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A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts

BACKGROUND: Some parts of a maxillary fracture—for example, the medial and posterior walls—may remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal c...

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Autores principales: Chung, Chan Min, Tak, Seung Wan, Lim, Hyoseob, Cho, Sang Hun, Lee, Jong Wook
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Cleft Palate-Craniofacial Association 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6949495/
https://www.ncbi.nlm.nih.gov/pubmed/31914491
http://dx.doi.org/10.7181/acfs.2019.00528
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author Chung, Chan Min
Tak, Seung Wan
Lim, Hyoseob
Cho, Sang Hun
Lee, Jong Wook
author_facet Chung, Chan Min
Tak, Seung Wan
Lim, Hyoseob
Cho, Sang Hun
Lee, Jong Wook
author_sort Chung, Chan Min
collection PubMed
description BACKGROUND: Some parts of a maxillary fracture—for example, the medial and posterior walls—may remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal computed tomography (CT) analysis of cases of unilateral facial bone injuries involving the maxillary sinus walls. METHODS: Thirty-two patients who had undergone unilateral facial bone reduction surgery involving the maxillary sinus walls without reduction of the medial and posterior walls were analyzed in this retrospective chart review. Preoperative, immediate postoperative, and 3-month postoperative CT scans were analyzed. The maxillary sinus volume was calculated and improvements in bone continuity and alignment were evaluated. RESULTS: The volume of the traumatized maxillary sinuses increased after surgery, and expanded significantly by 3 months postoperatively (p< 0.05). The significant preoperative volume difference between the normal and traumatized sides (p= 0.024) resolved after surgery (p> 0.05), and this resolution was maintained at 3 months postoperatively (p > 0.05). The unreduced parts of the maxillary bone showed improved alignment and continuity (in 75.0% and 90.6% of cases, respectively), and improvements in bone alignment and bone continuity were found to be correlated using the Pearson chi-square test (p= 0.002). CONCLUSION: Maxillary wall remodeling through self-healing occurred concomitantly with an increase in sinus volume and simultaneous improvements in bone alignment and continuity. Midfacial surgeons should be aware of the natural course of unreduced fractured medial and posterior maxillary walls in complex maxillary fractures.
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spelling pubmed-69494952020-01-16 A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts Chung, Chan Min Tak, Seung Wan Lim, Hyoseob Cho, Sang Hun Lee, Jong Wook Arch Craniofac Surg Original Article BACKGROUND: Some parts of a maxillary fracture—for example, the medial and posterior walls—may remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal computed tomography (CT) analysis of cases of unilateral facial bone injuries involving the maxillary sinus walls. METHODS: Thirty-two patients who had undergone unilateral facial bone reduction surgery involving the maxillary sinus walls without reduction of the medial and posterior walls were analyzed in this retrospective chart review. Preoperative, immediate postoperative, and 3-month postoperative CT scans were analyzed. The maxillary sinus volume was calculated and improvements in bone continuity and alignment were evaluated. RESULTS: The volume of the traumatized maxillary sinuses increased after surgery, and expanded significantly by 3 months postoperatively (p< 0.05). The significant preoperative volume difference between the normal and traumatized sides (p= 0.024) resolved after surgery (p> 0.05), and this resolution was maintained at 3 months postoperatively (p > 0.05). The unreduced parts of the maxillary bone showed improved alignment and continuity (in 75.0% and 90.6% of cases, respectively), and improvements in bone alignment and bone continuity were found to be correlated using the Pearson chi-square test (p= 0.002). CONCLUSION: Maxillary wall remodeling through self-healing occurred concomitantly with an increase in sinus volume and simultaneous improvements in bone alignment and continuity. Midfacial surgeons should be aware of the natural course of unreduced fractured medial and posterior maxillary walls in complex maxillary fractures. Korean Cleft Palate-Craniofacial Association 2019-12 2019-12-20 /pmc/articles/PMC6949495/ /pubmed/31914491 http://dx.doi.org/10.7181/acfs.2019.00528 Text en Copyright © 2019 The Korean Cleft Palate-Craniofacial Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Chung, Chan Min
Tak, Seung Wan
Lim, Hyoseob
Cho, Sang Hun
Lee, Jong Wook
A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts
title A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts
title_full A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts
title_fullStr A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts
title_full_unstemmed A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts
title_short A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts
title_sort retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6949495/
https://www.ncbi.nlm.nih.gov/pubmed/31914491
http://dx.doi.org/10.7181/acfs.2019.00528
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