Characteristics of pediatric maxillofacial fractures in Kuwait: A single-center retrospective study.

BACKGROUND: Pediatric maxillofacial fractures always present a challenge due to the unique nature of the facial skeleton anatomy and development. The aim of this study was to investigate the incidence, etiology, site of fracture, and management modalities of pediatric maxillofacial fractures in Kuwait. METHODS: A retrospective cross-sectional study was conducted. The records of all pediatric patients who were diagnosed with maxillofacial fractures and admitted to one of the major hospitals in Kuwait between January 2007 and March 2020 were reviewed. RESULTS: A total of 186 patients aged between 0 and 13 years old were included. An average of 13 patients was seen each year between 2007 and 2020. The leading cause of the pediatric maxillofacial trauma was road traffic accidents (RTA) that accounted for 38.2% of the patients followed by 22% falls from height (FFH). Male patients were more affected than females, with a ratio of 2.3:1. More than half of the children had mid-face fractures, of which 57% were in multiple sites. Conservative management was the main approach for 52.2% of the patients. CONCLUSIONS: Pediatric maxillofacial fractures were mainly attributed to road traffic accidents in Kuwait. Mid-face bone fractures were reported more than mandibular fractures and were mostly managed conservatively.

Masseteric artery: anatomic location and relationship to the temporomandibular joint area.

PURPOSE: This study was performed to determine the precise location of the masseteric artery in relation to the temporomandibular joint region to reduce the risk of injury during surgery. MATERIALS AND METHODS: A careful dissection of 16 intact human cadaveric head specimens was carried out to determine the course of the masseteric artery. The location of the masseteric artery was then determined in relation to 3 points in the anterior-posterior plane between the mandibular condyle and the coronoid process: 1) the anterior-superior aspect of the condylar neck, 2) the most inferior aspect of the articular tubercle, and 3) the inferior aspect of the sigmoid notch. RESULTS: The mean distance of the masseteric artery to the most anterior-superior aspect of the condylar neck was 10.3 mm; to the most inferior aspect of the articular tubercle, 11.4 mm; and to the most inferior aspect of the sigmoid notch, 3 mm. CONCLUSIONS: These results show that there is considerable variability in the location of the masseteric artery. Although it is generally closest to the depth of the sigmoid notch, which can explain why this vessel can be easily damaged during intraoral vertical ramus osteotomies, in some instances it can also be close to either the neck of the condylar process or the coronoid process. The data provided in this study can serve as a guide for locating the vessel when operating in these areas.

Psychological factors associated with response to maxillofacial injury and its treatment.

PURPOSE: This study evaluated symptoms of acute stress disorder (ASD), satisfaction with appearance postsurgery, and satisfaction with care in patients with maxillofacial injury at their first postsurgical physician visit. To determine the best predictors of patients' ASD symptoms and satisfaction, data also were obtained on the patients' strategies for coping with the stress of the injury, on the patients' and doctors' interpersonal appraisals of each other, and on the doctors' participatory behavior during the visits. PATIENTS AND METHODS: A total of 47 patients who had sustained traumatic maxillofacial injury requiring emergency medical/surgical treatment were administered self-report measures immediately before and after their first postsurgical visit 10 to 12 days after trauma exposure. Doctors completed self-report measures after the visit and evaluated the patients' severity of injury. RESULTS: Patients experienced high levels of ASD in the short-term period after surgery. Use of emotion-focused strategies by patients to cope with stress was associated with more ASD symptoms but better satisfaction with facial appearance. The more severely injured patients were less satisfied with their appearance and were viewed by their doctors as being more interpersonally controlling during the postsurgical visit. CONCLUSIONS: Closer attention by doctors to patients' interpersonal behavior may aid in early identification of those patients with maxillofacial injury who may experience longer-term social problems related to their altered facial appearance.