97 results match your criteria Endoscopic Management of Facial Fractures

Frontal Sinus Fractures: A Contemporary Approach in the Endoscopic Era.

Facial Plast Surg Clin North Am 2022 Feb;30(1):71-83

Department of Otolaryngology -Head and Neck Surgery, University of California Davis, 2521 Stockton Boulevard, Suite 7200, Sacramento, CA 95817, USA. Electronic address:

Although frontal sinus fractures are relatively uncommon, the potential for long-term morbidity is significant. Management strategies remain controversial due to a lack of strong clinical evidence. Despite a paucity of strong literature, a logical treatment algorithm is presented based on the structural integrity of three anatomic parameters: anterior table, frontal sinus outflow tract, and the posterior table/dura. Read More

View Article and Full-Text PDF
February 2022

Comparative Evaluation of Clinical and Radiological Outcomes of Retromandibular Transparotid and Transoral Endoscopic-Assisted Approach for Surgical Management of Mandibular Subcondylar Fractures.

Craniomaxillofac Trauma Reconstr 2021 Jun 13;14(2):90-99. Epub 2020 Aug 13.

Department of Oral and Maxillofacial Surgery, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India.

Study Design: A prospective randomized comparative study was conducted to evaluate the clinical and radiological outcomes of the retromandibular transparotid (RMT) approach with endoscopic-assisted transoral (ENDO) approach used for open reduction and internal fixation (ORIF) of adult mandibular subcondylar fractures.

Objectives: To evaluate and compare the primary functional outcome using the Helkimo's dysfunction index, the surgical ease, the incidence of facial nerve weakness, the cosmetic outcomes and the number of complications following ORIF of mandibular subcodylar fractures using the RMT and ENDO approaches.

Methods: In this prospective study, 20 patients with unilateral/bilateral subcondylay fractures requiring ORIF were recruited between 2017 and 2018. Read More

View Article and Full-Text PDF

Head, Face, and Neck Fractures Secondary to Ladder-Related Injuries Treated in United States Emergency Departments in 2009-2018.

J Emerg Med 2020 Aug 16;59(2):186-192. Epub 2020 Jun 16.

Division of Otolaryngology Head and Neck Surgery, Rhinology and Endoscopic Skull Base Surgery, William Beaumont Hospital, Royal Oak, Michigan.

Background: Ladders are a commonly used piece of equipment; however, their use is accompanied by a significant potential for injury. Fractures of the head, face, and neck are potential consequences of ladder use and can be devastating due to potential for severe sequalae.

Objectives: To describe the frequency and pattern of ladder-related head, face, and neck fractures from 2009-2018. Read More

View Article and Full-Text PDF

What Is the Role of the Endoscope in the Sinus Preservation Management of Frontal Sinus Fractures?

J Oral Maxillofac Surg 2020 Oct 23;78(10):1811.e1-1811.e9. Epub 2020 Apr 23.

Professor, Department of Otolaryngology, Head and Neck Surgery, and Maxillofacial Surgery, Mansoura University, Mansoura, Egypt.

Purpose: The management of frontal sinus fractures has remained controversial. The present study investigated the role of minimally invasive endoscopic surgery in a sinus preservation treatment protocol and described the ideal approach for each frontal sinus fracture type.

Patients And Methods: We performed a prospective cohort study of patients with multiple frontal sinus fracture types. Read More

View Article and Full-Text PDF
October 2020

Endoscopically assisted computer-guided repair of internal orbital floor fractures: an updated protocol for minimally invasive management.

J Craniomaxillofac Surg 2019 Dec 27;47(12):1943-1951. Epub 2019 Nov 27.

Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Italy. Electronic address:

Background: Performing accurate anatomical reconstruction is a challenging task in the treatment of internal orbital floor fractures. Compared with traditional transcutaneous incisions, endoscopic transmaxillary approaches have the advantage of avoiding complications related to external scars, and provide direct access to the orbital floor. Autogenous bone provides the ideal material for defect reconstruction, but determination of the correct size and shape of the graft is crucial for a stable support. Read More

View Article and Full-Text PDF
December 2019

Management of Frontal Sinus Fractures.

Facial Plast Surg 2019 Dec 29;35(6):645-650. Epub 2019 Nov 29.

Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas.

Fractures of the frontal sinus occur from extreme forces and are often associated with other injuries. Management of frontal sinus fractures is variable and dependent on involvement of the anterior table, posterior table, and frontal outflow tract. Severe complications can developed from poorly managed fractures, such as meningitis, mucocele, mucopyocele, and brain abscess. Read More

View Article and Full-Text PDF
December 2019

Contemporary management of frontal sinus fractures.

Curr Opin Otolaryngol Head Neck Surg 2019 Aug;27(4):253-260

Department of Otolaryngology - Head and Neck Surgery, University of California, Davis, Sacramento, California, USA.

Purpose Of Review: Frontal sinus fracture management is evolving. This article will highlight recent literature and provide an evidence-based algorithm in the contemporary management of frontal sinus fractures.

Recent Findings: The role of transnasal endoscopic treatment of frontal sinus fractures has expanded to include fracture reduction and posterior table reconstruction. Read More

View Article and Full-Text PDF

Upper Eyelid Approach for the Reconstruction of Isolated Fractures of the Anterior Wall of the Frontal Sinus.

J Craniofac Surg 2018 Oct;29(7):1903-1905

Loma Linda University, Loma Linda.

The management of frontal sinus fractures can vary widely depending on involvement of the anterior wall, the posterior wall, and the frontonasal duct. The main morbidity associated with isolated anterior wall fractures is an aesthetic deformity. Treatment includes coronal, endoscopic, and transcutaneous approaches. Read More

View Article and Full-Text PDF
October 2018

Outcome of Surgically Treated Fractures of the Condylar Process by an Endoscopic Assisted Transoral Approach.

J Oral Maxillofac Surg 2019 01 24;77(1):133.e1-133.e9. Epub 2018 Aug 24.

Fellow, Clinic for Cranio-Maxillofacial Surgery, University Hospital, Zurich, Switzerland.

Purpose: Fractures of the condylar process are frequent. Ideal management of these fractures, as discussed in the literature, is controversial. Some recent meta-analyses have favored open reduction and internal fixation using various approaches. Read More

View Article and Full-Text PDF
January 2019

Endoscopic-Assisted Intraoral Open Reduction Internal Fixation of Mandibular Subcondylar Fractures: Initial Experiences from a Tertiary-Care Maxillofacial Center in India.

Craniomaxillofac Trauma Reconstr 2018 Sep 12;11(3):183-191. Epub 2017 Jun 12.

Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India.

Management of condylar fractures is a highly controversial and debatable area. Open reduction and internal fixation (ORIF) using an extraoral approach has certain benefits over the nonsurgical treatment. Risk of damage to the facial nerve and an extraoral scar remains constant deterrents. Read More

View Article and Full-Text PDF
September 2018

Blunt rupture of the thoracic duct after severe thoracic trauma.

Trauma Surg Acute Care Open 2018 20;3(1):e000183. Epub 2018 Jun 20.

Department of Surgery, CHI Health Creighton University Medical Center Bergan Mercy, Omaha, Nebraska, USA.

A 53-year-old man was admitted to our trauma center after sustaining thoracoabdominal injuries, secondary to a rear-end motor vehicle collision. As he stepped out of his vehicle, he was struck by a tractor trailer at 55 mph. The following were the initial vital signs on his arrival: heart rate 140 beats/min, blood pressure 142/80 mm Hg, respiratory rate 28 breaths/min, temperature 36. Read More

View Article and Full-Text PDF

Criteria for diagnosis and postoperative control of acromegaly, and screening and management of its comorbidities: Expert consensus.

Endocrinol Diabetes Nutr (Engl Ed) 2018 May 10;65(5):297-305. Epub 2018 Apr 10.

Servicio de Endocrinología y Nutrición, Hospital Universitari Dexeus, Barcelona, España.

Acromegaly is a rare disease with many comorbidities that impair quality of life and limit survival. There are discrepancies in various clinical guidelines regarding diagnosis and postoperative control criteria, as well as screening and optimal management of comorbidities. This expert consensus was aimed at establishing specific recommendations for the Spanish healthcare system. Read More

View Article and Full-Text PDF

Referral patterns from emergency department to otolaryngology clinic.

Laryngoscope 2018 05 20;128(5):1062-1067. Epub 2017 Nov 20.

Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Objectives/hypothesis: Patients who present to the emergency department (ED) with various otolaryngologic disorders are frequently referred to an otolaryngologist for follow-up care. Our aim was to further characterize this group as it has not been well described in the literature.

Study Design: Cross-sectional retrospective study. Read More

View Article and Full-Text PDF

Endoscopic Removal of Displaced Sagittal Intracapsular Condylar Fracture.

J Craniofac Surg 2017 Nov;28(8):2036-2037

*Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, Dental School at Araraquara, UNESP †Medicine School at University Center of Araraquara, UNIARA, Araraquara, Brazil.

Fractures involving the mandibular condyle are among the most common fractures of facial bones and still generate great discussion concerning therapeutic issues. Several factors have influence on the decision of treatment management of these fractures. In some patients, even when there is displacement of fractured fragments, the choice for conservative treatment is made. Read More

View Article and Full-Text PDF
November 2017

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

Facial Plast Surg Clin North Am 2017 Nov;25(4):577-580

Department of Otolaryngology and Communication Sciences, State University of New York Upstate Medical University, 241 CWB, 750 East Adams Street, Syracuse, NY 13210, USA.

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. Read More

View Article and Full-Text PDF
November 2017

Transnasal endoscopic ultrasound-guided reduction of maxillary sinus wall fracture.

Eur Arch Otorhinolaryngol 2017 Sep 12;274(9):3383-3390. Epub 2017 Jun 12.

Department of Anatomy, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea.

Surgical morbidity from open reduction and internal fixation (ORIF) of maxillary sinus wall fracture often surpasses the benefits of ORIF. Hence, the authors devised transnasal endoscopic-assisted reduction of maxillary sinus wall fracture (TERM) without internal fixation as a minimally invasive surgery for maxillary sinus wall fracture. The purpose of this study was to investigate the feasibility of TERM in cadavers and patients. Read More

View Article and Full-Text PDF
September 2017

Survey of Current Practice Patterns in the Management of Frontal Sinus Fractures.

Craniomaxillofac Trauma Reconstr 2017 Jun 3;10(2):106-116. Epub 2017 Feb 3.

Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina.

The management of frontal sinus fractures has evolved in the endoscopic era. The development of functional endoscopic sinus surgery (FESS) has been incorporated into management algorithms proposed by otolaryngologists, but the extent of its influence on plastic surgeons and oral and maxillofacial surgeons is heretofore unknown. A cross-sectional survey was performed to assess the practice pattern variations in frontal sinus fracture management across multiple surgical disciplines. Read More

View Article and Full-Text PDF

Frontal Sinus Fractures.

Semin Plast Surg 2017 May;31(2):80-84

Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.

The frontal bone serves a protective role, representing the transition between the facial skeleton and the cranium. Within its enclosure, the frontal sinus lies adjacent to many important intracranial structures, and injury to this region has severe complications if not properly managed. Historically, the goals of frontal sinus fracture management have been to best prevent intracranial complications with invasive procedures, but a recent shift favoring conservative management now aims to preserve the form and function of the frontal sinus and its outflow tract. Read More

View Article and Full-Text PDF

Evaluation of a Minimally Disruptive Treatment Protocol for Frontal Sinus Fractures.

JAMA Facial Plast Surg 2017 May;19(3):225-231

Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle.

Importance: Despite common goals of frontal sinus fracture treatment (restoring forehead contour and creating a safe sinus), there remains significant variability in evaluation and treatment.

Objective: To describe our experience with a minimally disruptive treatment protocol for the treatment of frontal sinus fractures.

Design, Setting, And Participants: Analysis of prospectively collected data from 2010 through 2015 at a level 1 trauma center. Read More

View Article and Full-Text PDF

Mandibular Subcondylar Fractures: A Review on Treatment Strategies.

Electron Physician 2016 Oct 25;8(10):3144-3149. Epub 2016 Oct 25.

DMD, Resident of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Shariati General Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Condylar injuries are often subjected to discussion and controversy in maxillofacial surgery as they constitute many of the facial fractures. The condylar area has a great clinical value due to its important components. Vital components in this area are susceptible to functional disability due to either the fracture itself or the subsequent surgical intervention. Read More

View Article and Full-Text PDF
October 2016

A new approach to nasoseptal fractures: Submucosal endoscopically assisted septoplasty and closed nasal reduction.

J Craniomaxillofac Surg 2016 Oct 16;44(10):1635-1640. Epub 2016 Jul 16.

Maxillofacial Surgery Division, Hospital del Trabajador de Santiago, Chile.

Background: Nasal bone fracture is the most common among facial bone fractures. The prevalence of concomitant septal and nasal bone fractures fluctuates between 34% and 96.2%. Read More

View Article and Full-Text PDF
October 2016

Controversies in the Management of the Trauma Patient.

Facial Plast Surg Clin North Am 2016 Aug 24;24(3):299-308. Epub 2016 May 24.

Department of Otolaryngology, SUNY Upstate, 750 East Adams Street, Syracuse, NY 13207, USA.

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. Read More

View Article and Full-Text PDF

Contemporary Approach to the Diagnosis and Management of Cerebrospinal Fluid Rhinorrhea.

Ochsner J 2016 ;16(2):136-42

Department of Otorhinolaryngology, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.

Background: Cerebrospinal fluid (CSF) rhinorrhea, when left untreated, can lead to meningitis and other serious complications. Treatment traditionally has entailed an open craniotomy, although the paradigm has now evolved to encompass endoscopic procedures. Trauma, both accidental and iatrogenic, causes the majority of leaks, and trauma involving skull base and facial fractures is most likely to cause CSF rhinorrhea. Read More

View Article and Full-Text PDF

An aesthetic approach in the repair of anterior frontal sinus fractures.

T Fattahi S Salman

Int J Oral Maxillofac Surg 2016 Sep 4;45(9):1104-7. Epub 2016 May 4.

Department of Oral and Maxillofacial Surgery, University of Florida Health Science Center, Jacksonville, FL, USA.

The management of upper facial trauma is a common responsibility of surgeons taking care of maxillofacial injuries. Historically, the most commonly used surgical approach has been the bi-temporal (coronal) incision. As is well known, the coronal incision carries some inherent complications such as hair loss, long scars, and increased length of hospital stay. Read More

View Article and Full-Text PDF
September 2016

Update on mandibular condylar fracture management.

Curr Opin Otolaryngol Head Neck Surg 2016 Aug;24(4):273-8

Department of Otolaryngology - Head and Neck Surgery, University of Florida, Gainesville, Florida, USA.

Purpose Of Review: Fractures of the mandibular condyle have provided a lasting source of controversy in the field of facial trauma. Concerns regarding facial nerve injury as well as reasonable functional outcomes with closed management led to a reluctance to treat with an open operative intervention. This article reviews how incorporating new technologies and surgical methods have changed the treatment paradigm. Read More

View Article and Full-Text PDF

Maxillofacial Fractures: Midface and Internal Orbit-Part II: Principles and Surgical Treatment.

Facial Plast Surg 2015 Aug 15;31(4):357-67. Epub 2015 Sep 15.

Department of Otorhinolaryngology-Head and Neck Surgery, Cantonal Hospital, St. Gallen, Switzerland.

Current clinical assessment and imaging techniques were described in part 1, and this article presents a systematic review of the surgical treatment principles in the management of midface and internal orbit fractures from initial care to definitive treatment, including illustrative case examples. New developments enabled limited surgical approaches by standardization of osteosynthesis principles regarding three-dimensional buttress reconstruction, by newly developed individualized implants such as titanium meshes and, especially for complex fracture patterns, by critical assessment of anatomical reconstruction through intraoperative endoscopy, as well as intra- and postoperative imaging. Resorbable soft tissue anchors can be used both for ligament and soft tissue resuspension to reduce ptosis effects in the cheeks and nasolabial area and to achieve facial aesthetics similar to those prior to the injury. Read More

View Article and Full-Text PDF

Experience with the transparotid approach via a mini-preauricular incision for surgical management of condylar neck fractures.

J Craniomaxillofac Surg 2015 Oct 31;43(8):1595-601. Epub 2015 Jul 31.

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Keelung, College of Medicine, Chang Gung University, Craniofacial Research Center, 222, Maijin Road, Keelung, Taiwan.

Introduction: The aim of this study was to describe our experiences of a mini-preauricular transparotid approach for direct reduction and plating of condylar neck fractures.

Materials And Methods: A retrospective study was conducted on 58 patients from 2009 to 2011 with 69 condylar neck fractures in Chang Gung Memorial Hospital. The fractures were treated surgically either with a 2-cm mini-preauricular and transparotid approach in 29 patients with 36 fractures, or via endoscope-assisted intraoral, or facelift or retromandibular approaches in a control group of 29 patients with 32 fractures. Read More

View Article and Full-Text PDF
October 2015

Benefits of the Retrocaruncular Approach to the Medial Orbit: A Clinical And Anatomic Study.

Ann Plast Surg 2016 Mar;76(3):295-300

From the *Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospital and Clinics, Madison, WI; †Straub Clinic and Hospital, Plastic Surgery Practice, Honolulu, HI; ‡Department of Plastic Surgery, Wake Forest Medical Center, Winston-Salem, NC; and §Department of Plastic and Reconstructive Surgery, Loma Linda University, Loma Linda, CA.

Background: Current trends in the management of medial orbital wall fractures are toward the development of transconjunctival incisions and the use of endoscopic-assisted methods. Different authors have suggested variations of the medial transconjunctival approach.

Methods: (1) In 30 fresh cadaver orbits, the classic transcaruncular approach was compared with the precaruncular and retrocaruncular approach under magnified dissection. Read More

View Article and Full-Text PDF

Transoral vs. extraoral approach in the treatment of condylar neck fractures.

J Craniomaxillofac Surg 2015 Mar 18;43(2):224-31. Epub 2014 Nov 18.

Department of Oral and Maxillofacial Surgery, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany.

Purpose: The aim of this study was to assess a non-endoscopic transoral versus extraoral technique in the open reduction and internal fixation of displaced or dislocated fractures of the condylar neck.

Material And Methods: A total of 104 patients, treated from 2007 to 2012 with 114 class II or class IV fractures according to Spiessl and Schroll were included in this study. Facial nerve function, scarring, pain and functional clinical parameters, such as protrusion, mediotrusion and maximum interincisal distance, were judged clinically (at 21 ± 12. Read More

View Article and Full-Text PDF