fractures.

METHODSIn this investigation, 12 patients under the age of 16 years treated for severe injuries to the frontobasilar region were included. Their records were reviewed to evaluate the clinical diagnosis, preoperative findings, hospital course, postoperative results, and long-term follow-up. Preoperative and postoperative CT scans were performed in all children treated. Postoperative complications were reviewed in detail. Surgical procedures were evaluated for type and location of fixation. All complications and treatments were recorded.

RESULTSThree of the patients presented with a cerebrospinal fluid (CSF) leak and required pericranial flaps. Only 3 patients underwent removal of plates and screws due to palpability in 1 patient, loose hardware in 1 patient, and limited disturbance on growth in the rest patient. Seven patients underwent open reduction and internal fixation with resorbable plates, 4 patients with titanium plates, and 1 patient with a combination. Follow-up ranged from 6 months to 5 years. No patients with a preoperative CSF leak developed any recurrence of the leak.

CONCLUSIONAccording to basic craniofacial principles, reducing and stabilizing the fractures should reconstruct the anterior cranial base. However, the treatment of paediatric maxillofacial trauma requires the evaluation of several factors. The facial skeleton of a child is constantly evolving and its growth depends on the balance of basal bone and soft tissues.

Adolescent ; Child ; Device Removal ; Female ; Fracture Fixation, Internal ; methods ; Frontal Bone ; diagnostic imaging ; injuries ; Humans ; Internal Fixators ; Male ; Postoperative Complications ; diagnostic imaging ; Skull Fractures ; diagnostic imaging ; etiology ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

Purpose::Dental and orofacial trauma among the adult population constitutes a major public health problem. The impact is not just physical but also psychological. To analyse the impacts of dental and orofacial trauma on oral health-related quality of life (OHRQoL) in adults and determine whether the 2 variables are closely interlinked.Methods::This is a systematic review. The terms "dental trauma", "orofacial trauma", "oral health", "oral health related impact life", "OHRQoL", "positive and negative affect scale", "quality of life", "facial injuries", "adults", and "young adults" were researched in the databases of PubMed, ScienceDirect, Scopus and Google Scholar for associated studies up to December 30, 2022. A comprehensive search was designed and the articles were independently screened for eligibility by 2 reviewers. The included studies’ author, year of publication, the country where the study was conducted, population demographics (number and age), an instrument used for assessing OHRQoL and the relevant result were recorded and compared. The quality of the evidence was assessed using Joanna Briggs Institute checklist for observational studies.Results::Out of 482 unique records, 3 articles were included for data extraction. Observational studies were included. Two studies did not mention confounding factors. Different scales were used for dental and orofacial trauma and OHRQoL. OHRQoL has a directly proportional relationship with orofacial trauma. Adolescents with orofacial trauma have a significant impact on this value with a prevalence of 88.4%.Conclusion::The highest impact on OHRQoL was seen immediately after the diagnosis of an orofacial trauma. The impact increases with the severity of the trauma. Therefore, to promote overall dental and general health, health education initiatives should include information on the causes, prevention, and requirement for prompt responses by the populace in seeking dental intervention.