phenylephrine-hydrochloride and Fractures--Bone

Traumatic brain injury can result in frontobasal fractures (FBF). The goals of treatment for FBF are to eliminate primary morbidity and/or prevent secondary morbidity. Of particular importance in this regard is the proximity of important sensory organs for hearing, vision, smell, and taste, as well as their supplying nervous structures. Medical history, clinical findings, or CT scan are necessary and should lead to an individual evaluation. Depending on the severity of the fractures, the following disciplines may be involved in the treatment of FBF: neurosurgery, plastic surgery, oral and maxillofacial surgery, and/or otorhinolaryngology. Particularly less invasive endoscopic endonasal therapy is a specialty of otorhinolaryngologic surgeons and has not been widely established in other disciplines. The present work provides an overview of the current state of the art in terms of the following aspects, taking into account the current literature: anatomic principles, classification of fractures, diagnostics (in particular clinical examination, imaging, and laboratory chemistry tests), clinical symptoms, and treatment.. Schädel-Hirn-Traumata können zu frontobasalen Frakturen (FBF) führen. Die Ziele der Therapie von FBF liegen in der Beseitigung einer primären Morbidität und/oder der Verhinderung einer sekundären Morbidität. Von besonderer Bedeutung ist hierbei die unmittelbare Nähe wichtiger Sinnesorgane für das Hören, Sehen, Riechen und Schmecken sowie deren versorgende nervale Strukturen. Anamnese, klinische Untersuchungsbefunde oder eine ggf. schon vorliegende Computertomographie (CT) sind hier wegweisend und sollten zu einer individuellen Bewertung führen. Je nach Ausprägung der Frakturen können folgende Fachdisziplinen an der Versorgung von FBF beteiligt sein: Neurochirurgie, plastische Chirurgie, Mund-Kiefer-Gesichts(MKG)-Chirurgie und/oder HNO-Heilkunde. Insbesondere ist die weniger invasive endoskopische endonasale Therapie bisher dem HNO-Chirurgen vorbehalten und hat sich in anderen Fachdisziplinen noch nicht umfassend etabliert. Die vorliegende Arbeit gibt einen Überblick über den aktuellen Stand zu folgenden Aspekten unter Berücksichtigung der aktuellen Literatur: Anatomische Grundlagen, Einteilung von Frakturen, Diagnostik (insbesondere klinische Untersuchung, Bildgebung, und laborchemische Tests), klinische Symptome sowie Therapie.

Topics: Fractures, Bone; Humans; Neurosurgical Procedures; Nose; Plastic Surgery Procedures; Skull Fractures; Tomography, X-Ray Computed

Impairment of smell may occur following injury to any portion of the olfactory tract, from nasal cavity to brain. A thorough understanding of the anatomy and pathophysiology combined with comprehensively obtained history, physical exam, olfactory testing, and neuroimaging may help to identify the mechanism of dysfunction and suggest possible treatments. Although most olfactory deficits are neuronal mediated and therefore currently unable to be corrected, promising technology may provide novel treatment options for those most affected. Until that day, patient counseling with compensatory strategies and reassurance is essential for the maintenance of safety and QoL in this unique and challenging patient population.

Topics: Activities of Daily Living; Brain Contusion; Brain Injuries, Traumatic; Cerebral Cortex; Facial Bones; Facial Injuries; Fractures, Bone; Humans; Magnetic Resonance Imaging; Nose; Olfaction Disorders; Olfactory Nerve Injuries; Paranasal Sinuses; Positron-Emission Tomography; Quality of Life; Tomography, Emission-Computed, Single-Photon

This article reviews the trends in management of preadolescent facial fractures - a challenging population because of the need to consider growth, dynamic changes in dentition, and evolving fracture patterns.. Recent findings are a more thorough understanding of fracture patterns and distribution because of recent comprehensive studies isolating the preadolescent age cohort; the role of rigid internal fixation for significantly displaced fractures; and the potential applications and indications for the use of resorbable hardware for fracture fixation in the preadolescent.. As preadolescent fractures occur in a period of growth and evolving dentition in the facial skeleton, it is mandatory for the treating surgeon to have a thorough knowledge of standard and alternative treatment options to optimally manage these patients.

Topics: Child; Facial Bones; Fracture Fixation, Internal; Fractures, Bone; Humans; Mandibular Fractures; Nose; Orbital Fractures; Radiography; Skull Base; Skull Fractures; Zygomatic Fractures

Pediatric nasal deformities comprise a broad range of congenital and acquired pathologies. The congenital deformities are rare and often require specific surgical interventions. The acquired deformities are more common, and in the majority of cases surgical intervention is not necessary. The decision to operate is based primarily on the extent of the functional impairment and the severity of the aesthetic deformity.

Topics: Child, Preschool; Fractures, Bone; Humans; Infant; Infant, Newborn; Nose; Nose Neoplasms

The nasal bones are the most commonly fractured bones in the body. Accurate diagnosis and appropriate surgical intervention are key in the management of nasal fractures. While these injuries are not life-threatening, mismanagement of nasal fractures can lead to both aesthetic and functional deformities. A thorough history and careful physical examination are adequate for the diagnosis of nasal fractures. Literature in the field does not support the use of x-ray films to aid in the diagnosis. The majority of injuries are seen after significant edema becomes present and cannot be accurately reduced at that time. Therefore, with the exception of grossly displaced fractures, open fractures, and septal hematomas, most nasal fractures should be definitively treated after 3 to 10 days once swelling has resolved. This article will review pertinent nasal anatomic structure, pathophysiological characteristics of nasal fractures, diagnostic techniques, treatment modalities, and common controversies associated with nasal fractures.

Topics: Fracture Fixation; Fracture Fixation, Internal; Fractures, Bone; Humans; Nose; Splints

Implicit in all types of nasal surgery is the potential for worsening of olfactory function. Not only can injury occur to the delicate olfactory neuroepithelium itself, but also more indirect disturbances are engendered by pharmacologic agents, distortions of intranasal anatomy, persistent mucosal edema or crusts, and other processes. This study examined 93 patients undergoing various types of nasal surgery, including ethmoidectomy, polypectomy, Caldwell-Luc procedure, open reduction of nasal fracture, closed reduction of nasal fracture, rhinoplasty, and septoplasty. Factors considered as contributing to loss of olfactory acuity were age, gender, use of general anesthesia, and type of operation. The University of Pennsylvania Smell Identification Test (UPSIT), a 40-item, microencapsulated scratch-and-sniff procedure, was used to ascertain olfactory ability. Sixty-one patients (66%) had either improved or unchanged UPSIT scores after surgery; the remaining 32 patients (34%) had a decline in score. One patient (1%) became anosmic. Statistical treatment of outcome data using analysis of covariance with repeated measures showed no effect of age, gender, type of operation, or anesthetic.

Topics: Adolescent; Adult; Age Factors; Aged; Anesthesia, General; Anesthesia, Local; Ethmoid Bone; Female; Fractures, Bone; Humans; Male; Middle Aged; Nasal Bone; Nasal Polyps; Nasal Septum; Nose; Olfaction Disorders; Postoperative Complications; Prospective Studies; Rhinoplasty; Risk Factors; Sex Factors; Smell

Topics: Esthetics; Female; Fractures, Bone; Humans; Male; Nasal Bone; Nasal Septum; Nose; Nose Deformities, Acquired; Osteotomy; Postoperative Care; Rhinoplasty

Although the general principles for evaluation and management of facial fractures in children are the same as for adults, some modification in assessment, timing, and technique must be considered. This article has a double purpose: to re-emphasize acute assessment and medical management so that the pediatrician can function as the coordinator of the maxillofacial trauma team, and to present both established and new techniques for the reduction of simple and complex fractures in children.

Topics: Child; Child, Preschool; Ethmoid Bone; Fractures, Bone; Humans; Infant; Mandibular Fractures; Maxillary Fractures; Maxillofacial Injuries; Nose; Orbital Fractures; Radiography; Skull Fractures

Topics: Athletic Injuries; Child; Ear; Ear Diseases; Fractures, Bone; Humans; Larynx; Nasal Bone; Neck Injuries; Nose; Wounds, Nonpenetrating; Wounds, Penetrating

Topics: Cerebrospinal Fluid Rhinorrhea; Cranial Nerve Injuries; Diplopia; Ethmoid Bone; Ethmoid Sinus; Fixation, Ocular; Fractures, Bone; Hemorrhage; Humans; Lacrimal Apparatus; Maxillofacial Injuries; Nose; Oculomotor Muscles; Oculomotor Nerve Injuries; Orbit; Radiography; Tendon Injuries; Vision Disorders; Visual Acuity

Topics: Facial Injuries; Fractures, Bone; Humans; Mandibular Fractures; Maxillofacial Injuries; Nose; Orbit; Zygoma

Topics: Facial Bones; Fracture Fixation; Fractures, Bone; Humans; Jaw Fractures; Maxillofacial Injuries; Nose; Surgery, Plastic; Zygoma

Topics: Epistaxis; Europe; Fractures, Bone; Humans; Hypersensitivity; Hypophysectomy; Nasal Cavity; Nose; Nose Neoplasms; Papilloma; Paranasal Sinuses; Polyps; Rhinitis; Rhinitis, Atrophic

Simple fractures of the nasal pyramid without significant septal deformity may be reduced as effectively under local as under general anaesthesia. Currently, the former may involve regional nerve blockade by intranasal infiltration and is often unpleasant. We have attempted to find a more acceptable method. Fifty consecutive, adult patients with clinically displaced nasal fractures were randomized to receive either blocks of the infraorbital, infratrochlear and external nasal nerves by intranasal infiltration or generalized infiltration of the nasal dorsum by an external route. All patients received intranasal cocaine. Following manipulation, each patient recorded their overall discomfort level and subjective nasal airway patency. The surgeon recorded the cosmetic result. Analysis revealed the internal route to be significantly more painful (P less than 0.001) and with no advantage to the patient with respect to post-operative airway patency or cosmesis. We recommend the technically easier external method for this procedure.

Topics: Adult; Airway Resistance; Anesthesia, Local; Bupivacaine; Cocaine; Female; Fractures, Bone; Humans; Male; Nasal Bone; Nerve Block; Nose; Pain Measurement

We report a case of unilateral Keros type III variant of the cribriform plate (olfactory fossa >7 mm deep) that caused non-traumatic pneumocephalus. A 61-year-old male patient presented to the emergency room complaining of acute-onset headache after blowing his nose. Computed tomographic (CT) examination showed a massive pneumocephalus; a CT scan from three months before showed a Keros type III variant. The defect was repaired endoscopically with mucoperichondrial and mucoperiostal grafts. Pneumocephalus that has developed in a Keros type III variant has been theorised about, but never reported to our knowledge. Radiologists should be familiar with the Keros classification so that they can identify patients who are at increased risk of fractures of the cribriform plate.

Topics: Ethmoid Bone; Fractures, Bone; Humans; Male; Middle Aged; Nose; Pneumocephalus; Tomography, X-Ray Computed

While various forms of facial trauma, bruising, burns, and fractures are frequently seen in cases of child abuse, purposeful nasal erosion has rarely been identified as a form of abusive injury. Progressive destruction of nasal tissue in children provokes a wide differential diagnosis crossing multiple subspecialties: infectious, primary immunodeficiencies, inflammatory conditions, malignancy, and genetic disorders. Progressive nasal erosion also can be a manifestation of child abuse. The proposed mechanism is repetitive mechanical denudation of the soft tissue and cartilage resulting in chronic inflammation, bleeding, and ultimately destruction of the insulted tissue. We report 6 cases of child abuse manifesting as overt nasal destruction.

Topics: Child; Child Abuse; Child, Preschool; Contusions; Diagnosis, Differential; Facial Injuries; Female; Fractures, Bone; Humans; Infant; Male; Nose; Tomography, X-Ray Computed

Soccer participation continues to increase among all ages in the US. Our objective was to analyze trends in soccer-related facial injury epidemiology, demographics, and mechanisms of injury.. The National Electronic Injury Surveillance System was evaluated for soccer-related facial injuries from 2010 through 2014. Results for product code "soccer" were filtered for injures to the face. Number of injuries was extrapolated, and data were analyzed for age, sex, specific injury diagnoses, locations, and mechanisms.. In all, 2054 soccer-related facial trauma entries were analyzed. During this time, the number of injures remained relatively stable. Lacerations were the most common diagnosis (44.2%), followed by contusions and fractures. The most common sites of fracture were the nose (75.1%). Of fractures with a reported mechanism of injury, the most common was head-to-head collisions (39.0%). Patients <19 years accounted for 66.9% of injuries, and athletes over 18 years old had a higher risk of fractures.. The incidence of soccer-related facial trauma has remained stable, but the severity of such injuries remain a danger. Facial protection in soccer is virtually absent, and our findings reinforce the need to educate athletes, families, and physicians on injury awareness and prevention.

Topics: Adolescent; Adult; Age Distribution; Child; Contusions; Databases, Factual; Facial Bones; Facial Injuries; Female; Fractures, Bone; Humans; Incidence; Jaw Fractures; Lacerations; Male; Nose; Orbital Fractures; Sex Distribution; Soccer; United States; Young Adult

This study proposes that the bony anatomy of the human nose and masonry structure of the Gothic cathedral are geometrically similar, and have common fracture patterns. We also aim to correlate the fracture patterns observed in patients' midface structures with those seen in the Gothic cathedral using computational approach. CT scans of 33 patients with facial fractures were examined and compared with computer simulations of both the Gothic cathedral and human nose. Three similar patterns were found: (1) Cracks of the nasal arch with crumpling of the vertical buttresses akin to the damage seen during minor earthquakes; (2) lateral deviation of the central nasal arch and collapse of the vertical buttresses akin to those due to lateral forces from wind and in major earthquakes; and (3) Central arch collapse seen as a result of collapse under excessive dead weight. Interestingly, the finding of occult nasal and septal fractures in the mandible fractures with absence of direct nasal trauma highlights the possibility of transmission of forces from the foundation to the arch leading to structural failure. It was also found that the structural buttresses of the Gothic cathedral delineate the vertical buttresses in the human midface structure. These morphologic similarities between the human nose and Gothic cathedral will serve as a basis to study the biomechanics of nasal fractures. Identification of structural buttresses in a skeletal structure has important implications for reconstruction as reestablishment of structural continuity restores normal anatomy and architectural stability of the human midface structure.

Topics: Fractures, Bone; Humans; Nose; Tomography, X-Ray Computed

Topics: Facial Injuries; Fractures, Bone; Humans; Incisor; Male; Mandible; Nose; Tomography, X-Ray Computed; Young Adult

Topics: Adult; Facial Injuries; Female; Fracture Fixation; Fractures, Bone; Humans; Incidence; Male; Northern Ireland; Nose; Retrospective Studies; Rhinoplasty

Topics: Adult; Anesthesia, General; Cardiac Catheterization; Echocardiography, Transesophageal; Electric Countershock; Electrocardiography; Fractures, Bone; Humans; Intraoperative Complications; Male; Military Personnel; Nose; Postoperative Complications; Stress Disorders, Post-Traumatic; Stress, Psychological; Takotsubo Cardiomyopathy; Treatment Outcome; Troponin I; Ventricular Fibrillation

A fracture of nasal bones is becoming a very common injury due to the increasingly greater number of car accidents and aggravated criminal situation. A total of 500 cases of nasal fracture associated with external deformities were included in the present study. The following kinds of deformities were identified: unilateral retraction, lateral displacement of the entire dorsum of the nose, and depressed comminuted fracture. Rhinoscopy revealed in addition such abnormalities associated with septal fracture as submucous hemorrhage, pathological mobility of the pyramid, deflection of the nasal septum at an acute angle. All in all, four types of nasal septum fractures were distinguished depending on the shape and localization of the fracture line. Two of them resulted in marked impairment of nasal breathing while two others required surgical intervention in the acute period after the injury.

Topics: Adolescent; Adult; Female; Fracture Fixation; Fractures, Bone; Humans; Male; Middle Aged; Nose; Nose Deformities, Acquired; Retrospective Studies; Rhinoplasty; Trauma Severity Indices; Young Adult

Estimation of the treatment of the nasal septal hematoma and abscess after injury was performed.. In 1998-2005 in Department of Otolaryngology Children's Hospital in Warsaw 2500 children after nasal injury were examined. Nasal septal hematoma and abscess were diagnosed in 22 (0,9%). They were reviewed retrospectively and some of them were examined 1-8 years after.. In 22 children with nasal septal hematoma and abscess no complication were observed during treatment. In 12 children examined 1-8 year after treatment 1 child developed saddle nose deformity (qualified to observation) and 1 child developed nasal septum deformities with nasal obstruction (qualified to septoplasty).. Complex treatment of nasal septal hematoma, drainage of the hematoma with septoplasty and reduction of fracture of the nose, makes good functional and cosmetic effect. Drainage of the nasal septal abscess with antibiotic prevent the early complications but it isn't enough functional and cosmetic effect in the future.

Topics: Abscess; Adolescent; Child; Drainage; Female; Follow-Up Studies; Fractures, Bone; Hematoma; Humans; Male; Nasal Septum; Nose; Nose Diseases; Retrospective Studies

Septal haematoma following nasal trauma is a complication that, if not diagnosed and treated early, may evolve into a nasal septal abscess. We present the case of a 10-year-old male who suffered nasal trauma with fracture and an undiagnosed septal haematoma that evolved into a septal abscess. During drainage of the abscess, necrosis of the quadrangular cartilage was noted. The patient later presented collapse of the nasal dorsum and deviation of the nasal septum. This sequela was corrected by means of an osteochondral costal graft. In the presence of any nasal trauma, it is important to explore the nasal septum correctly to discard the presence of a haematoma which, if not drained early, may evolve into an abscess due to compression of the quadrangular cartilage, leading to its necrosis in a few days and later collapse of the nasal dorsum as the child grows.

Topics: Abscess; Child; Fractures, Bone; Hematoma; Humans; Male; Nasal Septum; Nose

Antley-Bixler syndrome (ABS) is characterized by craniofacial dysmorphism and radiohumeral synostosis with other associated anomalies. Prior studies have commonly described the entirety of the syndrome or the genetic abnormalities underlying the syndrome, however, no study has specifically addressed the otologic findings of ABS. We present a case of ABS, specifically focusing on the otologic ramifications of the disease, and provide recommendations for approaching the otologic management of these complex patients.

Topics: Abnormalities, Multiple; Child; Craniofacial Abnormalities; Ear; Female; Fractures, Bone; Humans; Humerus; Nose; Radius; Skull; Syndrome; Synostosis; Tomography, X-Ray Computed

Septal haematoma after nasal trauma is a complication that can lead to septal abscess if unrecognized or early intervention is not performed. It can cause compression and thereby necrosis that evolve to a septal abscess in which cultures reveal saprophyte bacteria. Cartilage necrosis and destruction can produce impaired breathing and aesthetic deformities with collapse of the dorsum and the tip of the nose. We present a 10 year old masculine infant, that suffered a nasal fracture with a septal haematoma that remained undiagnosed. The patient developed a septal abscess that required drainage and resulted in nasal sequelae with collapse of dorsum and cranial displacement of tip and columella. Functional and aesthetic reconstruction was performed using rib cartilage grafts. No complications occurred. Functional and aesthetic improvement was observed. Result after 2 months of follow-up is considered favourable.

Topics: Abscess; Child; Fractures, Bone; Hematoma; Humans; Male; Nasal Bone; Nasal Septum; Nose

Nasoethmoid orbital fractures are perhaps the most complicated aspect of craniomaxillofacial trauma. Involvement of the medial canthal tendon markedly increases the complexity of the repair. We report a case of type II nasoethmoid orbital fracture in a 32-year-old man that was managed without formal medial canthal tendon repair; instead, we used open reduction and internal fixation of the central fragment and the nasoethmoid complex. However, during the immediate postoperative period, we noted anterior and inferior displacement of the medial canthus. We took the patient back to the operating room to address the detachment. Revision surgery was successful, and at the 6-month follow-up, his medial canthi were completely symmetrical in all dimensions. We describe our intraoperative technique and measures to prevent complications that can help the surgeon intraoperatively. We also discuss an important point that has not been adequately addressed in the literature to date--that is, the fact that the use of the frontoethmoid suture line and the anterior ethmoid artery as a guide to the skull base can be inaccurate. Problems associated with this inaccuracy can be avoided by carefully reviewing preoperative computed tomography, which can help keep the surgeon from entering the intracranial cavity while fixing the medial canthal tendon during transnasal canthal repair.

Topics: Adult; Ethmoid Bone; Fractures, Bone; Humans; Male; Nose; Orbital Fractures; Otorhinolaryngologic Surgical Procedures; Tomography, X-Ray Computed

To determine how nasal injuries are managed by accident and emergency (A&E) consultants and produce a management protocol if the survey indicated a need.. A postal survey of UK A&E consultants.. The response rate was 59%. A great deal of variation was found between departments and clinicians regarding the training of junior A&E staff, the equipment available, the management strategies employed, and the reasons for referral to ENT or maxillofacial departments.. This survey shows that many more nasal injuries could be managed within the A&E setting without referral to ENT or maxillofacial departments. A flow chart of the optimal management of nasal injuries in Accident and Emergency departments is presented.

Topics: Emergency Service, Hospital; Fractures, Bone; Health Care Surveys; Humans; Nose; Practice Patterns, Physicians'; Referral and Consultation; Surveys and Questionnaires; United Kingdom

Topics: Anesthesia, General; Anesthesia, Local; Fractures, Bone; Humans; Nose; Nose Diseases; Plastic Surgery Procedures

Nosebleeds from a break and/or obstructon can result in life-threatening problems. The nose is the airway opening that warms, humidifies and filters air. Control epistaxis with well-aimed direct pressure for 10-15 minutes. Nasal fractures, which are the most common facial fracture, can be the outward sign of skull fracture, brain injury or c-spine impairment, and may pose a threat to the airway and breathing. The greatest concern of a nose obstruction is aspiration.

Topics: Emergency Medical Services; Epistaxis; Fractures, Bone; Humans; Nose; Patient Care

Ultrasound is commonly performed to diagnose pathological processes of the neck and the salivary glands. In contrast, pathological changes of the sinuses and the bony structures of the face are only rarely examined sonographically. This paper deals with the diagnostic scope of ultrasound in the case of orbital and nasal fractures as well as for cases of sinus pathology excluding acute sinusitis. 51 patients with different diseases of this area were examined using US and X-ray or CT scan. Fractures of the nose could all be diagnosed correctly by ultrasound, which is of clinical importance if children or pregnant patients are examined. Blow-out fractures of the orbit were not detected. In contrast, pathological changes of the orbit itself could be distinguished sufficiently well from those infiltrating the orbit and originating from the sinuses. Real-time examination allows the detection of infiltration of orbital muscles and the bulb of the eye better than any other imaging method.

Topics: Carcinoma, Renal Cell; Female; Fractures, Bone; Humans; Kidney Neoplasms; Male; Neoplasm Metastasis; Nose; Nose Diseases; Nose Neoplasms; Paranasal Sinus Diseases; Paranasal Sinuses; Reproducibility of Results; Tomography, X-Ray Computed; Ultrasonography

Nasal trauma does not always require ENT clinic follow-up. We assess the appropriateness of referral to the ENT department from A&E of suspected nasal fractures.. The 342 case notes of patients referred to ENT from A&E with suspected nasal fractures were reviewed. The patients were divided into groups depending on whether or not they showed clinical features in A&E.. Patients showing clinical features in A&E initially were significantly [P < .005] more likely to attend their clinic appointment than those without clinical features. They were also significantly more likely [P < 0.001] to undergo surgical correction of their nose.. Suspected nasal fractures following trauma should be referred to ENT only if they show clinical features on presentation to A&E. For patients developing clinical features over the next 3 weeks a telephone number should be given to the patient for rapid access to the ENT clinic.

Topics: Emergencies; Emergency Service, Hospital; Fractures, Bone; Humans; Nasal Obstruction; Nose; Otolaryngology; Patient Acceptance of Health Care; Referral and Consultation

The goal of this report is to describe the therapeutic methods and surgical techniques used by Hippocrates (5th century BC) in the treatment of nasal injuries. We studied the original Greek texts of the (generally considered genuine) Hippocratic book Mochlicon and, especially, the analytical On Joints. We identified the treatments and techniques applied to the restoration of injured noses. We found that Hippocrates classified nasal injuries, from simple contusions of soft tissues to complicated fractures. Hippocrates provided detailed instructions for each case, from poultice application and bandaging to reconstruction and reshaping of the nasal bones in cases of fractures and deviation. Hippocrates' texts reflect the interest of the classical period in nasal injuries, a common enough accident in athletics. Hippocratic conservative and surgical management for each form of injury was adopted by later physicians and influenced European medicine.

Topics: Bandages; Contusions; Fractures, Bone; History, Ancient; Humans; Nose; Otolaryngology; Rhinoplasty; Splints

Topics: Biomechanical Phenomena; Facial Bones; Fracture Fixation, Internal; Fractures, Bone; Fractures, Comminuted; Hematoma; Humans; Nasal Bone; Nasal Cartilages; Nose

Topics: Adolescent; Cefuroxime; Cephalosporins; Facial Injuries; Female; Floxacillin; Fractures, Bone; Humans; Infusions, Intravenous; Nose; Ocular Motility Disorders; Orbit; Penicillins; Streptococcal Infections; Visual Acuity

Precise lateral nasal osteotomies combined with digital greenstick infracture can be a key feature in determining the success of a rhinoplasty procedure. This procedure may be difficult to perform consistently because the surgeon relies on tactile cues transmitted through intact soft tissue. In 17 cadavers with known demographics, bone fracture patterns after lateral osteotomy and digital greenstick infracture were studied and compared with measured lateral bone pyramid thicknesses. One side of each nose served to measure lateral wall thicknesses by drilling holes in a grid pattern and taking depth gauge measurements. Contralaterally, lateral osteotomy with digital greenstick infractures were performed. Consistent patterns of bone thickness were found. Bone was thinner near the pyriform aperture with a high fragmentation rate after osteotomy. Cephalocaudal thinning of the lateral bony pyramid near the medial canthus corresponded to the zone of greenstick fracture in 14 of 14 noses. Two major fracture pattern groups were noted. When lateral osteotomy was taken to the level of the medial canthus vertically, the greenstick fracture was consistent and predictable based on the transition in bone thickness from the radix area down across the lateral bony vault in untraumatized white cadavers.

Topics: Fractures, Bone; Humans; Nasal Bone; Nose; Osteotomy; Rhinoplasty

Topics: Adult; Anesthesia, General; Female; Fractures, Bone; Humans; Nose; Reflex, Oculocardiac

Pneumosinus dilatans is an abnormal dilatation of the paranasal sinuses, which contains only air and is lined by normal mucosa. It is a rare condition, the aetiology of which is unclear. We describe four patients who presented to our department with pneumosinus dilatans. The aetiology was either developmental hydrocephalus (n = 1), post-traumatic (n = 1) or idiopathic (n = 2). Two patients underwent surgery, and follow-up is at least 12 months to date. The radiological aspects of this rare condition and the possible aetiologies are discussed.

Topics: Adolescent; Adult; Dilatation, Pathologic; Encephalomalacia; Ethmoid Sinus; Female; Fractures, Bone; Frontal Sinus; Humans; Hydrocephalus; Magnetic Resonance Imaging; Male; Middle Aged; Nose; Paranasal Sinus Diseases; Tomography, X-Ray Computed

Topics: Accidents, Traffic; Anti-Bacterial Agents; Fractures, Bone; Granuloma, Foreign-Body; Nose; Ointments; Postoperative Complications; Rhytidoplasty; Stapes Surgery; Surgery, Plastic

Topics: Fractures, Bone; Humans; Nose; Rhinoplasty

Topics: Adolescent; Finger Injuries; Foreign Bodies; Fractures, Bone; Humans; Male; Metacarpophalangeal Joint; Nose; Radiography; Wound Infection

Cutaneous sarcoidosis may occur at sites of trauma. Two patients are reported in whom lupus pernio developed in the area of facial fractures. Injury may be a factor in the site of development of lupus pernio in some individuals and may have medico-legal implications. Cutaneous sarcoidosis is known to occur at the sites of scars and trauma but lupus pernio has not been widely recognized to show this phenomenon. We report two patients in whom lupus pernio developed at the site of facial trauma.

Topics: Erythema; Facial Dermatoses; Female; Fractures, Bone; Humans; Lupus Vulgaris; Middle Aged; Nose

We present four patients complaining of neuralgic pains across the nasal bridge following trauma, who were successfully treated by division of the external nasal nerve. We believe it is a useful treatment in selected cases.

Topics: Adult; Female; Fractures, Bone; Humans; Male; Middle Aged; Nasal Bone; Neuralgia; Nose

Topics: Adolescent; Adult; Ambulatory Surgical Procedures; Anesthesia, General; Child; Child, Preschool; Female; Fractures, Bone; Humans; Male; Masks; Middle Aged; Nose; Respiratory Protective Devices

Topics: Child; Fracture Fixation; Fractures, Bone; Humans; Male; Nose

Topics: Fracture Fixation; Fractures, Bone; Humans; Nose

Topics: Adolescent; Adult; Aged; Child; Denmark; Female; Fractures, Bone; Humans; Male; Middle Aged; Nose

The nose is a three-walled pyramid separated into two nostrils by a midline septum. The septum has been shown to provide considerable support to the shape of the nose. Previously nasal trauma was thought to damage solely the anterior cartilaginous septum with sparing of the posterior bony septum. Cadaver nasal fracture experiments have shown that the bony septum is often involved (Murray, 1984). This may be the reason that reduction of the fractured nasal bones by simple reposition, has been found to give a poor cosmetic and functional end result. Also seen were clinical and radiological confirmation of bony septal fractures associated with nasal bone fractures (Murray, 1984). In this experiment, the use of perspex models and bipolarised light demonstrates the lines of force passing through the bony septum which accounts for its involvement.

Topics: Biomechanical Phenomena; Cartilage; Fractures, Bone; Fractures, Cartilage; Humans; Models, Anatomic; Nasal Bone; Nasal Septum; Nose

Lebanon has witnessed over the past 10 years fierce outbreaks of violence resulting in heavy casualties. Head and neck injuries secondary to bullets, shrapnel, and/or glass were quite frequent: 1,357 injuries in 1,021 patients were taken care of by members of the Department of Otolaryngology between 1975 and 1984. They were distributed as follows: (Formula: see text). Fractures of the mandible were treated by closed reduction in 54% of cases and by open reduction in 46%; 74% healed well and 26% required secondary surgery. Primary repair of oral cavity injuries resulted in healing in 68% of cases; 32% had dehiscences or fistulae. In around one-third of the orbital injuries, the orbital contents herniated into the maxillary sinus, so orbital floor repairs had to be done with good results in 82% of cases. The nasal fractures were treated by closed reduction in 75% of cases and open reduction when the wound was open in the rest. The overall infection rate was 12%. The most common offending organisms were, in order of frequency, S. aureus, P. aeruginosa, and E. coli.

Topics: Bacteria; Craniocerebral Trauma; Fractures, Bone; Humans; Lebanon; Mandibular Fractures; Mandibular Injuries; Maxillary Fractures; Maxillofacial Injuries; Military Medicine; Mouth; Neck Injuries; Nose; Orbit; Orbital Fractures; Outcome and Process Assessment, Health Care; Wounds and Injuries

Topics: Airway Resistance; Fractures, Bone; Humans; Nose; Nose Deformities, Acquired; Nose Diseases; Rhinitis

To determine the frequency with which fractures are encountered in emergency care and to estimate the incidence of fractures in a well-defined population, a population-based sample of emergency department (ED) visits was examined. Eleven percent of ED visits for trauma involved fractures. The incidence of fractures was 21 per 1,000 persons per year and had two peaks, the first at ages 10 to 14 and the second at ages greater than 60. Among young people, falls (often related to sports or recreation), striking objects, motor vehicle injuries, and assaults were the major causes of fractures. Among the elderly, falls caused 87% of all fractures.

Topics: Accidents; Accidents, Occupational; Accidents, Traffic; Adolescent; Adult; Age Factors; Aged; Athletic Injuries; Child; Child, Preschool; Emergency Service, Hospital; Female; Finger Injuries; Fractures, Bone; Hip Fractures; Humans; Male; Middle Aged; Nose; Ohio; Toes

The usual radiologic postoperative appearance of the bony nasal pyramid following a typical cosmetic rhinoplasty is demonstrated, and possible atypical sequelae are discussed. More specifically, the sites of the osteotomies performed as part of this surgical procedure are diagrammatically illustrated. It is believed that because of the increasing popularity of rhinoplastic operations, it is timely to acquaint radiologists with the postsurgical stigmata which, though minor, might be erroneously interpreted as resulting from accidental trauma or other pathologic processes. Beyond academic considerations, potential medicolegal implications also exist. A brief historical overview is included.

Topics: Chin; Esthetics; Follow-Up Studies; Fractures, Bone; Humans; Nasal Bone; Nose; Nose Deformities, Acquired; Radiography; Rhinoplasty

The standard treatment in ENT and plastic surgical departments of a fractured nose is closed manipulation. Two recent retrospective studies have cast doubt on the value of this manoeuvre. This review of 70 patients between one and three years following injury shows that only 26% had a normal appearance and 48% had normal function. The presence of a septal fracture is of prime importance in determining the outcome.

Topics: Adolescent; Adult; Airway Obstruction; Female; Follow-Up Studies; Fractures, Bone; Humans; Male; Manipulation, Orthopedic; Middle Aged; Nose

After having emphasized the frequency of the newborn's and young child's nasal fractures, the authors insist on the difficulty of: - a precise outcome of the lesions, - the complications due to nasal obstruction, - the impossibility to anticipate the evolution of these lesions, which is being precised by a brief embryological recall. The traumas are deliberately presented according to the age of the patients: 1) the newborn's fractures: - the prenatal fractures, which generally have a favorable evolution. - obstetrical traumas, with nasal obstruction and feeding difficulty, both being indications to surgery. 2) The young child's fractures: often misknown, and relatively frequent, the nasal wall's hematoma is a dreadful complication. 3) During school years: (sports, car accidents, Silverman's syndrome) Nasal fractures are here generally associated to other facial lesions. Indications to surgery: Always: If it is a recent fracture, provoquing nasal obstruction with respiratory and feeding problems. Sometimes: Septoplasty as minima in case of respiratory difficulties. Never perform true rhinoplasty and/or osteotomies.

Topics: Age Factors; Birth Injuries; Child, Preschool; Female; Fractures, Bone; Fractures, Closed; Humans; Infant; Infant, Newborn; Labor Presentation; Nasal Septum; Nose; Pregnancy; Rhinoplasty

A patient is described with an orbital fistula complicating frontal sinusitis and osteomyelitis of the frontal bone. The fistula was excised, but a fortnight later an acute exacerbation occurred. From the discharging pus a Staphylococcus aureus was cultured and from mucosa obtained during surgery a microaerophilic Streptococcus. These findings led to the diagnosis: synergistic bacterial inflammation of the frontal sinus, with osteomyelitis and orbital cellulitis.

Topics: Adult; Fistula; Fractures, Bone; Frontal Sinus; Humans; Male; Nose; Orbital Diseases; Osteomyelitis; Radiography; Sinusitis; Skin Diseases; Staphylococcal Infections; Streptococcal Infections

Topics: First Aid; Fractures, Bone; Humans; Nasal Bone; Nose; Wounds, Nonpenetrating

The physician who initially examines the patient with a nasal or facial injury should thoroughly inspect the external and internal aspects of the nose and also evaluate the facial bones. General anesthesia may be necessary in examining children. Although roentgenograms of the nose and facial bones are usually obtained in cases of nasal injury, they rarely influence treatment. Treatment goals should be to maintain or restore satisfactory function and to ensure a good cosmetic result. The patient (or parents) should be advised to be alert to possible delayed abnormalities from the injury.

Topics: Adolescent; Adult; Anesthesia, General; Child, Preschool; Female; Fractures, Bone; Humans; Male; Nasal Bone; Nose; Radiography

Naso-orbital trauma can cause medial orbital wall disruption and detachment of the medial canthal ligament. Damage to the nasolacrimal drainage apparatus, cerebrospinal fluid rhinorrhea and frontal sinusitis can occur. Twelve cases of naso-orbital trauma have been reviewed. There is a high incidence of associated injury to adjacent structures. Medial canthal ligament separation was missed acutely in a number of cases leading to the necessity of delayed repair. Important diagnostic and therapeutic points are stressed in the acute and delayed management, particularly medial canthal ligament separation. A wire to intranasal button technique for the delayed repair of traumatic telecanthus is presented.

Topics: Adolescent; Adult; Brain Injuries; Cerebrospinal Fluid Rhinorrhea; Child; Child, Preschool; Eye Injuries; Fractures, Bone; Humans; Ligaments; Nose; Orbit; Surgery, Plastic

The completeness of the Emergency Room evaluation of the injured nose was determined by reviewing 250 cases of acute nasal injury. A recorded examination of intranasal structures was found for only 42 (21 percent) of 200 patients with blunt nasal trauma. In another group of 50 patients with roentgenographically documented nasal fractures, only 21 (42 percent) had a recorded intranasal examination. Failure to examine the internal nose thoroughly will leave undiagnosed such serious pathologic conditions as septal hematomas, mucosal tears, and fractures and dislocations of the bony and cartilaginous septum, which may cause permanent functional disturbances (nasal airway obstruction) and cosmetic deformities.

Topics: Adult; Child; Child, Preschool; Emergency Medical Services; Emergency Service, Hospital; Fractures, Bone; Humans; Infant; Nose; Primary Health Care

Topics: Adolescent; Adult; Age Factors; Aged; Child; Female; Fractures, Bone; Fractures, Cartilage; Humans; Male; Manipulation, Orthopedic; Middle Aged; Nasal Bone; Nasal Septum; Nose; Nose Deformities, Acquired; Prospective Studies; Sex Factors

Topics: Fractures, Bone; Humans; Nose

Topics: Fractures, Bone; Humans; Nasal Bone; Nose

Topics: Ear; Ear, External; Emergencies; Fracture Fixation, Internal; Fractures, Bone; Humans; Maxillofacial Injuries; Nose; Orbit; Patient Care Team

For correction of the twisted nose, the use of a dorsal onlay cartilage graft, obtained from the resected septum, produces the illusion of a straight nose. This persists in spite of any recurrences of deviations in the septum or upper lateral cartilages.

Topics: Cartilage; Follow-Up Studies; Fractures, Bone; Humans; Nasal Septum; Nose; Nose Deformities, Acquired; Rhinoplasty; Transplantation, Autologous

Evaluation in maxillofacial trauma is primarily an extension of the art of the physical examination, with inspection, palpation, and evaluation of loss of normal function as the primary requisites. X-ray evaluation is critical, and best results are usually obtained by taking films as soon following the injury as possible, before opacification of the sinus with blood, swelling, or hematoma obscures critical bone landmarks. Primary reduction and surgical management of these fractures can usually be delayed for a reasonable period; however, the most accurate findings on both physical examination and x-ray studies are those obtained as soon as possible after the injury.

Topics: Child; Emergencies; Fractures, Bone; Frontal Bone; Humans; Mandibular Fractures; Maxillary Fractures; Maxillofacial Development; Maxillofacial Injuries; Nose; Orbit; Zygomatic Fractures

This chapter has emphasized the relative infrequency of severe skeletal maxillofacial injuries in children. When they do occur, it is extremely important that they be approached by a team of physicians, each of whom is competent to manage the injury and complications related to his specialty. Particular attention must be given to the issues of general facial bone growth as well as future dental development. All operative procedures must be designed to avoid further injury to unerupted teeth, and the traditional methods of immobilization must be modified in order to avoid the avulsion of deciduous teeth.

Topics: Child; Fractures, Bone; Humans; Mandibular Fractures; Maxillary Fractures; Maxillofacial Development; Maxillofacial Injuries; Nose; Orbit; Zygomatic Fractures

The author has reviewed the 69 patients upon whom he has performed septorhinoplasty in treatment of posttraumatic deformities. These have been followed over a 12-year period; however, only the 59 followed over one year have been studied. In analyzing the deformities, it was noted that three characteristics occur alone or in combination: excessive width, depression, and twisting. The wide nose was best treated by removal of medial tissue, full mobilization of the nasal bones, and postoperative compression exercises. The depressed nose was built forward by onlay grafts, the first choice being septal cartilage. Finally, the twisted nose was treated by freeing the nasal components, straightening the bone and cartilage, and replacing them in their anatomical positions. Not infrequently all three problems were treated in one operative session.

Topics: Adolescent; Adult; Child; Female; Fractures, Bone; Hemostasis, Surgical; Humans; Male; Nasal Bone; Nasal Septum; Nose; Nose Deformities, Acquired; Rhinoplasty

A method of intra-nasal splinting has been outlined which revives principles and improves on methods established particularly well by two French Stomatologists at the beginning of this century. It uses a simple splint, carefully chosen from a range of sizes, that requires precise insertion, and has proved to have several advantages over more commonly employed techniques.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Fracture Fixation; Fractures, Bone; Humans; Middle Aged; Nose; Splints; Stainless Steel

A retrospective study of 122 facial fractures in 109 children, under 16 years of age, is reported. The data are analyzed in terms of fracture type, sex, age, etiology, therapy, and complications.

Topics: Adolescent; Child; Facial Bones; Female; Fractures, Bone; Humans; Male; Mandibular Injuries; Maxillofacial Injuries; Nose; Orbit; Postoperative Complications; Retrospective Studies; Zygomatic Fractures

In the second article on pediatric otolaryngology, speed of diagnosis is stressed as vital to prevent permanent aftereffects such as deafness or facial paralysis. Aggressive education of parents in preventing emergencies is recommended.

Topics: Acids; Child; Ear; Emergencies; Esophagus; Facial Bones; Facial Injuries; Foreign Bodies; Fractures, Bone; Humans; Larynx; Lye; Nasopharynx; Nose; Otitis Media; Otorhinolaryngologic Diseases; Respiratory System; Temporal Bone

Topics: Adult; Child; Fracture Fixation; Fractures, Bone; Frontal Bone; Humans; Mandibular Fractures; Maxillary Fractures; Maxillofacial Injuries; Nose; Skull Fractures; Time Factors; Zygomatic Fractures

Topics: Child; Facial Injuries; Fractures, Bone; Humans; Nasal Bone; Nose; Nose Deformities, Acquired

Films of 50 normal patients and 50 dry skulls were examined to detect lines which might stimulate a nasal fracture. These were visible on the occipito-mental view but on the lateral view any line which reaches the anterior cortex must be regarded as a fracture. The results of an analysis of 100 patients with trauma to the nasal bone are also presented. It is concluded that radiography of the nasal bone is an unnecessary examination unless requested by the E.N.T. surgeon, and this will in any case occur infrequently.

Topics: Fractures, Bone; Humans; Nasal Bone; Nose; Radiography

In 100 adults the effect of treatment of nasal fractures was followed up after 14 to 65 months. In 30% of 53 patients with closed reduction of the nose long-term results as to shape and function of the nose were not satisfying. Nasal obstruction deformity slowly developed several months after treatment mainly because of untreated septal fractures and green-stick fractures of the nasal bones. After open reduction and septal reconstruction only 1 of 17 patients had a poor result. By roentgenographic examinations three types of fracturelines could be distinguished: osseous (40), fibrous (37), and mixed transformations (23). In all types there was found a solid nasal pyramid. The osseous transformation of the fracture-line was promoted by reduction of the fracture within the first posttraumatic days, by a small distance of the fractured ends and if the injury was not too violent.

Topics: Adolescent; Adult; Aged; Facial Injuries; Female; Follow-Up Studies; Fractures, Bone; Fractures, Cartilage; Humans; Male; Middle Aged; Nasal Bone; Nasal Septum; Nose; Nose Deformities, Acquired; Radiography; Respiration Disorders

Topics: Bandages; Elasticity; Fractures, Bone; Humans; Nose; Polymers

Topics: Airway Obstruction; Child; Fractures, Bone; Humans; Infant, Newborn; Nose; Nose Deformities, Acquired

Topics: Adolescent; Adult; Female; Fractures, Bone; Humans; Ilium; Male; Middle Aged; Nasal Bone; Nose; Nose Deformities, Acquired; Rhinoplasty; Transplantation, Autologous

Topics: Accidents, Traffic; Adult; Child; Craniocerebral Trauma; Facial Injuries; Fractures, Bone; Humans; Male; Nose

Topics: Adult; Arteries; Epistaxis; Ethmoid Bone; Facial Injuries; Fractures, Bone; Humans; Ligation; Male; Nasal Bone; Nose; Zygomatic Fractures

The extent to which emotional factors play a direct or indirect role in the causation of traffic accidents has been presented along with the early and late emotional response of individuals to facial injuries as a result of traffic accidents. Illustrated case histories are presented.

Topics: Accidents, Traffic; Adult; Age Factors; Automobile Driving; Craniocerebral Trauma; Depression; Emotions; Facial Injuries; Female; Fractures, Bone; Humans; Judgment; Male; Mental Disorders; Middle Aged; Neurotic Disorders; Nose; Personality Disorders; Phobic Disorders; Schizophrenia; Stress Disorders, Post-Traumatic; Suicide

Nasal injuries frequently occur and may result in immediate or delayed disturbances in both function and appearance. Early evaluation and management are beneficial in lessening the complications and disturbances in nasal function. A thorough intranasal examination is necessary to evaluate the injury, and examination may require local or general anesthesia to assess the injury properly. Specific management depends on the extent of injury. Minimal nasal injuries in children may result in a major disturbance of nasal function.

Topics: Anesthesia, General; Anesthesia, Local; Child; Cocaine; Facial Bones; Facial Injuries; Fractures, Bone; Hematoma; Humans; Nasal Bone; Nasal Septum; Nose; Nose Diseases; Radiography

Topics: Bandages; Cartilage; Esthetics; Female; Fractures, Bone; Humans; Male; Nasal Bone; Nasal Septum; Nose; Nose Deformities, Acquired; Osteotomy; Postoperative Care; Rhinoplasty

The authors describe the diagnosis and operative methods for the treatment of 36 patients which were operated on in the last two years. These patients included 32 with various face fractures, of which 7 had blow-out fractures. In 4 patients the diplopia was caused by injuries to the soft tissues without bony fracture. The examinations comprised x-ray methods and also ophthalmological examinations, especially with the synoptometer. In 24 operated patients, reposition of the bony fragments or autologous bone grafts were done according to the kind of injury present. Although 17 patients were operated on very late (some weeks up to several months after the trauma), in 13 patients (54%) a complete cure could be achieved, and all the other patients showed an improvement. In 3 patients there was only a minor improvement, and it was decided to perform further operations on the extrinsic eye muscles. The authors emphasize the special sense of multi-disciplinary working together in the diagnosis and therapy of patients with face injuries, while this is very important for the success of the treatment.

Topics: Adult; Diplopia; Facial Injuries; Fractures, Bone; Humans; Male; Nose; Orbit

Topics: Adult; Ethmoid Bone; Face; Fractures, Bone; Humans; Male; Melanoma; Mucocele; Neck; Nose; Optic Neuritis; Orbit; Orbital Neoplasms; Postoperative Complications; Rhinitis

Topics: Adult; Angiography; Carotid Artery, Internal; Epistaxis; Ethmoid Bone; Fractures, Bone; Humans; Male; Nose

Topics: Facial Injuries; Fractures, Bone; Humans; Nose; Surgery, Plastic

Topics: Age Factors; Child; Fractures, Bone; Humans; Nose; Surgery, Plastic

Topics: Accidents, Traffic; Adult; Belgium; Cervical Vertebrae; Coma; Disability Evaluation; Facial Injuries; Female; Fractures, Bone; France; Humans; Male; Nose; Physician-Patient Relations; Rib Fractures; Spinal Injuries; Wounds and Injuries

Topics: Cerebrospinal Fluid Rhinorrhea; Cryosurgery; Epistaxis; Fractures, Bone; Histiocytoma, Benign Fibrous; Humans; Mucous Membrane; Nasal Polyps; Nasopharyngeal Neoplasms; Nose; Nose Deformities, Acquired; Nose Diseases; Nose Neoplasms; Rhinitis; Rhinoplasty; Rosacea; Skin Neoplasms

Topics: Fractures, Bone; Humans; Methods; Nose; Osteotomy; Rhinoplasty

Topics: Airway Obstruction; Cerebrospinal Fluid Rhinorrhea; Edema; Facial Injuries; Fracture Fixation; Fracture Fixation, Internal; Fractures, Bone; Humans; Maxillary Sinus; Methods; Nose; Orbit; Zygomatic Fractures

Topics: Fractures, Bone; Methods; Nose; Physical Examination; Wounds and Injuries

Topics: Birth Injuries; Burns; Diaphragm; Embolism, Amniotic Fluid; Female; Fractures, Bone; Humans; Infant, Newborn; Infant, Newborn, Diseases; Nose; Obstetrical Forceps; Pelvic Bones; Pregnancy; Pregnancy Complications; Scalp; Snake Bites; Uterine Rupture; Uterus; Wounds and Injuries

Topics: Birth Injuries; Cartilage; Child; Child, Preschool; Fracture Fixation; Fractures, Bone; Fractures, Cartilage; Humans; Infant; Infant, Newborn; Nasal Bone; Nose

Topics: Athletic Injuries; Bandages; Boxing; Facial Bones; Fractures, Bone; Greece, Ancient; History, Ancient; Humans; Jaw Fractures; Joint Dislocations; Nose

Topics: Accidents, Traffic; Adult; Fracture Fixation; Fractures, Bone; Humans; Male; Maxillary Fractures; Middle Aged; Nose; Orbit

Topics: Adolescent; Adult; Child; Conjunctiva; Dacryocystitis; Dacryocystorhinostomy; Facial Injuries; Female; Follow-Up Studies; Fractures, Bone; Humans; Intubation; Lacrimal Apparatus; Male; Methods; Middle Aged; Nose; Polyethylenes; Radiography

Topics: Accidents, Traffic; Adolescent; Adult; Aged; Casts, Surgical; Child; Child, Preschool; Female; Femoral Fractures; Fractures, Bone; Humans; Ilium; Intestines; Kidney; Leg Injuries; Male; Metacarpus; Middle Aged; Nose; Orbit; Pelvic Bones; Rib Fractures; Rupture; Skull Fractures; Spleen; Splenectomy; Tibial Fractures; Urethra; Urinary Bladder; Wounds and Injuries

Topics: Anesthesia, General; Anesthesia, Local; Anti-Bacterial Agents; Epistaxis; Fractures, Bone; Humans; Maxillary Sinus; Methods; Nose; Oral Hemorrhage; Orbit; Postoperative Care; Preoperative Care; Tampons, Surgical; Time Factors

Topics: Adolescent; Adult; Aged; Child; Facial Injuries; Female; Follow-Up Studies; Fracture Fixation; Fractures, Bone; Humans; Male; Middle Aged; Nose; Scotland

Topics: Cervical Vertebrae; Craniocerebral Trauma; Education, Medical; Education, Nursing; Fractures, Bone; Head; Humans; Mandibular Fractures; Maxillary Fractures; Models, Structural; Neck; Neck Injuries; Neurologic Manifestations; Nose; Pupil; Teaching; Zygomatic Fractures

Topics: Bone and Bones; Bone Resorption; Bony Callus; Cadaver; Cartilage; Collagen; Connective Tissue; Elastic Tissue; Fractures, Bone; Humans; Nose; Osteogenesis; Wound Healing

Topics: Accidents, Home; Adolescent; Age Factors; Child; Child, Preschool; Facial Injuries; Female; Fractures, Bone; Germany, West; Humans; Joint Dislocations; Male; Nose; Prognosis; Rhinoplasty

Topics: Facial Bones; Facial Injuries; Female; Fractures, Bone; Fractures, Cartilage; Hematoma; Humans; Intubation, Intratracheal; Male; Maxillofacial Injuries; Nasal Septum; Nose

Topics: Adolescent; Adult; Aged; Airway Obstruction; Anesthesia, Intravenous; Carcinoma, Squamous Cell; Cough; Epistaxis; Female; Fracture Fixation, Internal; Fractures, Bone; Hemorrhage; Humans; Ketamine; Male; Mandibular Neoplasms; Nose; Orthopedic Fixation Devices; Pharynx; Reflex; Surgery, Oral

Topics: Accidents, Traffic; Adult; Ethanol; Female; Fractures, Bone; Humans; Male; Mandibular Fractures; Maxillary Fractures; Nose; Prospective Studies; Substance-Related Disorders; Violence; Zygomatic Fractures

Topics: Anesthesia, Local; Cocaine; Fractures, Bone; Humans; Nose; Preoperative Care; Procaine; Surgical Instruments

Topics: Fracture Fixation; Fractures, Bone; Fractures, Cartilage; Frontal Sinus; Humans; Laryngeal Cartilages; Mandibular Fractures; Maxillary Fractures; Maxillofacial Injuries; Nose; Temporal Bone; Zygomatic Fractures

Topics: Facial Bones; Facial Injuries; Fracture Fixation; Fractures, Bone; Humans; Nose; Postoperative Complications

Topics: Age Factors; Child; Female; Fractures, Bone; Growth; Humans; Male; Nose; Nose Deformities, Acquired; Rhinoplasty

Topics: Adolescent; Child; Child, Preschool; Female; Fractures, Bone; Humans; Infant; Infant, Newborn; Nasal Septum; Nose; Nose Deformities, Acquired; Rhinoplasty

Topics: Accidents, Traffic; Adult; Airway Obstruction; Child; Child, Preschool; Facial Injuries; Fracture Fixation; Fractures, Bone; Humans; Intubation, Intratracheal; Male; Mandibular Fractures; Maxillary Fractures; Maxillofacial Injuries; Nose; Orbit; Tracheotomy; Zygomatic Fractures

Topics: Accidents, Traffic; Adult; Facial Injuries; Fractures, Bone; Frontal Sinus; Humans; Male; Nose

Topics: Adolescent; Adult; Facial Bones; Facial Injuries; Fractures, Bone; Humans; Male; Mandibular Fractures; Maxillofacial Injuries; Nose; Orbit; Protective Devices; Recreation; Sports Medicine; Zygomatic Fractures

Topics: Adult; Casts, Surgical; Femoral Fractures; Fractures, Bone; Frontal Sinus; Humans; Knee; Male; Nose; Radiography; Splints; Tibial Fractures

Topics: Facial Injuries; Fractures, Bone; Humans; Mandibular Fractures; Maxillary Fractures; Nose; Orbit; Zygomatic Fractures

Topics: Accidents, Traffic; Child; Child, Preschool; Facial Injuries; Female; Fractures, Bone; Humans; Infant; Infant, Newborn; Male; Mandibular Fractures; Maxillary Fractures; Nose; Protective Devices; Zygoma

Topics: Adolescent; Age Factors; Cartilage; Child; Female; Fractures, Bone; Humans; Methods; Nasal Septum; Nose; Nose Deformities, Acquired; Transplantation, Heterologous; Transplantation, Homologous

Topics: Adult; Athletic Injuries; Evaluation Studies as Topic; Fractures, Bone; Humans; Male; Mandibular Fractures; Maxillary Fractures; Maxillofacial Injuries; Nose; Protective Devices; Zygomatic Fractures

Topics: Facial Injuries; Fractures, Bone; Humans; Maxillofacial Injuries; Methods; Nose; Orbit; Skull Fractures

Topics: Facial Injuries; Fracture Fixation; Fractures, Bone; Humans; Mandibular Fractures; Maxillary Fractures; Maxillofacial Injuries; Nose; Orbit; Physical Examination; Radiography; Skull Fractures; Zygomatic Fractures

Topics: Costs and Cost Analysis; Fracture Fixation; Fractures, Bone; Humans; Nose; Radiography

Topics: Anesthesia, Conduction; Epinephrine; Fractures, Bone; Humans; Lidocaine; Nose

Topics: Fracture Fixation; Fractures, Bone; Humans; Maxillary Fractures; Methods; Nose

Topics: Adolescent; Adult; Child; Facial Bones; Female; Fracture Fixation; Fractures, Bone; Humans; Jaw Fractures; Male; Maxillofacial Injuries; Middle Aged; Mouth, Edentulous; Nose; Zygoma

Topics: Accidents, Traffic; Bone Transplantation; Facial Bones; Facial Injuries; Fracture Fixation; Fracture Fixation, Internal; Fractures, Bone; Frontal Bone; Humans; Ilium; Mandibular Fractures; Maxillary Fractures; Methods; Nose; Orbit; Prostheses and Implants; Radiography; Ribs; Transplantation, Autologous; Zygoma

Topics: Bone Transplantation; Fractures, Bone; Humans; Nose; Nose Deformities, Acquired; Rhinoplasty

Topics: Bone Transplantation; Cartilage; Fractures, Bone; Humans; Methods; Nasal Septum; Nose; Nose Deformities, Acquired; Postoperative Complications; Prostheses and Implants; Rhinoplasty; Transplantation, Autologous; Transplantation, Homologous

Topics: Child; Facial Bones; Facial Injuries; Fractures, Bone; Humans; Male; Maxillofacial Injuries; Nose; Radiography

Topics: Biomechanical Phenomena; Fractures, Bone; Humans; Methods; Models, Theoretical; Nasal Septum; Nose; Rhinoplasty; Stress, Physiological

Topics: Facial Injuries; Fractures, Bone; Frontal Bone; Humans; Male; Middle Aged; Nose; Orbit; Zygoma

Topics: Adolescent; Child; Child, Preschool; Female; Fractures, Bone; Humans; Infant; Infant, Newborn; Male; Nose

Topics: Child; Fractures, Bone; Humans; Nose; Rhinoplasty; Rubber; Splints

Topics: Fracture Fixation; Fractures, Bone; Humans; Male; Methods; Nose; Orbit

Topics: Esthetics; Fracture Fixation, Internal; Fractures, Bone; Humans; Male; Nose; Orbit; Tendon Injuries

Topics: Child; Child, Preschool; Facial Bones; Facial Injuries; Female; Fractures, Bone; Humans; Infant; Male; Nose

Topics: Dentures; Facial Bones; Facial Injuries; Fracture Fixation; Fractures, Bone; Humans; Jaw; Mandibular Fractures; Mandibular Prosthesis; Methods; Nose; Orbit; Splints; Zygoma

Topics: Adolescent; Adult; Ethmoid Bone; Female; Fractures, Bone; Humans; Ligaments; Male; Middle Aged; Nose

Topics: Fractures, Bone; Humans; Nose; Nose Deformities, Acquired

Topics: Casts, Surgical; Child, Preschool; Fracture Fixation; Fractures, Bone; Humans; Methods; Nose; Rhinoplasty; Time Factors

Topics: Accidents, Traffic; Facial Bones; Fracture Fixation; Fractures, Bone; Humans; Immobilization; Mandibular Fractures; Maxillary Fractures; Maxillofacial Injuries; Nose; Pneumonia, Aspiration; Radiography; Respiratory Insufficiency; Transportation of Patients

Topics: Accidents; Diagnosis, Differential; Facial Bones; Fracture Fixation; Fractures, Bone; Humans; Mandibular Fractures; Maxillary Fractures; Nose; Orbit; Time Factors; Zygoma

Topics: Fractures, Bone; Humans; Nose

Topics: Brain Injuries; Craniocerebral Trauma; Fractures, Bone; Humans; Maxillofacial Injuries; Nose; Rhinoplasty; Skull

Topics: Fracture Fixation; Fractures, Bone; Humans; Nose; Splints

Topics: Accidents, Traffic; Athletic Injuries; Black or African American; Black People; Crime; Facial Injuries; Female; Fracture Fixation; Fractures, Bone; Humans; Male; Maxillofacial Injuries; Nose; South Africa; White People

Topics: Fracture Fixation; Fractures, Bone; Humans; Nose; Orbit

Topics: Aluminum; Calcium Sulfate; Casts, Surgical; Dental Impression Materials; Female; Fracture Fixation; Fractures, Bone; Frontal Bone; Humans; Male; Maxillary Fractures; Nose; Splints

Topics: Fractures, Bone; Humans; Nose; Splints; Time Factors

Topics: Child; Child, Preschool; Congenital Abnormalities; Eyelids; Female; Fracture Fixation; Fractures, Bone; Humans; Male; Methods; Nose; Orbit; Photography; Surgery, Plastic

Topics: Child, Preschool; Fractures, Bone; Humans; Nose

Topics: Elbow Injuries; Fracture Fixation; Fractures, Bone; Hospitals, General; Humans; Humeral Fractures; Joint Dislocations; Male; Middle Aged; Nose; Quebec; Radius Fractures; Ulna

Topics: Abscess; Adult; Bone Transplantation; Child; Female; Fractures, Bone; Hematoma; Humans; Male; Nasal Septum; Nose; Nose Deformities, Acquired

Topics: Accidents, Traffic; Diplopia; Fracture Fixation; Fractures, Bone; Humans; Maxillary Fractures; Nose; Orbit; Periosteum; Polyethylenes; Postoperative Complications; Prostheses and Implants; Zygoma

Topics: Diplopia; Fractures, Bone; Frontal Bone; Humans; Nose; Oculomotor Muscles; Orbit; Orthoptics; Prostheses and Implants; Tissue Adhesions; Visual Fields; Zygoma

Topics: Adult; Arm Injuries; Femoral Fractures; Fractures, Bone; Humans; Leg Injuries; Male; Nose; Paraplegia; Pelvis; Quadriplegia; Rib Fractures; Scapula; Skull Fractures

Topics: Adult; Fractures, Bone; Humans; Male; Methods; Nose; Radiography

Topics: Adult; Brain Injuries; Diagnosis, Differential; Electroencephalography; Female; Fractures, Bone; Humans; Nose

Topics: Adult; Facial Injuries; Female; Fluorocarbon Polymers; Fracture Fixation; Fractures, Bone; Humans; Male; Mandibular Injuries; Middle Aged; Nose; Orbit; Prostheses and Implants; Zygoma

Topics: Child Abuse; Child, Preschool; Eye Injuries; Facial Injuries; Female; Fractures, Bone; Humans; Infant; Male; Nose

Topics: Eye Injuries; Fracture Fixation; Fractures, Bone; Humans; Maxillary Fractures; Maxillofacial Injuries; Nose; Orbit; Zygoma

Topics: Adult; Biophysical Phenomena; Biophysics; Cartilage; Child; Fractures, Bone; Humans; Nose; Nose Deformities, Acquired; Rhinoplasty

Topics: Adolescent; Adult; Child; Child, Preschool; Female; Fracture Fixation; Fractures, Bone; Humans; Male; Nasal Septum; Nose; Nose Deformities, Acquired; Rhinoplasty

Topics: Accidents; Adolescent; Adult; Aged; Child; Child, Preschool; Epinephrine; Female; Fractures, Bone; Humans; Hyaluronoglucosaminidase; Infant; Infant, Newborn; Lidocaine; Male; Middle Aged; Nasal Septum; Nose

Topics: Anesthesia, General; Fracture Fixation; Fractures, Bone; Humans; Male; Nose; Splints; Surgical Instruments

Topics: Fractures, Bone; Humans; Male; Methods; Nose

Topics: Adult; Anesthesia; Bandages; Child; Fracture Fixation; Fractures, Bone; Humans; Nose

Topics: Adolescent; Adult; Child; Child, Preschool; Facial Injuries; Female; Fractures, Bone; Growth; Humans; Infant; Infant, Newborn; Male; Maxilla; Maxillary Fractures; Nose; Skull Fractures; Zygoma

Topics: Facial Injuries; Fractures, Bone; Humans; Nose; Nose Deformities, Acquired; Rhinitis, Atrophic; Rhinoplasty; Surgery, Plastic

Topics: Eye Injuries; Facial Injuries; Fractures, Bone; Humans; Maxillofacial Injuries; Nose

Topics: Fracture Fixation; Fractures, Bone; Humans; Nose; Splints

Topics: Facial Bones; Facial Injuries; Fractures, Bone; Humans; Mandibular Fractures; Maxillary Fractures; Nose; Orbit; Skull Fractures; Zygoma

Topics: Epistaxis; Fractures, Bone; Humans; Nose

Topics: Fractures, Bone; Humans; Nose

Topics: Fractures, Bone; Humans; Nose; Nose Diseases; Skull Fractures

Topics: Child; Facial Injuries; Fracture Fixation; Fractures, Bone; Geriatrics; Humans; Mandibular Injuries; Maxilla; Nose; Palate; Surgical Procedures, Operative; Zygoma

Topics: Facial Bones; Fractures, Bone; Humans; Maxilla; Nose; Orbit; Orbital Fractures

Topics: Burns; Facial Bones; Facial Injuries; Fracture Fixation; Fractures, Bone; Humans; Mandible; Nose

Topics: Fracture Fixation; Fractures, Bone; Humans; Joint Dislocations; Maxilla; Nasal Septum; Nose; Nose Deformities, Acquired; Osteotomy; Rhinoplasty; Surgical Equipment; Wounds and Injuries

Topics: Accidents; Esthetics; Facial Bones; Facial Injuries; Fractures, Bone; Humans; Insurance, Accident; Maxilla; Nose

Topics: Diagnosis; Facial Injuries; Fractures, Bone; Humans; Nose; Prognosis; Rhinoplasty; Surgical Procedures, Operative

Topics: Anatomy; Bays; Fractures, Bone; Nasal Bone; Nasal Obstruction; Nasal Septum; Nose; Nose Deformities, Acquired; Physiology; Respiration; Rhinoplasty

Topics: Accidents; Accidents, Traffic; Ankylosis; Fractures, Bone; Fractures, Ununited; Humans; Immobilization; Mandibular Fractures; Mandibular Injuries; Maxillofacial Injuries; Nose; Radiography; Surgical Procedures, Operative; Temporomandibular Joint

Topics: Anatomy; Facial Bones; Facial Injuries; Fracture Fixation; Fractures, Bone; Humans; Nose; Physiology

Topics: Accidents; Accidents, Traffic; Facial Injuries; Fractures, Bone; Humans; Nose

Topics: Fractures, Bone; Humans; Nose; Orbit; Pharynx

Topics: Facial Injuries; Fractures, Bone; Fractures, Malunited; Humans; Nose; Rhinoplasty

Topics: Child; Classification; Facial Injuries; Fracture Fixation; Fractures, Bone; Humans; Nose; Rhinoplasty

Topics: Adolescent; Child; Fractures, Bone; Humans; Nasal Septum; Nose; Nose Deformities, Acquired; Surgical Procedures, Operative

Topics: Diagnosis; Facial Injuries; Fracture Fixation; Fractures, Bone; Humans; Maxilla; Nose; Plastics; Postoperative Complications; Surgery, Plastic; Zygoma

Topics: Facial Injuries; Fractures, Bone; Humans; Nose; Plastics; Surgery, Plastic

Topics: Facial Bones; Facial Injuries; Fracture Fixation; Fractures, Bone; Frontal Bone; Humans; Maxilla; Nose; Orbit; Zygoma

Topics: Child; Facial Bones; Fractures, Bone; Humans; Infant; Nasal Bone; Nose; Skull Fractures

Topics: Child; Fractures, Bone; Humans; Infant; Joint Dislocations; Nose; Skull Fractures

Topics: Child; Facial Bones; Fractures, Bone; Humans; Infant; Joint Dislocations; Nose; Skull Fractures

Topics: Child; Fractures, Bone; Humans; Infant; Nose; Nose Diseases; Skull Fractures

Topics: Child; Fractures, Bone; Humans; Infant; Nose; Skull Fractures

Topics: Child; Fractures, Bone; Humans; Infant; Nose; Rhinoplasty

Topics: Child; Facial Bones; Fractures, Bone; Humans; Infant; Nasal Bone; Nose; Nose Diseases; Skull Fractures

Topics: Cheek; Eyelids; Facial Injuries; Fractures, Bone; Humans; Lip; Nose

Topics: Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Dental Occlusion; Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Child; Facial Bones; Fractures, Bone; Humans; Infant; Maxilla; Nose; Skull Fractures; Splints

Topics: Fractures, Bone; Humans; Nose; Skull Fractures; Wound Healing

Topics: Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Fractures, Bone; Humans; Nose; Nose Diseases; Skull Fractures

Topics: Facial Bones; Fractures, Bone; Humans; Nose; Nose Diseases; Skull Fractures

Topics: Fractures, Bone; Humans; Nose; Rhinoplasty; Skull Fractures

Topics: Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Fractures, Bone; Humans; Nose; Nose Diseases; Sutures

Topics: Facial Bones; Fractures, Bone; Humans; Nose

Topics: Fractures, Bone; Humans; Joint Dislocations; Nose; Skull Fractures

Topics: Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Fractures, Bone; Humans; Nose

Topics: Fractures, Bone; Humans; Nose; Nose Diseases; Skull Fractures

Topics: Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Facial Bones; Fractures, Bone; Humans; Nose

Topics: Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Facial Bones; Fractures, Bone; Humans; Nasal Bone; Nose; Skull Fractures; Zygoma; Zygomatic Fractures

Topics: Ear Diseases; Emergencies; Epistaxis; Fractures, Bone; Humans; Nose; Pharynx

Topics: Disease Management; Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Facial Bones; Fractures, Bone; Humans; Nose

Topics: Facial Bones; Facial Injuries; Fractures, Bone; Humans; Jaw Fractures; Nose; Skull Fractures; Zygoma; Zygomatic Fractures

Topics: Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Facial Bones; Facial Injuries; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Accidents; Fractures, Bone; Humans; Nasal Bone; Nose

Topics: Fractures, Bone; Humans; Nose; Paranasal Sinuses; Wounds and Injuries; Wounds, Gunshot

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Anesthesia, Local; Fractures, Bone; Humans; Hyaluronoglucosaminidase; Nose; Pain; Pain Management; Procaine

Topics: Facial Bones; Fractures, Bone; Humans; Nose; Paranasal Sinuses; Zygoma; Zygomatic Fractures

Topics: Facial Bones; Fractures, Bone; Humans; Jaw; Maxilla; Nose; Orbit; Orbital Fractures; Paranasal Sinuses

Topics: Cerebrospinal Fluid; Fractures, Bone; Humans; Nose; Skull

Topics: Fractures, Bone; Humans; Nose; Rhinoplasty; Skull Fractures

Topics: Fractures, Bone; Fractures, Open; Humans; Nose; Postoperative Care

Topics: Fractures, Bone; Humans; Nose; Rhinoplasty

Topics: Facial Bones; Fever; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Fractures, Bone; Frontal Bone; Humans; Nose; Torso

Topics: Fractures, Bone; Humans; Nose; Nose Diseases; Skull Fractures

Topics: Face; Facial Bones; Fractures, Bone; Humans; Nose

Topics: Arthritis; Fascia; Fractures, Bone; Humans; Nose; Nose Diseases; Rheumatic Diseases; Splints; Tin

Topics: Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Fractures, Bone; Hematoma; Humans; Nose; Temporal Bone

Topics: Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Fractures, Bone; Humans; Nose

Topics: Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Fractures, Bone; Humans; Nose

Topics: Equipment and Supplies; Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Facial Bones; Fractures, Bone; Humans; Jaw Fractures; Maxilla; Nose

Topics: Cellulitis; Cheek; Face; Facial Bones; Fractures, Bone; Humans; Nose; Nose Diseases; Skull Fractures

Topics: Fractures, Bone; Humans; Nose; Nose Diseases; Skull Fractures

Topics: Facial Bones; Fractures, Bone; Humans; Nose; Skull Fractures; Zygoma; Zygomatic Fractures

Topics: Fractures, Bone; Humans; Nose; Skull Fractures

Topics: Fractures, Bone; Frontal Bone; Humans; Nose; Skull Fractures