Purpose: To assess the diagnostic accuracy of physical examination findings and to construct clinical decision aids to discern emergency department patients without and with midfacial and mandibular fractures that require treatment.
Methods: A prospective multicentre cohort study was conducted in four hospitals in the Netherlands. Consecutive maxillofacial trauma patients were included whereupon each patient underwent a standardized physical examination consisting of 15 and 14 findings for midfacial and mandibular trauma, respectively. The primary outcome was the decision whether to treat during the emergency department stay or within 24 h of admission. The diagnostic accuracy was calculated for the individual physical examination findings and ensuing clinical decision aids with the focus being on detecting midfacial and mandibular fractures that require active treatment.
Results: A total of 766 midfacial trauma patients were identified of whom 339 (44.3%) had midfacial fractures. Of those, 74 (21.8%) required active treatment. A total of 280 mandibular trauma patients were identified of whom 66 (23.6%) had mandibular fractures. Of those, 37 (56.0%) required active treatment. The decision aid for midfacial trauma consisting of facial depression, epistaxis, ocular movement limitation, palpable step-off, objective malocclusion and tooth mobility or avulsion had a sensitivity of 97.3 (90.7-99.3), a specificity of 38.6 (35.0-42.3), and a negative predictive value of 99.3 (97.3-99.8). The decision aid for mandibular trauma consisting of mouth opening limitation, jaw movement pain, objective malocclusion and tooth mobility or avulsion resulted in a sensitivity of 100.0 (90.6-100.0), a specificity of 39.1 (33.2-45.4), and a negative predictive value of 100.0 (96.1-100.0).
Conclusion: The clinical decision aids successfully identified midfacial and mandibular trauma patients requiring active fracture treatment and so may be useful in preventing unnecessary radiological procedures in the future.
Trial Registration: The study was registered at ClinicalTrials.gov with the identifier NCT03314480.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9360136 | PMC |
| http://dx.doi.org/10.1007/s00068-022-01892-4 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The impact of spheno-occipital synchondrosis exposure via extended endoscopic endonasal surgery on midface growth in pediatric patients.
J Neurosurg Pediatr
January 2025
1Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan; and.
Article Synopsis
- The study investigates the impact of drilling the spheno-occipital synchondrosis during endoscopic endonasal surgery (EES) on the growth of the midface in pediatric patients.
- It involved 14 patients under 12 years old with conditions like craniopharyngioma and others, with 8 undergoing an extended EES technique to enhance surgical exposure.
- The results showed no significant changes in facial growth angles post-surgery for the extended EES group compared to standard EES, indicating that the procedure may not adversely affect midfacial development.
Incidence of Maxillofacial Injuries in the Emergency Department-Retrospective Study.
J Maxillofac Oral Surg
October 2024
Vydehi Institute of Dental Sciences and Research Centre, Bangalore, Karnataka India.
Article Synopsis
- Maxillofacial injuries are frequently seen in Emergency Departments, prompting a study at Vydehi Institute to assess their occurrence and characteristics over nine years.
- The research, which analyzed medical records of 2831 patients, revealed that 71.49% of injuries were soft tissue, primarily due to road traffic accidents (56.8%), with the forehead being the most common injury site.
- The findings aim to inform better treatment strategies and advocate for public awareness campaigns to lower the incidence of these injuries.*
Intraoral Scanning Enables Virtual-Splint-Based Non-Invasive Registration Protocol for Maxillofacial Surgical Navigation.
J Clin Med
September 2024
Department of Oral and Maxillofacial Surgery, Heinrich Heine University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
Surgical navigation has advanced maxillofacial surgery since the 1990s, bringing benefits for various indications. Traditional registration methods use fiducial markers that are either invasively bone-anchored or attached to a dental vacuum splint and offer high accuracy but necessitate additional imaging with increased radiation exposure. We propose a novel, non-invasive registration protocol using a CAD/CAM dental splint based on high-resolution intraoral scans.
View Article and Find Full Text PDFMixed reality guided advancement osteotomies in congenital craniofacial malformations.
J Plast Reconstr Aesthet Surg
November 2024
Division of Plastic, Reconstructive & Aesthetic Surgery, National University Hospital, Singapore; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address:
Article Synopsis
- This paper discusses the use of mixed reality (MR) technology during surgeries for patients with congenital craniofacial malformations, highlighting two specific cases.
- In the first case involving bilateral hemifacial microsomia, MR glasses (HoloLens 2) displayed a hologram of the osteotomy line validated by a physical guide, while the second case with Crouzon's syndrome used MR to show osteotomy sites, validated by a traditional navigation system.
- The study emphasizes the benefits of MR, such as time and cost savings, continuous visibility in the surgical field, and potential to enhance or replace conventional surgical guides and navigation tools.
Paediatric maxillofacial fractures have increased in incidence and their nature and aetiology have changed during three decades.
Sci Rep
August 2024
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Turku, Turku, Finland.
The safety of children's living environment is affected by several factors. Safer living environments have been offered as one explanation to decreases in children's fractures. Earlier studies provide evidence of a decreasing trend in children's fractures in the past decades.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!