Cargando…

Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study

Background: When dealing with traumatized patients, it is crucial to prioritize securing their airway. However, intubating someone who has sustained significant facial injuries can pose difficulties, as the narrow and altered shape of their upper airway may impede their ability to open their mouth....

Descripción completa

Detalles Bibliográficos
Autores principales: Alassaf, Muath S, Khan, Hamza K, Habib, Osama A, Aboalkhair, Ayyob E, Albeshir, Hasan A, Samman, Mahmood M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646614/
https://www.ncbi.nlm.nih.gov/pubmed/38022114
http://dx.doi.org/10.7759/cureus.47081
_version_ 1785134929950015488
author Alassaf, Muath S
Khan, Hamza K
Habib, Osama A
Aboalkhair, Ayyob E
Albeshir, Hasan A
Samman, Mahmood M
author_facet Alassaf, Muath S
Khan, Hamza K
Habib, Osama A
Aboalkhair, Ayyob E
Albeshir, Hasan A
Samman, Mahmood M
author_sort Alassaf, Muath S
collection PubMed
description Background: When dealing with traumatized patients, it is crucial to prioritize securing their airway. However, intubating someone who has sustained significant facial injuries can pose difficulties, as the narrow and altered shape of their upper airway may impede their ability to open their mouth. In light of this, the purpose of this study is to evaluate the volumetric and morphological alterations to the upper airway resulting from facial trauma by utilizing computed tomography (CT) scans. Method: This is a single-centered retrospective analytical study. This study included CT scans of patients with traumatic facial injuries admitted to King Fahad Hospital in Madinah, Saudi Arabia. Study variables included age, gender, body mass index (BMI), fractured bones, airway symmetry, and airway volume. Using the 3D Slicer software (Slicer Community, USA), a three-dimensional model of the pharyngeal airway was constructed from the CT scan to evaluate symmetry and volume. IBM SPSS Statistics for Windows, version 23 (released 2013; IBM Corp., Armonk, New York, United States) was used to analyze data. Results: Among the screened scans, 136 cases with traumatic facial injuries were included in the study. Age ranged from four to 91 years, with a mean of 28.26 (±14.9). Mandibular and zygomatic fractures were the most common, with 71 (52.2%) and 69 (50.7%) cases, respectively. The pharyngeal airway was symmetric in 111 (81.6%) cases and not symmetric in the other 25 (18.4%) cases. A significant association was found between the side of the fracture and airway asymmetry in mandibular fractures (p-value = 0.03). The total airway volume in the displaced mandibular fractures showed a statistically significant decrease (p-value = 0.019). The fracture sites were not statistically linked to airway asymmetry except for parasymphyseal and symphyseal fractures, with a p-value of 0.038 and 0.041, respectively. Conclusion: The study findings suggest that the pharyngeal airway is not usually compromised in most facial bone fractures; however, bilateral displaced mandibular fractures have the potential to diminish the pharyngeal airway volume, especially in fractures involving the symphysis and parasymphysis area.
format Online
Article
Text
id pubmed-10646614
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-106466142023-10-15 Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study Alassaf, Muath S Khan, Hamza K Habib, Osama A Aboalkhair, Ayyob E Albeshir, Hasan A Samman, Mahmood M Cureus Emergency Medicine Background: When dealing with traumatized patients, it is crucial to prioritize securing their airway. However, intubating someone who has sustained significant facial injuries can pose difficulties, as the narrow and altered shape of their upper airway may impede their ability to open their mouth. In light of this, the purpose of this study is to evaluate the volumetric and morphological alterations to the upper airway resulting from facial trauma by utilizing computed tomography (CT) scans. Method: This is a single-centered retrospective analytical study. This study included CT scans of patients with traumatic facial injuries admitted to King Fahad Hospital in Madinah, Saudi Arabia. Study variables included age, gender, body mass index (BMI), fractured bones, airway symmetry, and airway volume. Using the 3D Slicer software (Slicer Community, USA), a three-dimensional model of the pharyngeal airway was constructed from the CT scan to evaluate symmetry and volume. IBM SPSS Statistics for Windows, version 23 (released 2013; IBM Corp., Armonk, New York, United States) was used to analyze data. Results: Among the screened scans, 136 cases with traumatic facial injuries were included in the study. Age ranged from four to 91 years, with a mean of 28.26 (±14.9). Mandibular and zygomatic fractures were the most common, with 71 (52.2%) and 69 (50.7%) cases, respectively. The pharyngeal airway was symmetric in 111 (81.6%) cases and not symmetric in the other 25 (18.4%) cases. A significant association was found between the side of the fracture and airway asymmetry in mandibular fractures (p-value = 0.03). The total airway volume in the displaced mandibular fractures showed a statistically significant decrease (p-value = 0.019). The fracture sites were not statistically linked to airway asymmetry except for parasymphyseal and symphyseal fractures, with a p-value of 0.038 and 0.041, respectively. Conclusion: The study findings suggest that the pharyngeal airway is not usually compromised in most facial bone fractures; however, bilateral displaced mandibular fractures have the potential to diminish the pharyngeal airway volume, especially in fractures involving the symphysis and parasymphysis area. Cureus 2023-10-15 /pmc/articles/PMC10646614/ /pubmed/38022114 http://dx.doi.org/10.7759/cureus.47081 Text en Copyright © 2023, Alassaf et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Alassaf, Muath S
Khan, Hamza K
Habib, Osama A
Aboalkhair, Ayyob E
Albeshir, Hasan A
Samman, Mahmood M
Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study
title Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study
title_full Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study
title_fullStr Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study
title_full_unstemmed Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study
title_short Morpho-Volumetric Changes of the Pharyngeal Airway With Traumatic Maxillofacial Injuries: A Retrospective Radiographic Study
title_sort morpho-volumetric changes of the pharyngeal airway with traumatic maxillofacial injuries: a retrospective radiographic study
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646614/
https://www.ncbi.nlm.nih.gov/pubmed/38022114
http://dx.doi.org/10.7759/cureus.47081
work_keys_str_mv AT alassafmuaths morphovolumetricchangesofthepharyngealairwaywithtraumaticmaxillofacialinjuriesaretrospectiveradiographicstudy
AT khanhamzak morphovolumetricchangesofthepharyngealairwaywithtraumaticmaxillofacialinjuriesaretrospectiveradiographicstudy
AT habibosamaa morphovolumetricchangesofthepharyngealairwaywithtraumaticmaxillofacialinjuriesaretrospectiveradiographicstudy
AT aboalkhairayyobe morphovolumetricchangesofthepharyngealairwaywithtraumaticmaxillofacialinjuriesaretrospectiveradiographicstudy
AT albeshirhasana morphovolumetricchangesofthepharyngealairwaywithtraumaticmaxillofacialinjuriesaretrospectiveradiographicstudy
AT sammanmahmoodm morphovolumetricchangesofthepharyngealairwaywithtraumaticmaxillofacialinjuriesaretrospectiveradiographicstudy