Complications of Open Reduction and Internal Fixation of Mandibular Condyle Fractures in Oman.

Objectives: This study aimed to report the complication rate associated with open reduction and internal fixation (ORIF) of mandibular condyle fractures in Oman. Methods: This retrospective cohort study was conducted among patients who underwent ORIF of mandibular condyle fractures at Al-Nahdha Hospital and the Sultan Qaboos University Hospital in Muscat, Oman, from January 2008 to December 2020. Data collected included patient demographics, fracture aetiology, fracture side and type, surgical approach and recorded complications and outcomes. Results: A total of 68 patients (59 males and 9 females; mean age of 30.1 years) with 83 mandibular condyle fractures underwent ORIF during the study period. Subcondylar fractures were the most common type, occurring in 62.7% of patients, while bilateral fractures were observed in 21 (30.8%) patients. The most common surgical approach was retromandibular, used in 42.2% of patients. The overall complication rate was 42.6%, with the most frequently reported complications being transient facial nerve palsy (18.1%), malocclusion (14.7%) and restricted mouth opening (10.3%). Subsequent surgical interventions to correct malocclusion were performed in 6 cases. There was no statistically significant association between the overall complication rate and the patients' clinical characteristics. Conclusion: Although ORIF of mandibular condyle fractures generally offers favourable outcomes, it carries a risk of complications.

Health-related quality of life and satisfaction following orthognathic surgery: a prospective cohort study.

PURPOSE: This study investigates the motivations for orthognathic surgery and assesses the quality of life (QoL) and satisfaction among patients treated at a hospital over 12 months. METHODS: We employed an Arabic version of the Orthognathic Quality of Life Questionnaire (OQLQ), used pre-surgery and at 2 weeks, 3 months, and 6 months post-surgery. This included demographic data, the OQLQ, and visual analogue scales (VAS). The OQLQ, originally by Cunningham et al., was translated and adapted by Al-Asfour et al. Additional validated questions were added to both pre- and post-operative surveys. RESULTS: Of 136 participants (51 males, 85 females, average age 25.1), most underwent surgery for facial aesthetics (85.2%) and bite correction (57.3%). Treatments included various osteotomies. OQLQ scores significantly dropped from 63.3% pre-surgery to 23% at 6 months, showing QoL improvement. 97.8% reported better psychological status post-surgery (p = 0.0001), with 94.1% satisfaction at 6 months (p = 0.0001). CONCLUSION: The orthognathic surgery yielded positive outcomes in functional and psychological aspects, leading to high satisfaction and improved QoL in patients with dentofacial deformity.

The Impact of Traffic Law Enforcement Regulations on the Incidence and Severity of Maxillofacial Injuries.

Objectives: This study aimed to assess the effectiveness of the new traffic law enforcement regulations (TLERs) on the incidence and severity of maxillofacial injuries in Oman, as road traffic accidents (RTAs) are the main cause of facial injuries in Oman. Methods: A retrospective longitudinal analytic study was conducted at three tertiary care hospitals in Muscat, Oman. All patients with RTA-related maxillofacial injuries during a five-year period from January 2005 to December 2009 (before the new TLERs) and the five-year period from January 2015 to December 2019 (after the new TLERs) were included in the study. Results: A total of 1,127 patients were included in the study. Of these, 646 (57.3%) patients sustained RTA-related maxillofacial injuries before the implementation of the new TLERs compared to 481 (42.7%) after the introduction of TLERs. No significant gender-based difference was found between the two study periods. The incidence of injury before the implementation of the new TLERs was 22.7 per 100,000 population, which then reduced significantly to 11 per 100,000 after the TLERs were implemented. Overall, the mean facial injury severity score reduced significantly, from 3.2 to 2.3, after the implementation of the new TLERs. Conclusions: The findings of this study indicate that the newly introduced TLERs have resulted in a reduction in the incidence and severity of RTA-related maxillofacial injuries. Continuous improvement and reinforcement of TLERs will further help reduce the burden of these injuries to society in general and health services in particular.

Unilateral Condylar Hyperplasia: Two Case Reports and a Literature Review.

Condylar hyperplasia (CH) is a rare idiopathic condition affecting the mandibular condyle where the growth of the condylar head and/or neck continues beyond the normal growth period. The disorder presents clinically as facial asymmetry and occlusal discrepancy. Here, we present two cases of CH managed at our centers between 2012 and 2017 with a successful outcome. We highlight the clinical presentation, investigation, and surgical management and give a brief literature review.

Chondroid Tenosynovial Giant Cell Tumor: A Rare Case Involving the Infratemporal Fossa.

Tenosynovial giant cell tumor (TGCT) is a benign soft-tissue neoplasm that rarely occurs in the craniofacial region. We report a case of a 27-year-old male who presented to our unit in September 2017 with severe temporomandibular joint (TMJ) pain and progressive limitation opening his mouth. Based on clinical and imaging examinations, a well-defined soft tissue lesion was identified within the right infratemporal fossa, causing pressure on the TMJ and the surrounding structures. The lesion was surgically excised through trans-mandibular and endoscopic approaches. Histopathology diagnosis revealed a rare chondroid subset of TGCT. At 18 months follow-up, the patient showed resolution of the jaw pain, good functional and esthetic outcomes, and no evidence of recurrence.

Modified Le Fort I Osteotomy and Genioplasty for Management of Severe Dentofacial Deformity in ß-Thalassaemia Major: Case report and review of the literature.

ß-thalassaemia major is an autosomal recessive form of haemoglobinopathy that is characterised by complete lack of production of the ß-chains resulting in multiple complications that include severe anaemia, failure to thrive and skeletal abnormalities. Facial deformities induced by ß-thalassaemia major are rare and are very challenging to treat from a surgical point of view. We report a 33-year-old female patient with ß-thalassaemia major who presented to the Dental & Maxillofacial Surgery Department, Sultan Qaboos University Hospital, Muscat, Oman, in 2017 with gross dentofacial skeletal deformity contributing to her psychosocial issues. The facial deformity was corrected surgically by excision of the enlarged maxilla, modified Le Fort I osteotomy and advancement genioplasty. This case highlights the pre-operative preparation, surgical management, encountered complications and treatment outcome within 24 months of follow-up.

Maxillary Artery Pseudoaneurysm as a Complication of Maxillofacial Injuries: Report of three cases and literature review.

Traumatic maxillary artery pseudoaneurysm is an uncommonly reported complication in the field of oral and maxillofacial surgery. It is usually discovered incidentally, either early after trauma or weeks-to-months later. Quick recognition and prompt management are essential to avoid devastating consequences. In this paper, we report three uncommon cases of maxillary artery pseudoaneurysm recognised during the surgical management of maxillofacial injuries in Muscat, Oman. All cases presented as sudden brisk bleeding during the intraoperative surgical repair and were subsequently diagnosed and successfully managed by endovascular embolisation with platinum coils. This case report highlights the clinical presentation, diagnosis and management of maxillary artery pseudoaneurysm, in addition to a brief review of the literature.

A Triad of Temporomandibular Joint Ankylosis, Mandibular Retrognathia and Severe Obstructive Sleep Apnoea: Case report.

The surgical management of paediatric patients with temporomandibular joint (TMJ) ankylosis, mandibular retrognathia and obstructive sleep apnoea (OSA) is challenging. We report a nine-year-old boy who presented to the Department of Oral Health, Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with complaints of limited mouth opening, loud snoring and excessive daytime sleepiness. He was diagnosed with TMJ ankylosis, mandibular retrognathia and severe OSA. The patient initially underwent mandibular distraction and, subsequently, release of the TMJ ankylosis and rib graft reconstruction. The overall patient outcome was successful, with improvement in OSA-related symptoms, good facial symmetry and adequate mouth opening.

Temporomandibular Joint Ankylosis as a Complication of Neonatal Septic Arthritis: Report of two cases.

Temporomandibular joint (TMJ) ankylosis as a complication of neonatal septic arthritis is rarely reported in the literature. We report two clinical cases of unilateral TMJ ankylosis occurring in paediatric patients subsequent to neonatal septic arthritis. The first case was a 15-month-old male infant who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in May 2010. According to the published English scientific literature, he is the youngest person yet to be diagnosed with this condition. The second case was a five-year-old female who presented to the Al-Nahda Hospital, Muscat, Oman, in October 2011. Both cases presented with facial asymmetry and trismus. They subsequently underwent gap arthroplasty and interpositional temporalis muscle and fascia grafts which resulted in an immediate improvement in mouth opening. Postoperatively, the patients underwent active jaw physiotherapy which was initially successful. Both patients were followed up for a minimum of two years following their surgeries.

Penetrating injuries to the orbit despite safety equipment.

Penetrating injuries to the orbit are uncommon but may have catastrophic consequences ranging from blindness, cerebral damage to death. Apparently similar injuries but with a slight difference in the anatomic pathway may have minimal morbidity. Prevention by the use of full safety equipment is recommended. This case report shows that full safety equipment may not prevent injury.