Tuğçe ŞİMŞEK, Sema AVCI, Mustafa ERDOĞAN

Acil servise maksillofasiyal travma ile başvuran hastaların demografik özellikleri ve travma etiyolojisi

Amaç: Travma, dünyada 40 yaş altındaki insanlarda en sık ölüm nedenidir ve özellikle gelişmekte olan ülkeler için ciddi bir morbidite nedenidir. Bir travmatik yaralanma şekli olan maksillofasiyal travmalar motorlu araç kazaları sonrası başvurularda yaklaşık %20-60 arasında görülen ve savunmasız yapısı nedeniyle travmaya daha kolay maruz kalan bir vücut bölgesi olan yüzde sık görülmektedir. Bu çalışmada, travma sonrası acil servise başvuran ve maksillofasiyal yaralanması olan hastalara ait demografik özellikler ve travma mekanizması geriye dönük değerlendirildi. Gereç ve yöntemler: Çalışmamızda hastane veri tabanı taranıp Ocak 2013-Aralık 2018 tarihleri arasında acil servise maksillofasiyal travma nedeni ile başvuran hastalar (213 kadın, 531 erkek) değerlendirildi. Yaş, cinsiyet gibi demografik özellikler, etiyolojik faktörler, travmanın mevsimsel dağılımı, travmaya maruz kalanların alkol kullanımı geriye dönük olarak kaydedildi. Bulgular: Hastaların %28,6'sı kadın ve %71,4'ü erkekti. Etiyolojik faktörler sırasıyla şöyleydi; düşme 450 (%60,5), trafik kazası 76 (%10,2), darp 166 (%22,3), bireyler arası şiddet 46 (%6,2), spor kazası 3 (%0,4), suisid 2 (%0,3), iş kazası 1 (%0,1). Sonuç: Düşme maksillofasiyal travmaların ana sebebi olarak tespit edildi. Ancak bireyler arası şiddet, darp ve trafik kazaları 18-65 yaş erkek grupta anlamlı şekilde diğer gruplara göre yüksek bulundu. Erkeklerde trafik kazalarını ve saldırganlığı önleyici ayrıca yaşlılar ve çocuklar için de düşmeyi önleyici ve yaşam kalitesini arttırıcı projeler geliştirilmesi faydalı olacaktır.

Anahtar Kelimeler:

Maksillofasiyal travma, etiyoloji, acil servis

Demographic characteristics and trauma etiology of patients admitted to emergency department with maxillofacial trauma

Aim: Trauma is the most common cause of death in people under the age of 40 in the world and is a serious cause of morbidity, especially for developing countries. Maxillofacial traumas, which is a form of traumatic injury, are frequently seen in admissions after motor vehicle accidents, between 20-60%, and the body area, which is more easily exposed to trauma due to its vulnerable nature. In this study, the demographic characteristics of the patients who admitted to the emergency department (ED) after the trauma and who had maxillofacial injury, and the mechanism of trauma were evaluated retrospectively.Material and method: In our study, the hospital database was scanned and patients (213 women, 531 men) who were admitted to the ED between January 2013 and December 2018 due to maxillofacial trauma were evaluated. Demographic features such as age, gender, etiological factors, seasonal distribution of trauma, alcohol use of those exposed to trauma were recorded retrospectively.Results: 28.6% of the patients were female and 71.4% were male. Etiological factors were as follows: fall 450 (60.5%), traffic accident 76 (10.2%), assault 166 (22.3%), interpersonal violence 46 (6.2%), sports accident 3 (0,4%), suicide 2 (0.3%), work accident 1 (0.1%). Conclusion: Falling was detected as the main cause of maxillofacial traumas. However, interpersonal violence, assault and traffic accidents were found to be significantly higher in the 18-65 year-old male group compared to the other groups. It would be beneficial to develop projects to prevent traffic accidents and aggression in men, as well as to prevent fall and to increase the quality of life for the elderly and children.

Keywords:

Maxillofacial trauma, etiology, emergency department,

PDF

___

1. Gassner R, Tuli T, Hächl O, Rudisch A, Ulmer, H. Cranio-maxillofacial trauma: A 10 year review of 9543 cases with 21 067 injuries. J Craniomaxillofac Surg 2003; 31: 51-61. 2. Avcı S, Arslan ED, Büyükcam F. Retrospective evaluation of traumatic deaths in emergency department. Sakarya Med J 2017; 7: 15-9. 3. Keskinoğlu P, İnan F. Analysis of trauma cases admitted to a state hospital emergency department. GMJ 2014; 25: 1-4. 4. Senkowski CK, McKenney MG. Trauma scoring systems: a review. J Am Coll Surg 1999; 189: 491–503. 5. Oikarinen KS. Clinical management of injuries to the maxilla, mandible, and alveolus. Dent Clin North Am 1995; 39: 113–31. 6. Gönüllü H, Karadaş S, Işık D, Koçak ÖF, Tekin H. Maxillofacial trauma cases applying to an emergency service: a retrospective study. Turk Plast Surg 2011; 19: 121-4. 7. Ferreira P, Marques M, Pinho C, Rodrigues J, Reis NJ, Amarante J. Midfacial fractures in children and adolescents: A review of 492 cases. Br J Oral Maxillofac Surg 2004; 42: 501-5. 8. Imahara SD, Hopper RA, Wang J, Rivara FP, Klein MB. Patterns and outcomes of pediatric facial fractures in the United States: A survey of the national trauma data bank. J Am Coll Surg 2008; 207: 710-6. 9. Bell RB. The role of oral and maxillofacial surgery in the trauma care center. J Oral Maxillofac Surg. 2007;65(12):2544-5. 10. Joshi SR, Saluja H, Pendyala GS, Chaudhari S, Mahindra U, Kini Y. Pattern and prevalence of maxillofacial fractures in rural children of central maharashtra, India. A retrospective study. J Maxillofac Oral Surg 2013; 12: 307-11. 11. Eggensperger Wymann NM, Hölzle A, Zachariou Z, Iizuka T. Pediatric craniofacial trauma. J Oral Maxillofac Surg 2008; 66: 58-64. 12. Karim T, Khan AH, Ahmed SS. Trauma of facial skeleton in children: an indian perspective. Indian J Surg 2010; 72: 232-5. 13. Thorén H, Iizuka T, Hallikainen D, Lindqvist C. Different patterns of mandibular fractures in children. An analysis of 220 fractures in 157 patients. J Craniomaxillofac Surg 1992; 20: 292-6. 14. Girotto JA, MacKenzie E, Fowler C, Redett R, Robertson B, Manson PN. Long-term physical impairment and functional outcomes after complex facial fractures. Plast Reconstr Surg 2001; 108: 312–27. 15. Sarasw ATV. Airway management in maxillofacial trauma: A retrospective review of 127 cases. Ind J Anesth 2008; 52: 311–6. 16. Kyrigidis A, Koloutsos G, Kommata A, Lazarides N, Antoniades K. Incidence, etiology, treatment outcome and complications of maxillofacial fractures. A retrospective study from Northern Greece. J Cranio Maxill Surg 2013; 41: 637-43. 17. Khadka R, Chaurasia NK. Four years prospective study of the maxillofacial trauma at a tertiary center in western Nepal. J Orofac Sci 2014; 6: 78. 18. Pham-Dang N, Barthélémy I, Orliaguet T, Artola A, Mondié J-M, Dallel R. Etiology, distribution, treatment modalities and complications of maxillofacial fractures. Med Oral Patol Oral Cir Bucal Ed Inglesa 2014; 19: 261–9. 19. Bali RK, Sharma P, Garg A, Dhillon G. A comprehensive study on maxillofacial trauma conducted in Yamunanagar, India. J Inj Violence Res 2013; 5: 108–16. 20. Khan AA. A retrospective study of injuries to the maxillofacial skeleton in Harare, Zimbabwe. Br J Oral Maxillofac Surg 1988; 26: 435–9. 21. Alves LS, Aragao I, Sousa MJ, Gomes E. Pattern of maxillofacial fractures in severe multiple trauma patients: a 7-year prospective study. Braz Dent J 2014; 25: 561-4. 22. Arslan ED, Solakoğlu AG, Komut E, et al. Assessment of maxillofacial trauma in emergency department. World J Emerg Surg 2014; 9: 13. 23. Teshome A, Andualem G, Tsegie R, Seifu S. Two years retrospective study of maxillofacial trauma at a tertiary center in North West Ethiopia. BMC Res Notes 2017; 10: 373. 24. Fonsceca RJ. Mandibular fractures. Oral and maxillofacial trauma. USA: Elsevier Sanders; 2005. 25. Abdullah WA, Al-Mutairi K, Al-Ali Y, Al-Soghier A, Al-Shnwani A. Patterns and etiology of maxillofacial fractures in Riyadh City, Saudi Arabia. Saudi Dent J 2013; 25: 33–8. 26. Dias E, Gomes ACA, Gomes DO, Vianna K, Melo P. Elderly trauma. Rev Cir Traumat Buco Maxilo-Facial 2001; 1:7-12. 27. Gil AP, Santos AJ, Kislaya I, et al. A sociography of elderly victims of family violence in Portugal. Cad Saúde Pública 2015; 31:1234-46. 28. Souza JAG, Iglesias ACRG. Trauma in the elderly. Rev Assoc Med Bras 2002; 48: 79-86. 29. Rehman K, Edmondson H. The causes and consequences of maxillofacial injuries in elderly people. Gerodontology 2002; 19: 60-4. 30. Cavalcanti AL, Bezerra PM, de Oliveira DM, Granville-Garcia AF. Maxillofacial injuries and dental trauma in patients aged 19–80 years, Recife, Brazil. Rev Esp Cir Oral Maxilofac 2010; 32: 11–6. 31. Arabion HR, Tabrizi R, Aliabadi E, Gholami M, Zarei K. A retrospective analysis of maxillofacial trauma in Shiraz, Iran: A 6-year-study of 768 patients (2004–2010). J Dent 2014; 15: 15. 32. Bataineh AB. Etiology and incidence of maxillofacial fractures in the north of Jordan. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 86: 31. 33. Shankar AN, Shankar VN, Hegde N, Sharma, Prasad R. The pattern of the maxillofacial fractures: a multicentre retrospective study. J Craniomaxillofac Surg 2012; 40: 675-9. 34. Einy S, Rahman NA, Siman-Tov M, Aizenbud D, Peleg K. Maxillofacial trauma following road accidents and falls. J Craniofac Surg 2016; 27; 857-61. 35. Owino RO, Macigo FG, Onyango FJ. Pattern and aetiology of mandibular fractures at Kenyatta national hospital. Afr J Oral Health Sci 2003; 4: 178–80. 36. Leles JLR, Dos Santos ÊJ, Jorge FD, Da Silva ET, Leles CR. Risk factors for maxillofacial injuries in a Brazilian emergency hospital sample. J Appl Oral Sci 2010; 18: 23–9. 37. Rubiev M. A retrospective analysis of facial fracture etiologies. J IMAB Annu Proc Sci Pap 2012; 18: 153–4. 38. Adebayo ET, Ajike OS, Adekeye EO. Analysis of the pattern of maxillofacial fractures in Kaduna, Nigeria. Br J Oral Maxillofac Surg 2003; 41: 396–400. 39. Garg V, Singh H, Vij K. Trends of maxillofacial trauma at tertiary care hospital in rural area of southern Punjab. J Indian Acad Forensic Med 2012; 34: 971–3. 40. Batista AM, de Ferreira F, Marques LS, Ramos-Jorge ML, Ferreira MC. Risk factors associated with facial fractures. Braz Oral Res 2012; 26: 119–25. 41. Abbas I, Fayyaz M, Shah I, et al. Demographic distribution of maxillofacial fractures in Ayub teaching hospital: A 7 year review. J Ayub Medical Coll Abottabad 2009; 21: 2. 42. Emshoff R, Schöning H, Rothler G, Waldhart E. Trends in the incidence and cause of sport-related mandibular fractures: a retrospective analysis. J Oral Maxillofac Surg 1997; 55: 585-92. 43. Siida, M. Kogo, T. Suguira, T. Mima, T. Matasuya. Retrospectiven analysis of 1502 patients with facial fractures Int J Oral Maxillofac Surg 2001; 30: 86–90. 44. Zargar M, Alikhaji MK, Reza M. An epidemiological study of facial injuries during a 13 month of trauma registry in Tehran. Indian J Med Sci 2004; 58: 3. 45. Kotecha S, Scanell J, Monaghan A, Williams R W. A four year retrospective study of 1062 patients presenting with maxillofacial emergencies at a specialist pediatric hospital. Br J Oral Maxillofac Surg 2007; 46: 293–6. 46. Gomes P, Augusto L, Ricardo J. A 5 year retrospective study of zygomatico-orbital complex fractures and zygomatic arch fractures in Sao Paulo Brazil. J Oral Maxillofac Surg 2006; 64: 63-7. 47. Telfer MR, Jones GM, Shepherd JP. Trends in the aetiology of maxillofacial fractures in the United Kingdom (1977–1987). Br J Oral Maxillofac Surg 1991; 29: 250–5. 48. Deliverska E. The role of alcohol involvement in maxillofacial trauma. J IMAB Annu Proc Sci Pap 2012; 18: 147–9. 49. Chaimowicz F. Health of the Brazilian elderly population on the eve of the 21st century: current problems, forecasts and alternatives. Rev Saúde Pública 1997; 31: 184-200. 50. Haug RH, Foss J. Maxillofacial injuries in the pediatric patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 2000; 90: 126–34. 51. Jaber MA, Porter SR. Maxillofacial injuries in 209 Libyan children under 13 years of age. Int J Paediatr Dent 1997; 7: 39–40. 52. Li R, Zhang R, Li W, Pei F, He W. Analysis of 126 hospitalized elder maxillofacial trauma victims in central China. Med Oral Patol Oral Cir Bucal 2015; 20: 464-70. 53. Gassner R, Tuli T, Hachl O. Craniomaxillofacial trauma in children a review of 3385 cases with 6060 injuries in 10 years. J Oral Maxillofac Surg 2004; 62: 399–407. 54. Nicole M, Eggensperger A. Pediatric craniofacial trauma. J Oral Maxillofacial Surg 2008; 66: 58–64.