Fractures of the Mandibular Condyle.

There exists no consensus "gold standard" treatment for condylar fractures, and there is continued debate on whether condylar fractures should undergo surgical or conservative management. Herein, we review various techniques of conservative, closed, and open surgical treatments of condylar fractures. Also, we review complications associated with each treatment modality and compare and contrast closed and open management.

Skull Base Trauma: Clinical Considerations in Evaluation and Diagnosis and Review of Management Techniques and Surgical Approaches.

Traumatic injuries to the skull base can involve critical neurovascular structures and present with symptoms and signs that must be recognized by physicians tasked with management of trauma patients. This article provides a review of skull base anatomy and outlines demographic features in skull base trauma. The manifestations of various skull base injuries, including CSF leaks, facial paralysis, anosmia, and cranial nerve injury, are discussed, as are appropriate diagnostic and radiographic testing in patients with such injuries.

Current Management of Subcondylar Fractures of the Mandible, Including Endoscopic Repair.

Treatment of subcondylar fractures has been the subject of debate for many years. Options for treatment include physical therapy, elastic maxillomandibular fixation, and open repair. Proper imaging and clinical evaluation are imperative when deciding on the best management option.

Controversies in the Management of the Trauma Patient.

Facial trauma is a significant cause of morbidity in the United States. Despite the large volume of trauma surgeries at most academic institutions, there is still controversy regarding management of many traumatic injuries. The literature lacks clear-cut best practices for most fractures.

Incidence of Concussion in Patients With Isolated Mandible Fractures.

Importance: This study examines the association between isolated mandible fractures and mild traumatic brain injury (mTBI).

Objective: To determine the rates of mTBI in patients who have sustained isolated mandible fractures.

Design, Setting, And Participants: A prospective study was conducted among patients who sustained isolated mandible fractures within 24 hours of presentation.

Decade review of mandible fractures and arch bar impact on outcomes of nonsubcondylar fractures.

Objectives/hypothesis: Review trends in mandible fracture management and outcomes in patients treated with and without intraoperative arch bar use.

Study Design: Retrospective chart review.

Methods: All patients with mandible fractures between October 1, 2001, and October 1, 2011, were reviewed.

Combined Transzygomatic and Pterional Approach for Resection of a Dermoid Cyst of the Foreman Ovale.

Dermoid cysts are rare, benign intracranial lesions commonly located in the posterior fossa. We describe a uniquely located dermoid cyst in the foreman ovale resected via a combined pterional and transzygomatic approach.

The Comprehensive AOCMF Classification System: Fracture Case Collection, Diagnostic Imaging Work Up, AOCOIAC Iconography and Coding.

The AO classification system for fractures in the adult craniomaxillofacial (CMF) skeleton is organized in anatomic modules in a 3 precision-level hierarchy with account for an increasing complexity and details. Level-1 is most elementary and identifies no more than the presence of fractures in 4 separate anatomical units: the mandible (code 91), midface (92), skull base (93) and cranial vault (94). Level-2 relates the detailed topographic location of the fractures within defined regions of the mandible, central and lateral midface, internal orbit, endo- and exocranial skull base, and the cranial vault.

The Comprehensive AOCMF Classification: Skull Base and Cranial Vault Fractures - Level 2 and 3 Tutorial.

The AOCMF Classification Group developed a hierarchical three-level craniomaxillofacial classification system with increasing level of complexity and details. The highest level 1 system distinguish four major anatomical units, including the mandible (code 91), midface (code 92), skull base (code 93), and cranial vault (code 94). This tutorial presents the level 2 and more detailed level 3 systems for the skull base and cranial vault units.

Pediatric craniomaxillofacial trauma.

Trauma is a leading cause of death in children. The pediatric facial skeleton goes through progressive development and major changes, including change in the size ratio of the cranium to the face; change in the ratio of facial soft tissue to bone, and pneumatization of the sinuses. The main goal of maxillofacial fracture repair is to reestablish normal or preinjury structure and function.

Radiation-induced epithelial-myoepithelial carcinoma in a patient previously treated with mantle-field radiation therapy for Hodgkin lymphoma.

Background: Radiation-induced salivary gland tumors are well described in the literature, with mucoepidermoid cancer being the most common histologic entity. Epithelial-myoepithelial carcinoma is a rare tumor accounting for <1% of all tumors in the salivary glands.

Methods And Results: We describe the first case of radiation-induced epithelial-myoepithelial carcinoma in the English-language medical literature.

Managing the frontal sinus in the endoscopic age: has the endoscope changed the algorithm?

Management of fractures involving the frontal sinus seems to be more complex than merely obtaining an ideal reduction of the bony injuries. Multiple articles on the management of these fractures suggest that a great deal of controversy persists despite many years of surgical experience. The question posed in this article is whether or not the advent of endoscopic approaches has changed or should change the approaches/algorithms used in the management of these challenging fractures.

Crumple zone effect of nasal cavity and paranasal sinuses on posterior cranial fossa.

Objectives/hypothesis: Examine a protective crumple zone effect of paranasal sinuses and nasal cavity on skull base fractures.

Study Design: Randomized-control, cadaveric study.

Methods: In the experimental group (n = 4), the nasal cavity and bilateral sinuses of cadavers were obliterated with bone cement, whereas the control group (n = 4) had native sinus architecture.

Complications in facial trauma.

This article reviews common complications encountered in the setting of facial trauma. Many complications are the result of the primary injury, and a facial plastic surgeon should be able to quickly identify these to prevent further morbidity. Common pitfalls and controversial topics are presented, as well as an overview of treatment for many complications.

Recent advances in fixation of the craniomaxillofacial skeleton.

Purpose Of Review: Fixation of the craniomaxillofacial skeleton is an evolving aspect for facial plastic, oral and maxillofacial, and plastic surgery. This review looks at the recent advances that aid in reduction and fixation of the craniomaxillofacial skeleton.

Recent Findings: More surgeons are using resorbable plates for craniomaxillofacial fixation.

Otologic considerations of blast injury.

The ear by design is exquisitely sensitive to barotrauma. As a result, it is typically the first organ affected in primary blast injury. The most common symptoms encountered include hearing loss, ringing, and drainage.

Osteochondroma of the coronoid process (Jacob's disease): an unusual cause of restricted jaw motion.

Osteochondromas are the most common benign bone tumor, most commonly found in the ends of long bones; however, they rarely involve facial bones, particularly the mandible. Osteochondromas involving the coronoid process have rarely been reported in the literature but pose a diagnostic dilemma. When large enough, osteochondromas of the mandibular coronoid process can form a joint with the zygomatic arch (Jacob's disease).