Yılmaz GEYİK, Cemal FIRAT, Ahmet Hamdi AYTEKİN, Serkan ERBATUR, Ömer ELMAS

Surgical modalities in maxillo-facial fractures: Retrospective analysis of 110 patients

Bu çalışmada amacımız kliniğimizde maksillo-fasiyal travma nedeniyle opere edilen hastaların geriye dönük olarak değerlendirilmesidir. Maksillo-fasiyal travmaların yüz kemiklerine (maksilla, zigoma, orbita, mandibula, nazal) göre dağılımı in- celendi. Maksilla ön duvarındaki çok parçalı kırıklarda, orbita taban kırıklarında ve zigomatik ark kırıklarında foley sonda ile balon tedavisi uygulandı. 110 maksillo-fasiyal travmalı hastada toplam 161 kırık onarımı yapılan hastalardan 82si (%74.54) erkek, 28u (% 25.45) kadın idi. Bu hastalardan 11i (%10) pediatrik yaş (0-16) grubundaydı. Maksillo-fasiyal travmalı 45 hastanın trafik kazası, 32 hastanın darp, 30 hastanın düşme, 3 hastanın da ateşli silah yaralanması olduğu saptandı. 161 maksillo-fasiyal kırık arasında en sık görülen anatomik lokalizasyonlar, mandibula 68 (%42,23), maksilla kırıkları 36 (%22.36), zigoma kırıkları 21 (%13.04 ), orbita kırıkları (nazo-orbital veya nazo-orbito-etmoidal kırıklar dahil) 26 (%16.14) idi. Maksilla kırıkları çoğunlukla diğer yüz kırıkları ile birliktelik göstermekteydi. Zigoma kırıkları da genellikle çoklu kırıklarla birlikteydi. Balon tedavisi çok parçalı maksilla ön duvar kırıklarında, orbita taban kırıklarında ve zigomatik ark kırıklarında oldukça etkili bir stabilizasyon sağladığı görüldü. Travma nedeniyle başvuran hastaların büyük çoğunluğunda maksillo-fasiyal travmalar da eşlik edebildiğinden bu alanda uğraşan hek- imlerin yeterli donanıma ve tecrübeye sahip olmaları mortalite ve morbiditeyi azaltan en önemli unsurdur. En sık karşılaşılacak hasta profili ise 30-40 yaşlarında ya trafik kazası ya da spor veya darp nedeniyle maksillo-fasiyal travmaya uğramış bir erkek hasta olacaktır. Yaptığımız bu çalışmaya benzeyen retrospektif veya epidemiyolojik çalışmalar risk gruplarının belirlenmesi, spesifik önlemlerin alınması, tedavide pratik ve etkin metotlarının belirlenmesi amacıyla oldukça faydalıdır.

Maksillo-fasiyal kırıklarda cerrahi yaklaşımlarımız: 110 hastanın geriye dönük değerlendirilmesi

The objective of this study is to carry out a retrospective analysis of patients in our clinic who underwent surgery for maxillofa- cial trauma. The retrospective analysis was carried out on data of 110 inpatients with maxillofacial trauma that were treated. The distribution of maxillofacial traumas according to facial bones (maxilla, zygoma, orbita, mandibular, and nasal) was exam- ined. Multi-fragmented fractures of the maxilla anterior wall, orbital base fractures and isolated zygomatic arch fractures were treated with a balloon treatment method by Foley catheter. A total of 161 fracture were treated that 82 (74.54 %) were male and 28 (25.45 %) were female. Of these patients, 11 (10%) were in the pediatric age group (0 16). The etiology of maxillofacial traumas was examined, as 45 cases were traffic accidents, 32 cases were blows, 30 cases were falling, and 3 were firearm injuries respectively. The anatomic localizations of the maxillofacial fracture were 68 (42.23%) mandibula, 36 (22.36%) maxilla fractures, 21 (13.04%) zygoma fractures, and 26 (16.14%) orbita fractures (naso-orbital or naso-orbito-etmoidal fractures were included). Maxilla fractures were most frequently observed with other facial fractures. Zygoma fractures were also generally observed together with multi-fragmented fractures. The balloon treatment was found very effective to stabilize of multi-fragmented frac- tures of the maxilla anterior wall, orbita base fractures and zygomatic arch fractures. Since maxillofacial fractures may be seen in many patients who apply to hospitals due to traumas, sufficient experience of doctors working in this field is an important factor in decreasing mortality and morbidity. The most frequent patients are males aged 30 to 40 with maxillofacial trauma caused by a traffic accident, a sports accident, or a blow. Retrospective or epidemiological studies similar to our study are very beneficial for the determination of risk groups, specific precautions, and practical and effective treatment methods.

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