phenylephrine-hydrochloride and Blast-Injuries

The relevance of diagnosis and treatment of mine-explosive wounds ENT high. Treatment of explosives, Russian Academy of Sciences-the challenge and consists of a series of sequential steps that need to be applied, taking into account all the particularities of each injury. Concepts of specialized surgical care of the wounded are formulated. The main are: 1) one-stage surgical treatment of comprehensive primary wounds with detent of bone fragments, reconstruction of defects of soft tissue with positive wound and related fascial spatium drainage; 2) general intensive care during the postoperative period, including water-electrolytic balance correction, sympathetic block, controlled hemodilution and adequate analgesia; 3) intensive therapy of postoperative wounds, aimed at creating favorable conditions for its healing and includes targeted selective influence on hemophoresis in the wound and the local proteoclastic processes.

Topics: Blast Injuries; Ear; Explosions; Humans; Larynx; Military Medicine; Nose; Pharynx

Distinctive mechanisms of primary blast effects have produced a transitional era of facial trauma. Implosion mechanism damage is one of these. Implosion mechanism damage results in injury limited to the gas-containing structures of the auditory canal, paranasal sinuses, gastrointestinal tract, and lungs. Worldwide, the victims of explosive detonations have increased and advanced dramatically. The outcome is greater mortality and morbidity and new types of injuries, especially in the maxillofacial region. Thus, the knowledge of, and experience with, their management should be shared globally by colleagues through publications.. The implosion and mini re-explosion of compressed air sinuses leads to skeletal crush injury to the nasal-orbital-ethmoidal, maxillary sinuses, and nasal bones. A variety of surgical approaches were used successfully under conditions of war. The assessment of the associated injuries to the lung and/or brain is the initial priority to any life-threatening blast injury. This article describes the biophysical results of blast injuries to the middle third facial skeleton and associated injuries and details the management and protection of crushed air containing paranasal spaces.. Easy, simple, and fast treatment and management were used successfully on the pulverized, fragmented skeletal architecture of the facial middle part without increasing morbidity and with the avoidance of unnecessary surgical trauma.. Injuries in one of the most difficult esthetic, physiologic, and anatomic regions of the body is best treated with an understanding of the biophysical effects of the implosion mechanism on air-containing spaces in the maxillofacial region. The introduction of new methods for the management of severe destruction of hard and soft tissue will decrease the incidence of complications and the operative time.

Topics: Blast Injuries; Facial Bones; Humans; Maxillofacial Injuries; Nose; Paranasal Sinuses

Topics: Adult; Blast Injuries; Foreign Bodies; Humans; Male; Nose; Radiography

The wearing of eye protection by United Kingdom soldiers in Afghanistan has reduced the morbidity caused by explosive fragments. However, the remaining face remains uncovered because there is a lack of evidence to substantiate the procurement of methods to protect it. Using a new computerised tool we entered details of the entry sites of surface wounds caused by explosive fragments in all UK soldiers who were injured in the face between 1 January 2010 and 31 December 2011. We compared clinical and predicted immediate and long term outcomes (as defined by the Abbreviated Injury Score (AIS) and the Functional Capacity Index (pFCI), respectively). We also used the tool to predict how additional protection in the form of a visor and mandible guard would affect outcomes. A soldier wearing eye protection was 9 times (1.03/0.12) less likely to sustain an eye injury than one without. However, 38% of soldiers in this series were not wearing eye protection at the time of injury. There was no significant difference between the AIS and pFCI scores predicted by the tool and those found clinically. There is limited evidence to support the use of a mandible guard; its greatest asset is better protection of the nose, but a visor would be expected to reduce long-term morbidity more than eye protection alone, and we recommend future trials to assess its acceptability to users. We think that use of this novel tool can help in the selection of future methods of ballistic facial protection.

Topics: Abbreviated Injury Scale; Blast Injuries; Computer-Aided Design; Equipment Design; Explosions; Eye Injuries, Penetrating; Eye Protective Devices; Facial Injuries; Forecasting; Head Protective Devices; Humans; Imaging, Three-Dimensional; Lasers; Male; Mandibular Injuries; Military Personnel; Nose; Personal Protective Equipment; Prospective Studies; Registries; Treatment Outcome; United Kingdom

A digitally captured, designed, and fabricated facial prosthesis is presented as an alternative to customary maxillofacial prosthodontics fabrication techniques, where a facial moulage and patient cooperation may be difficult.

Topics: Blast Injuries; Child, Preschool; Computer-Aided Design; Eye Enucleation; Eye Injuries, Penetrating; Eye, Artificial; Female; Humans; Nose; Optical Imaging; Photogrammetry; Prostheses and Implants; Prosthesis Coloring; Prosthesis Design

Blast injuries involving the frontobasilar region and orbit can present difficult evaluation and treatment challenges. This article presents the surgical treatment of four patients presenting with blast-type injuries involving the central periorbital region and anterior skull base. Three of these were the result of close-range gunshot wounds, and one was caused by an avulsive penetrating tree branch injury during a motor vehicle accident. All four patients underwent frontal craniotomy for exposure to repair significant intracranial injuries. Following intracranial repair of dural and brain injuries, anterior cranial fossa reconstruction was performed. In two of these patients, elective supraorbital osteotomies were performed to allow improved access to the posterior aspect of the anterior skull base. The healing period of all four patients has been without complications relative to the anterior fossa injuries.

Topics: Adult; Blast Injuries; Bone Transplantation; Brain Injuries; Cerebrospinal Fluid Rhinorrhea; Craniotomy; Dura Mater; Eye Injuries, Penetrating; Female; Follow-Up Studies; Frontal Bone; Humans; Male; Nose; Orbital Fractures; Osteotomy; Skull Base; Skull Fractures; Surgical Flaps; Surgical Mesh; Wound Healing; Wounds, Gunshot; Wounds, Penetrating

We reviewed the records of 136 patients who had inner ear disorders including hearing loss and vertigo caused by pressure change. We divided them into three groups, according to the aetiology: group A, change in atmospheric pressure (diving, airplane travel, etc.); group B, rapid change in ear pressure in normal atmosphere (nose blowing, heavy lifting, etc.); and group C, blast injury. A flat initial audiogram was the most common type in groups A and B. In group C, high-tone hearing loss was the most common type of audiogram. These results correspond to findings previously reported in animal experiments. Exploratory tympanotomy was performed more than 12 days after the pressure change in 16 patients. Although the vertigo disappeared after surgery, hearing did not improve.

Topics: Adolescent; Adult; Aged; Animals; Audiometry; Aviation; Barotrauma; Blast Injuries; Child; Diving; Female; Hearing Disorders; Hearing Loss, High-Frequency; Hearing Loss, Sensorineural; Humans; Labyrinth Diseases; Lifting; Male; Middle Aged; Mountaineering; Nose; Pressure; Sneezing; Treatment Outcome; Tympanic Membrane; Vertigo

The article examines the questions of a specialized otorhinolaryngological care to the minor wounded with mine injuries. There are description of evacuation procedures for this category of wounded. Up to 70% of such patients can be treated at the HMW. The article contains schemes concerning the conservative treatment of auditory disorders caused by mine traumas. The authors describe the methods of conduction anesthesia via the low palpebral fissure in cases when patients have traumas of the middle facial zone.

Topics: Afghanistan; Blast Injuries; Correction of Hearing Impairment; Ear; Hearing Disorders; Humans; Military Personnel; Nose; Pharynx; Time Factors; Triage; USSR; Warfare; Wounds, Gunshot