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Sample records for complex facial trauma

  1. Children and Facial Trauma

    Science.gov (United States)

    ... an ENT Doctor Near You Children and Facial Trauma Children and Facial Trauma Patient Health Information News ... staff at newsroom@entnet.org . What is facial trauma? The term facial trauma means any injury to ...

  2. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

    OpenAIRE

    2015-01-01

    The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a frac...

  3. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

    Directory of Open Access Journals (Sweden)

    Yeliz Guven

    2015-01-01

    Full Text Available The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case.

  4. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries.

    Science.gov (United States)

    Guven, Yeliz; Zorlu, Sevgi; Cankaya, Abdulkadir Burak; Aktoren, Oya; Gencay, Koray

    2015-01-01

    The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case.

  5. Facial nerve palsy due to birth trauma

    Science.gov (United States)

    Seventh cranial nerve palsy due to birth trauma; Facial palsy - birth trauma; Facial palsy - neonate; Facial palsy - infant ... this condition. Some factors that can cause birth trauma (injury) include: Large baby size (may be seen ...

  6. Experience With Esthetic Reconstruction of Complex Facial Soft Tissue Trauma; Application of the Pulsed Dye Laser

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    Ebrahimi

    2014-08-01

    Full Text Available Background Facial soft tissue injury can be one of the most challenging cases presenting to the plastic surgeon. The life quality and self-esteem of the patients with facial injury may be compromised temporarily or permanently. Immediate reconstruction of most defects leads to better restoration of form and function as well as early rehabilitation. Objectives The aim of this study was to present our experience in management of facial soft tissue injuries from different causes. Patients and Methods We prospectively studied patients treated by plastic surgeons from 2010 to 2012 suffering from different types of blunt or sharp (penetrating facial soft tissue injuries to the different areas of the face. All soft tissue injuries were treated primarily. Photography from all patients before, during, and after surgical reconstruction was performed and the results were collected. We used early pulsed dye laser (PDL post-operatively. Results In our study, 63 patients including 18 (28.5% women and 45 (71.5% men aged 8-70 years (mean 47 years underwent facial reconstruction due to soft tissue trauma in different parts of the face. Sharp wounds were seen in 15 (23% patients and blunt trauma lacerations were seen in 52 (77% patients. Overall, 65% of facial injuries were repaired primary and the remainder were reconstructed with local flaps or skin graft from adjacent tissues. Postoperative PDL therapy done two weeks following surgery for all scars yielded good results in our cases. Conclusions Analysis of the injury including location, size, and depth of penetration as well as presence of associated injuries can aid in the formulation of a proper surgical plan. We recommend PDL in the early post operation period (two weeks after suture removal for better aesthetic results.

  7. Warfare facial trauma: who will treat?

    Science.gov (United States)

    Holmes, D K

    1996-09-01

    Most of the facial trauma in the United States is treated in trauma centers in large urban or university medical centers, with limited trauma care taking place in our military medical treatment facilities. In many cases, active duty facial trauma surgeons may lack the current experience necessary for the optimal care of facial wounds of our inquired military personnel in the early stages of the conflict. Consequently, the skills of the reservist trauma surgeons who staff our civilian trauma centers and who care for facial trauma victims daily will be critical in caring for our wounded. These "trauma-current" reservists may act as a cadre of practiced surgeons to aid those with less experience. A plan for refresher training of active duty facial trauma surgeons is presented.

  8. Giant sialocele following facial trauma

    OpenAIRE

    Medeiros Júnior,Rui; Rocha Neto,Alípio Miguel da; Queiroz, Isaac Vieira; Cauby,Antônio de Figueiredo; Gueiros,Luiz Alcino Monteiro; Leão,Jair Carneiro

    2012-01-01

    Injuries in the parotid and masseter region can cause serious impairment secondary to damage of important anatomical structures. Sialocele is observed as facial swelling associated with parotid duct rupture due to trauma. The aim of this paper is to report a case of a giant traumatic sialocele in the parotid gland, secondary to a knife lesion in a 40-year-old woman. Conservative measures could not promote clinical resolution and a surgical intervention for the placement of a vacuum drain was ...

  9. Retained crossbow bolt after penetrating facial trauma.

    Science.gov (United States)

    Shah, Manan U; Sridhara, Shankar K; Wolf, Jeffrey S; Ambro, Bryan T

    2016-01-01

    We present an unusual case of a retained crossbow bolt in the maxillofacial area of a 31-year-old man. While crossbow injuries are rare, this case is of interest because otolaryngologists are often faced with treating retained foreign objects after penetrating facial trauma. These cases are difficult to manage because of the complexity and variety of injuries that can occur during both the initial trauma and the removal. We focus on the management of the bolt's removal and provide a brief discussion of the relevant literature on crossbow injuries to the head and neck.

  10. Giant sialocele following facial trauma.

    Science.gov (United States)

    Medeiros Júnior, Rui; Rocha Neto, Alípio Miguel da; Queiroz, Isaac Vieira; Cauby, Antônio de Figueiredo; Gueiros, Luiz Alcino Monteiro; Leão, Jair Carneiro

    2012-01-01

    Injuries in the parotid and masseter region can cause serious impairment secondary to damage of important anatomical structures. Sialocele is observed as facial swelling associated with parotid duct rupture due to trauma. The aim of this paper is to report a case of a giant traumatic sialocele in the parotid gland, secondary to a knife lesion in a 40-year-old woman. Conservative measures could not promote clinical resolution and a surgical intervention for the placement of a vacuum drain was selected. Under local anesthesia, a small incision was performed adjacent to parotid duct papilla, followed by muscular divulsion and draining of significant amount of saliva. An active vacuum suction drain was placed for 15 days, aiming to form a new salivary duct. This technique was shown to be a safe, effective and low-cost option, leading to complete resolution and no recurrence after 28 months of follow up.

  11. Facial palsy after blunt trauma and without facial bone fracture.

    Science.gov (United States)

    Coltro, Pedro Soler; Goldenberg, Dov Charles; Aldunate, Johnny Leandro Conduta Borda; Alessi, Mariana Sisto; Chang, Alexandre Jin Bok Audi; Alonso, Nivaldo; Ferreira, Marcus Castro

    2010-07-01

    A 14-year-old patient had a low-energy facial blunt trauma that evolved to right facial paralysis caused by parotid hematoma with parotid salivary gland lesion. Computed tomography and angiography demonstrated intraparotid collection without pseudoaneurysm and without radiologic signs of fracture in the face. The patient was treated with serial punctures for hematoma deflation, resolving with regression and complete remission of facial paralysis, with no late sequela. The authors discuss the relationship between facial nerve traumatic injuries associated or not with the presence of facial fractures, emphasizing the importance of early recognition and appropriate treatment of such cases.

  12. Psychological issues in acquired facial trauma

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    De Sousa, Avinash

    2010-01-01

    The face is a vital component of one’s personality and body image. There are a vast number of variables that influence recovery and rehabilitation from acquired facial trauma many of which are psychological in nature. The present paper presents the various psychological issues one comes across in facial trauma patients. These may range from body image issues to post-traumatic stress disorder symptoms accompanied by anxiety and depression. Issues related to facial and body image affecting social life and general quality of life are vital and the plastic surgeon should be aware of such issues and competent to deal with them in patients and families. PMID:21217982

  13. Analysis of Traffic Accident-Related Facial Trauma.

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    Choi, Su Hyun; Gu, Ja Hea; Kang, Dong Hee

    2016-10-01

    The consequences of facial trauma remain of great significance both functionally and esthetically. Traffic accident-related facial trauma is a frequent and significant cause of maxillofacial injury. The purpose of this study was to determine the natural history of traffic accident-related facial injuries in 846 patients over a 10-year period at a regional emergency center. The authors report a retrospective study of 846 patients with facial trauma from traffic accidents. The medical records of these patients were reviewed and analyzed to determine clinical characteristics, treatments, and outcomes of traffic accident-related facial trauma. In total, 687 of the 846 patients (81.2%) had fractures of the face, and nasal bone fractures were the most common followed by zygomatic complex fractures, blow-out fractures, and maxilla fractures. About 51.2% patients had open wounds on the face, such as lacerations, abrasions, skin or soft tissue defects, and friction burns. Only 7.4% of patients were treated conservatively and the others underwent repair or closed and open reduction. The complication rate was 46.3%, and scars were the most common followed by nose-related complication, hypoesthesia, and eyelid deformities. In addition, 47.6% of complication patients underwent secondary operations. Almost 15% of drivers were drunk, and about 8.7% were confessed drowsy during drive. Almost 30% of pedestrians were hit when they jaywalked across the street. Epidemiological data regarding traffic accident-related facial trauma are important and useful not only for decisions about patient care and developing optimal treatment regimens but to develop new methods to prevent injuries.

  14. Alcohol abusive use increases facial trauma?

    Science.gov (United States)

    Soares-Carneiro, Suzana-Célia-de-Aguiar; Matos da-Silva, Gessyca-Suielly-Melo; de-Barros-Caldas, Luciano-Cruz; Porto, Gabriela-Granja; Leal, Jefferson-Figueiredo; Catunda, Ivson

    2016-01-01

    Background Trauma is among the main death causes and morbidity in the world and is often related to the use of alcohol and its abuse has reached massive proportions, no matter if the country is developed or not, being considered as public health problem. Since there are very few randomized and prospective studies in literature about the association of facial trauma and the use of alcohol, this study aims to investigate the impact of alcohol use in facial trauma. Material and Methods This was a prospective and cross sectional study, involving facial trauma patients attended at Oral Maxillofacial Surgery Division of a State Hospital. Variables included patient´s profile, trauma etiology, facial region involved, type of injury and treatment and days of hospitalization. AUDIT test was applied to identify risks and damages of alcohol use and chemical dependence. Absolute distribution, uni and mutilvaried percentages were made for data evaluation. Pearson´s qui-squared and Fisher´s Exact tests were also used. Results One hundred patients were evaluated. The patient´s mean age was 33.50 years-old, 48% had between 17 and 29 years old, 28% had 30 to 39, and 24% 40 or more. Most of them were male (86%). The most frequent etiology was traffic accident (57%), the extraoral area was most committed (62%), the most frequent type of injury was fractures (78%) and the most affected bone was the mandible (36%). More than half of the patients (53%) had surgical treatment. 38% had their discharge from hospital right after the first attendance. The AUDIT most frequent answer was “moderate use” (46%) and use at risk (39%). There was significant difference between the use of alcohol (AUDIT) and hematoma (0.003) and number of days of hospitalization (p=0.005). Conclusions In this study it was not observed association between alcohol consumption using the AUDIT and trauma etiology, but patient victims of traffic accidents were classified as with risk in the scale. Most of the

  15. Facial trauma among victims of terrestrial transport accidents

    OpenAIRE

    Sérgio d'Avila; Kevan Guilherme Nóbrega Barbosa; Ítalo de Macedo Bernardino; Lorena Marques da Nóbrega; Patrícia Meira Bento; Efigênia Ferreira e Ferreira

    2016-01-01

    ABSTRACT INTRODUCTION: In developing countries, terrestrial transport accidents - TTA, especially those involving automobiles and motorcycles - are a major cause of facial trauma, surpassing urban violence. OBJECTIVE: This cross-sectional census study attempted to determine facial trauma occurrence with terrestrial transport accidents etiology, involving cars, motorcycles, or accidents with pedestrians in the northeastern region of Brazil, and examine victims' socio-demographic characteri...

  16. Facial trauma among victims of terrestrial transport accidents.

    Science.gov (United States)

    d'Avila, Sérgio; Barbosa, Kevan Guilherme Nóbrega; Bernardino, Ítalo de Macedo; da Nóbrega, Lorena Marques; Bento, Patrícia Meira; E Ferreira, Efigênia Ferreira

    2016-01-01

    In developing countries, terrestrial transport accidents - TTA, especially those involving automobiles and motorcycles - are a major cause of facial trauma, surpassing urban violence. This cross-sectional census study attempted to determine facial trauma occurrence with terrestrial transport accidents etiology, involving cars, motorcycles, or accidents with pedestrians in the northeastern region of Brazil, and examine victims' socio-demographic characteristics. Morbidity data from forensic service reports of victims who sought care from January to December 2012 were analyzed. Altogether, 2379 reports were evaluated, of which 673 were related to terrestrial transport accidents and 103 involved facial trauma. Three previously trained and calibrated researchers collected data using a specific form. Facial trauma occurrence rate was 15.3% (n=103). The most affected age group was 20-29 years (48.3%), and more men than women were affected (2.81:1). Motorcycles were involved in the majority of accidents resulting in facial trauma (66.3%). The occurrence of facial trauma in terrestrial transport accident victims tends to affect a greater proportion of young and male subjects, and the most prevalent accidents involve motorcycles. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  17. Management of facial trauma in children: A case report

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    Das U

    2006-09-01

    Full Text Available Children are uniquely susceptible to cranio facial trauma because of their greater cranial mass to body ratio. Below the age of 5, the incidence of pediatric facial fractures in relation to the total is very low ranging from 0.6-1.2%. Maxillo-facial injuries may be quite dramatic causing parents to panic and the child to cry uncontrollably with blood, tooth and soft tissue debris in the mouth. The facial disfigurement caused by trauma can have a deep psychological impact on the tender minds of young children and their parents. This case report documents the trauma and follow up care of a 4-year-old patient with maxillofacial injuries.

  18. Differences in the Management of Pediatric Facial Trauma.

    Science.gov (United States)

    Braun, Tara L; Xue, Amy S; Maricevich, Renata S

    2017-05-01

    Craniofacial trauma is common in the pediatric population, with most cases limited to soft tissue and dentoalveolar injury. Although facial fractures are relatively rare in children compared with adults, they are often associated with severe injury and cause significant morbidity and disability. Initial evaluation of a child with facial trauma generally involves stabilizing the patient and identifying any severe concomitant injuries before diagnosing and managing facial injuries. The management of pediatric facial fractures is relatively more conservative than that of adults, and nonsurgical management is preferred when possible to prevent the disruption of future growth and development. Outcomes depend on the site of the injury, management plan, and subsequent growth, so children must be followed longitudinally for monitoring and the identification of any complications.

  19. Emergency intubation using a light wand in patients with facial trauma

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    Sahu Sandeep

    2009-01-01

    Full Text Available Airway management in the operating room is the responsibility of anesthesiologists, although a variety of personnel may be responsible for airway management outside the operating room. Emergency department physicians are prominently involved in airway management in the emergency room both independently and with anesthesiologists. Airway management in trauma patients remains the domain of anesthesiologists. An 18-year old male patient was brought to our emergency room after an alleged history of suicidal attempt with gunshot under the chin. He was scheduled to undergo emergency tracheotomy, debridement, and closure of facial laceration under general anaesthesia, presenting a challenge for. He had to undergo emergency tracheotomy, debridement, and closure of facial lacerations under general anesthesia. The injuries made the patient′s airway management a complex issue. We present the use of the light wand to manage the difficult airway of this patient with complex facial trauma.

  20. Evaluation of facial trauma in pediatric population

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    Pushkar P Waknis

    2014-01-01

    Full Text Available Aim: The aim of this study was to retrospectively evaluate the incidence and treatment rendered for fractures in pediatric population over a period of 13 years. Materials and Methods: Surgical data over 13 years were evaluated for age, type of fracture, and treatment rendered. Out of a total of 423 trauma cases operated, a total of 38 pediatric trauma cases were seen, with 30 patients requiring at least some type of surgical intervention. The etiology of most of the fractures was road traffic accidents. Results: The eight cases of dentoalveolar and undisplaced parasymphysis trauma were managed by wiring and four cases of soft tissue injury treated by suturing while 18 cases required surgery in the form of osteosynthesis. Bioresorbable plating system was used in 11 cases while Titanium plates were used in seven patients, which were removed within 3 months.Conclusion: We recommend the use of open reduction internal fixation with bioresorbable plating system in children above 10 years of age and arch bar fixation for dentoalveolar trauma.

  1. Blunt Facial Trauma Causing Isolated Optic Nerve Hematoma

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    R. Parab

    2013-01-01

    Full Text Available Traumatic optic neuropathy is an uncommon, yet serious, result of facial trauma. The authors present a novel case of a 59-year-old gentleman who presented with an isolated blunt traumatic left optic nerve hematoma causing vision loss. There were no other injuries or fractures to report. This case highlights the importance of early recognition of this rare injury and reviews the current literature and management of traumatic optic neuropathy.

  2. Penetrating trauma to the facial skeleton by pickaxe – case report

    OpenAIRE

    Neskoromna-Jędrzejczak Aneta; Bogusiak Katarzyna; Przygoński Aleksander; Timler Dariusz

    2016-01-01

    Number of deaths related with injuries suffered as a result of experienced traumas is increasing. Penetrating traumas of the facial skeleton occur relatively rarely and much more often concern rather children than adults. Epidemiology relating this kind of trauma differs depending on the region of the world. In Poland, gunshot injuries as well as traumas caused by explosions of firecrackers or fireworks amount only to a slight percentage among all facial skeleton traumas, and the most common ...

  3. The use of three-dimensional tomographic reconstructions in the diagnosis on facial trauma: report of three cases and literature review; O uso das reconstrucoes tomograficas tridimensionais no diagnostico do trauma facial: relato de tres casos e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Lima Junior, Jose Lacet de; Goes, Kilma Keilla Honorio de; Dias-Ribeiro, Eduardo; Araujo, Tulio Neves de [Hospital de Emergencia e Trauma Senador Humberto Lucena (HETSHL), Joao Pessoa, PB (Brazil). Servico de Cirurgia e Trauma Buco-Maxilo-Facial; Costa, Vanio Santos [Universidade Federal da Bahia (UFBA), Salvador, BA (Brazil); Oliveira, Patricia Teixeira de [Universidade Potiguar (UnP), Natal, RN (Brazil)

    2007-01-15

    Fractures on the maxillofacial complex demand a detailed three dimensional comprehension of the damaged area. A correct radiographic evaluation is essential for the planning of the repair surgery. The surgical maneuvers involving this type of trauma depend on the knowledge of anatomy and an image diagnosis. The three dimensional images are especially important for the surgeons due to the fact that they allow a panoramic representation of the facial complex and of the fracture, facilitating the treatment planning. This study aims to report three clinical cases, as well as a literature review, discussing the utilization of three-dimensional tomography reconstructions on the diagnosis of the facial trauma. (author)

  4. What Is Expected from a Facial Trauma Caused by Violence?

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    Douglas Rangel Goulart

    2014-12-01

    Full Text Available Objectives: The aim of this retrospective study was to compare the peculiarities of maxillofacial injuries caused by interpersonal violence with other etiologic factors. Material and Methods: Medical records of 3,724 patients with maxillofacial injuries in São Paulo state (Brazil were retrospectively analyzed. The data were submitted to statistical analysis (simple descriptive statistics and Chi-squared test using SPSS 18.0 software. Results: Data of 612 patients with facial injuries caused by violence were analyzed. The majority of the patients were male (81%; n = 496, with a mean age of 31.28 years (standard deviation of 13.33 years. These patients were more affected by mandibular and nose fractures, when compared with all other patients (P < 0.01, although fewer injuries were recorded in other body parts (χ2 = 17.54; P < 0.01; Victims of interpersonal violence exhibited more injuries when the neurocranium was analyzed in isolation (χ2 = 6.85; P < 0.01. Conclusions: Facial trauma due to interpersonal violence seem to be related to a higher rate of facial fractures and lacerations when compared to all patients with facial injuries. Prominent areas of the face and neurocranium were more affected by injuries.

  5. Facial trauma: how dangerous are skiing and snowboarding?

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    Tuli, Tarkan; Haechl, Oliver; Berger, Natalie; Laimer, Klaus; Jank, Siegfried; Kloss, Frank; Brandstätter, Anita; Gassner, Robert

    2010-02-01

    The aim of this study was to investigate maxillofacial injuries sustained in both skiing and snowboarding accidents and correlate injury mechanisms and patterns evaluating a large population. Between 1991 and 2003, all patients with maxillofacial injuries due to skiing and snowboarding accidents (1,393 cases) were reviewed and statistically analyzed according to age, gender, type of injury, cause of accident, location of trauma, and associated injuries. Skiing accidents resulted in a total of 1,250 injuries, and snowboarding resulted in 143. In this study 686 skiers presented with 1,452 facial bone fractures and 80 snowboarders sustained 160 fractures of the face. Skiers had dentoalveolar trauma in 810 cases and 1,295 soft tissue injuries, whereas snowboarders had 88 dental injuries and 187 soft tissue lesions. Mechanisms of injury included 542 cases due to skiing and 85 falls due to snowboarding (a 1.79-fold higher risk for snowboarders). The gender distribution showed a male-female ratio of 3:1 in skiers and 5.5:1 in snowboarders. In both groups male patients were more prone to have a facial bone fracture than female patients. Snowboarders aged between 10 and 29 years had a 2.14-fold higher risk of sustaining a maxillofacial injury than skiers. In both groups facial bone fractures occurred more often in male patients, and they were more likely to result from falls and collisions with other persons. Young snowboarders had a higher risk of maxillofacial injuries (especially soft tissue lesions) than skiers, whereas for children and old persons, skiing posed a much higher risk. Wearing a helmet while skiing and snowboarding should be mandatory to prevent serious trauma to the head. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  6. The Big Bang: Facial Trauma Caused by Recreational Fireworks.

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    Molendijk, Josher; Vervloet, Bob; Wolvius, Eppo B; Koudstaal, Maarten J

    2016-06-01

    In the Netherlands, it is a tradition of setting off fireworks to celebrate the turn of the year. In our medical facility, each year patients with severe skeletal maxillofacial trauma inflicted by recreational fireworks are encountered. We present two cases of patients with severe blast injury to the face, caused by direct impact of rockets, and thereby try to contribute to the limited literature on facial blast injuries, their treatment, and clinical outcome. These patients require multidisciplinary treatment, involving multiple reconstructive surgeries, and the overall recovery process is long. The severity of these traumas raises questions about the firework traditions and legislations not only in the Netherlands but also worldwide. Therefore, the authors support restrictive laws on personal use of fireworks in the Netherlands.

  7. Trauma-Focused CBT for Youth with Complex Trauma

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    Cohen, Judith A.; Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

    2012-01-01

    Objectives: Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive…

  8. Trauma-Focused CBT for Youth with Complex Trauma

    Science.gov (United States)

    Cohen, Judith A.; Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

    2012-01-01

    Objectives: Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive…

  9. Multidetector Computed Tomography Imaging of Facial Trauma in Accidental Falls from Heights

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    Salonen, E.M.; Koivikko, M.P.; Koskinen, S.K. [Helsinki Medical Imaging Center, Dept. of Radiology, Toeoeloe Trauma Center, Helsinki Univ. Hospital, Helsinki (Finland)

    2007-04-15

    Purpose: To assess multidetector computed tomography (MDCT) findings in facial trauma in adults who accidentally fall from heights. Material and Methods: Of the MDCT scans of 2413 cases requested by emergency-room physicians for suspected facial injury, 155 (age 15.3-76.7, mean 42.0 years; 134 male, 21 female) met the criteria of falling from heights. These were reviewed by two researchers by consensus. Results: Of these 155, 118 (104 male, 14 female) had 247 fractures, while 37 had no fracture. The fractures were classified into 13 categories, the zygomatic complex being the region most frequently involved. Mean falling height, known in 132 of 155 cases, was 5.7 m (range 0.4-25) in all, 6.0 m (0.4-25) in those suffering a fracture, and 5.0 m (range 0.4-13) in those without a fracture. Patients with Le Fort II, Le Fort III, or frontal bone fractures had fallen higher and frequently had associated skull base fractures, but with considerable overlap in falling heights. Zygomatic arch and nasal bone fractures rarely occurred solitarily. Conclusion: In a fall-from-height injury, nasal bone and zygomatic arch fractures indicate the presence of more severe fractures. Height cannot solely predict injury probability. Clear sinus sign is a valuable aid in assessing midface trauma in falls from heights. Keywords: CT; face; trauma.

  10. Acupuncture Treatment of Facial Paralysis Caused by Craniocerebral Trauma in 50 Cases

    Institute of Scientific and Technical Information of China (English)

    赵建平

    2003-01-01

    @@ Cooperating with doctors in the Department of Brain Surgery, the author have treated 50 cases of facial paralysis caused by craniocerebral trauma in recent 3 years. The results are reported as follows.

  11. Anaesthetic Management of Myasthenia Gravis with Thymic Mass in Facial Trauma

    OpenAIRE

    2010-01-01

    Myasthenia gravis is an immunologic disorder characterised by polyclonal antibodies directed against nicotinic acetylcholine receptors at postneuromuscular junction. This case describes perioperative management of a patient suffering facial trauma with underlying myasthenia gravis with thymic mass

  12. Electronic cigarette devices and oro-facial trauma (Literature review)

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    Ghazali, A. F.; Ismail, A. F.; Daud, A.

    2017-08-01

    Detrimental effects of cigarette smoking have been well described and recognized globally. With recent advancement of technology, electronic cigarette has been introduced and gained its popularity and became a global trend, especially among young adults. However, the safety of the electronic devices remains debatable. This paper aimed to compile and review the reported cases of oro-facial trauma related to the usage of electronic cigarette devices. A literature search was conducted using PubMed/Medline in December 2016. The search terms used were a combination of “oral trauma”, “dental trauma”, “oral injury” and “electronic cigarette”. The search included all abstract published from the inception of the database until December 2016. Abstract that was written in English, case report, letter to editors, clinical and human studies were included for analysis. All selected abstract were searched for full articles. A total of 8 articles were included for review. All of the articles were published in 2016 with mostly case reports. The sample size of the studies ranged from 1 to 15 patients. Seven of the included articles are from United States of America and one from Mexico. Our review concluded that the use of electronic cigarette devices posed not only a safety concern but also that the devices were mostly unregulated. There should be a recognized authority body to regulate the safety and standard of the electronic devices.

  13. Etiology, diagnosis, and characteristics of facial fracture at a midwestern level I trauma center.

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    Smith, Hayden; Peek-Asa, Corinne; Nesheim, Dustin; Nish, Andrew; Normandin, Pamela; Sahr, Sheryl

    2012-01-01

    Study purpose was to describe facial fracture frequency, demography, injury characteristics, and diagnostic modalities at a Midwestern level I trauma center. A retrospective review was conducted on a Midwestern trauma center registry for years 2008 and 2009. Patient and injury data were collected along with diagnostic modality for facial fracture patients. Comparative statistics were conducted on the basis of the number of facial fractures, route of admission, presence of traumatic brain injury, and gender. There were 154 patients diagnosed with 443 facial fractures, representing 5% of the trauma population. Median patient age was 45 years. Median number of fractures was 2. Fractures were frequently present in orbit (32%), malar bone and maxilla (26%), and the nasal bones (19%). Motor vehicle crash was the most common mechanism (47%). Most fractures were diagnosed with maxillofacial computed tomography (78%). Males had an odds ratio of 2.5 (95% confidence interval, 1.15-5.43) for multiple facial fractures and composed 67% of the sample. Traumatic brain injury was diagnosed in 71% of patients. This study of a medium-sized city and its surrounding rural areas revealed differences from studies in large urban centers. Differences included lower gender ratio, older average age, and mechanism of injury. While urban trauma centers report assault as a leading cause of facial fracture, this study noted higher frequencies of motor vehicle crash and falls and fewer assaults.

  14. A Robot with Complex Facial Expressions

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    J. Takeno

    2009-08-01

    Full Text Available The authors believe that the consciousness of humans basically originates from languages and their association-like flow of consciousness, and that feelings are generated accompanying respective languages. We incorporated artificial consciousness into a robot; achieved an association flow of language like flow of consciousness; and developed a robot called Kansei that expresses its feelings according to the associations occurring in the robot. To be able to fully communicate with humans, robots must be able to display complex expressions, such as a sense of being thrilled. We therefore added to the Kansei robot a device to express complex feelings through its facial expressions. The Kansei robot is actually an artificial skull made of aluminum, with servomotors built into it. The face is made of relatively soft polyethylene, which is formed to appear like a human face. Facial expressions are generated using 19 servomotors built into the skull, which pull metal wires attached to the facial “skin” to create expressions. The robot at present is capable of making six basic expressions as well as complex expressions, such as happiness and fear combined.

  15. Facial Trauma: Not a Stigma in a Newer Single Stage ...

    African Journals Online (AJOL)

    hanumantp

    Annals of Medical and Health Sciences Research | Jan-Feb 2014 | Vol 4 | Issue 1 |. Introduction .... Figure 3: Autologous dural patch from facial layer of frontalis muscle for dural .... How to cite this article: Tomar SS, Akheel MD, Javeed S. Facial.

  16. Abordagem multidisciplinar no trauma facial: um relato de caso

    Directory of Open Access Journals (Sweden)

    Carolina Ando Matsuno

    2014-10-01

    Full Text Available Introdução: Em todo o mundo, diversas medidas de segurança têm sido aplicadas para minimizar os danos relacionados aos acidentes de trabalho. Ainda assim, muitos casos são rotineiramente encaminhados aos Prontos Socorros do Sistema Único de Saúde (SUS, particularmente nas zonas rurais. Objetivo: Relatar a abordagem multidisciplinar de um caso de traumatismo facial grave secundário a acidente de trabalho atendido no Conjunto Hospitalar de Sorocaba (CHS. Relato do Caso: Paciente masculino, 19 anos, branco, trabalhador rural, vítima de trauma após ter saltado de um trator em movimento durante o exercício de sua atividade laboral, trazido por seus familiares com hemiface direita, desfigurada pela avulsão da pele e da musculatura com exposição óssea, caracterizada à TC como fratura complexa zigomático-maxilar Le Fort tipo 2 à direita além da destruição do seio maxilar, do assoalho da órbita e dos rebordos orbitários lateral, superior e inferior. A abordagem cirúrgica foi realizada pelas equipes de Cirurgia Plástica, Cirurgia Bucomaxilofacial e Cirurgia Oftalmológica que procederam à reconstrução óssea por placas de titânio, estabilização da arcada dentária superior por amarramento e reposicionamento das partes moles. O globo ocular foi preservado por apresentar-se íntegro. Conclusões: A abordagem multidisciplinar das fraturas faciais complexas busca primariamente restaurar a complexa anatomia de toda essa região por primeira intenção. Considerando tratar-se de fratura secundária a um “acidente de trabalho”, ilustramos aqui uma trágica consequência do não uso dos equipamentos de proteção individual e da inobservância das normas de segurança.

  17. Comparison of Medical Adhesive Tapes in Patients at Risk of Facial Skin Trauma under Anesthesia

    OpenAIRE

    Ling Antonia Zeng; Sui An Lie; Shin Yuet Chong

    2016-01-01

    Introduction. Adhesive tapes are used for taping eyelids closed and securing endotracheal tubes during general anesthesia. These tapes can cause facial skin injury. We compared the incidence of facial skin injury and patient satisfaction with different tapes used. Methods. A total of 60 adult patients at risk of skin trauma were randomized to use 3M™ Kind Removal Silicone Tape or standard acrylate tapes: 3M Durapore (endotracheal tube) and Medipore (eyelids). Patients were blinded to tape use...

  18. Impact of trauma and surgical treatment on the quality of life of patients with facial fractures.

    Science.gov (United States)

    Conforte, J J; Alves, C P; Sánchez, M del P R; Ponzoni, D

    2016-05-01

    This study assessed the impact of oral and maxillofacial trauma and surgical treatment on the quality of life of patients. The study included 66 patients (age range 18-65 years) with facial fractures; 33 required surgical treatment and 33 required conservative (non-surgical) treatment. Quality of life was evaluated by applying the Oral Health Impact Profile questionnaire (OHIP-14) immediately after diagnosis of the trauma (T1), 30 days after surgery or trauma (T2), and 90 days after surgery or trauma (T3). For the control group (conservative treatment), there was a change in quality of life at T1 and T2. A change in quality of life was found for all of the surgical patients, regardless of the type of fracture and the observation period analyzed. There was no statistical difference when T1, T2, and T3 were compared in cases of zygomatic, Le Fort I, and nasal fractures, however there was an improvement in the quality of life of patients with mandibular fractures (P=0.0102) and multiple facial fractures (P=0.0097) at T3. Facial trauma caused the greatest impact on the quality of life of surgical patients at T1. The surgical treatment significantly improved quality of life for patients with mandibular and multiple facial fractures.

  19. Vacuum formed splints: Novel method for managing oro-facial trauma

    Directory of Open Access Journals (Sweden)

    Shikha Choubey

    2014-01-01

    Full Text Available Objective: Trauma to the oro-facial structures in children is different from trauma in adults. There are several points of differentiation between the two, the most important being growth. Aim: The purpose of this paper is to present the advantages of a vacuum-formed splint which was chosen as a practical and effective conservative treatment approach for the management of maxillofacial trauma. Case Report: A 9-year old boy reported to the department of pediatric and preventive dentistry with right mandibular parasymphyseal fracture. The trauma presented with the unique challenge to save and support the unerupted and developing tooth buds. Therefore, a vacuum-formed splint was fabricated and cemented in place for the next 4 weeks. Conclusion: The splinting method used for stabilization of the injured teeth is an important issue in trauma therapy to support the periodontal healing. Pediatric maxillofacial traumas require different clinical treatment strategies compared with fractures of the adult population.

  20. [A case report of metal penetrating trauma in maxillo-facial, neck and chest].

    Science.gov (United States)

    Sheng, Guomin; Mo, Zhiyang; Gao, Dongwang

    2015-03-01

    A 21 years old male patient was admitted with a complex trauma of metal penetrating wound in maxillo facial region,neck and chest because of a high falling accident one hour ago. General examination:the vital signs were stable. Specialized examination: metal foreign body penetrated from the front wall of the axilla ,passing left clavicle superficies, through the middle of neck into the posterior pharyngeal wall, then piercing out from the superciliary arch lateral. The patient had apparent tenderness in the right arch,right zygomatic bone and the front of right maxilla. the degree of mouth was about 1. 8cm. X-ray showed the foreign body: from left armpit to right temporal part. The admission diagnosis was : 1. metal penetrating wound in maxillo-facial,neck and chest; 2. right zygomatic maxillary and zygomatic arch fractures. Treatment: the foreign body was removed smoothly through the concurrent operation, and by scendary operation of open reduction and internal fixation of fractures, the finally result of patient was good.

  1. Soccer-related Facial Trauma: Multicenter Experience in 2 Brazilian University Hospitals

    Directory of Open Access Journals (Sweden)

    Dov C. Goldenberg, MD, PhD

    2014-06-01

    Conclusions: Although it is less common than orthopedic injuries, soccer players do sustain maxillofacial trauma. Knowledge of its frequency is important to first responders, nurses, and physicians who have initial contact with patients. Missed diagnosis or delayed treatment can lead to facial deformities and functional problems in the physiological actions of breathing, vision, and chewing.

  2. Guide of maxillofacial trauma intervention for diagnosis and treatment of facial burns

    Directory of Open Access Journals (Sweden)

    Eduardo Duarte Marrero

    2010-07-01

    Full Text Available The guide for maxillofacial trauma intervention for diagnosis and treatment of facial burns has been developed on the basis of the results obtained in a retrospective descriptive study of a series of patients for facial burns, were treated in serving Burned Cienfuegos University General Hospital "Dr. Gustavo Lima Aldereguía "between January 2005 and September 2007. The document describes the set of diagnostic and therapeutic procedures, both general and local, to treat patients with facial burns depending on the extent and depth of burns, also describes some special considerations depending on their location in central facial structures (eyelids, flag ear, nose, mouth, neck. It took into account national guidelines and the Pan American Health Organization, were also consulted experts and specialists in the field. The guide was approved by the scientific council of the institution cited above.

  3. Concomitant abducens and facial nerve palsies following blunt head trauma associated with bone fracture.

    Science.gov (United States)

    Ji, Min-Jeong; Han, Sang-Beom; Lee, Seung-Jun; Kim, Moosang

    2015-07-15

    A 22-year-old man was referred for horizontal diplopia that worsened on left gaze. He had been admitted for a head trauma caused by a traffic accident. Brain CT scan showed a longitudinal fracture of the left temporal bone with extension to the left carotid canal and central skull base, including sphenoid lateral wall and roof, and left orbit medial wall non-displaced fracture. Prism cover test revealed 20 prism diopters of esotropia and abduction limitation in the left eye. Hess screening test results were compatible with left abducens nerve paralysis. Symptoms suggesting complete lower motor neuron palsy of the left facial nerve, such as unilateral facial drooping, inability to raise the eyebrow and difficulty closing the eye, were present. As there was no improvement in facial paralysis, the patient received surgical intervention using a transmastoidal approach. Three months postoperatively, prism cover test showed orthotropia, however, the facial nerve palsy persisted.

  4. [Complications in Le Fort facial fractures combined with craniocerebral trauma].

    Science.gov (United States)

    Dimov, Zh; Abramov, G; Dimov, K; Kr'stev, N; Kr'stev, D

    1999-01-01

    The present research is based on the most frequent traumas and fractures in the middle zone of the face (second and third type by Rene le Fort) and the proceeded from them complications for a period of four years in the clinic of Neurosurgery in NIUMN "Pirogov". From the 280 patients that were studied the complications were observed in 54 of them. We worked up the received results statistically and presented them in drawing.

  5. Seis anos de atendimento em trauma facial: análise epidemiológica de 355 casos Six years of facial trauma care: an epidemiological analysis of 355 cases

    Directory of Open Access Journals (Sweden)

    Thiago Bittencourt Ottoni Carvalho

    2010-10-01

    Full Text Available Traumas faciais são frequentes em emergências requerendo o diagnóstico de fraturas e lesões associadas. OBJETIVO: Avaliar dados epidemiológicos de atendimento em trauma facial. MATERIAL E MÉTODOS: Foram revisados 335 prontuários de pacientes com trauma facial tratados pelo Serviço de Otorrinolaringologia, no período de Janeiro de 2002 a Dezembro de 2008. Os seguintes dados foram coletados: idade, gênero, etiologia, local anatômico da fratura, lesão associada, consumo de álcool, tratamento e hospitalização. FORMA DO ESTUDO: Estudo de casos retrospectivo em corte longitudinal histórico. RESULTADOS: A maioria dos pacientes são homens adultos jovens (pFacial traumas are frequent in emergencies, and they require the diagnosis of fractures and associated lesions. AIM: To analyze epidemiological data concerning facial trauma care. MATERIALS AND METHODS: Three hundred and fifty-five charts from patients with facial trauma treated by the Service of Otorhinolaryngology, from January 2002 to December 2008, were revised. The following data was collected: age, gender, etiology, anatomical localization of the fracture, associated injuries, alcohol consumption, treatment, and hospitalization. STUDY DESIGN: A retrospective historical longitudinal study. RESULTS: Most of the patients are young adult men (p<0.05 with a male:female ratio of 4:1(p<0.05. Interpersonal violence is the most prevalent cause of facial trauma (27.9%, followed by motor vehicle accidents (16.6% (p<0.05. The mandible is the most prevalent facial bone fractured (44.2%, followed by nasal fracture (18.9% (p<0.05. 41.1% of the patients consumed alcohol with a male:female ratio of 11.2:1 (p<0.05. Seventy-seven percent of the patients required surgical intervention (p<0.05 and 84.5% were hospitalized (p<0.05. CONCLUSION: Young male adults are the most prevalent victims of facial trauma, and interpersonal violence is responsible for the majority of the facial injuries. Most of the

  6. Predicting facial characteristics from complex polygenic variations

    DEFF Research Database (Denmark)

    Fagertun, Jens; Wolffhechel, Karin Marie Brandt; Pers, Tune

    2015-01-01

    genetic principal components across a population of 1,266 individuals. For this we perform a genome-wide association analysis to select a large number of SNPs linked to specific facial traits, recode these to genetic principal components and then use these principal components as predictors for facial...

  7. Facial trauma as physical violence markers against elderly Brazilians: A comparative analysis between genders.

    Science.gov (United States)

    de Sousa, Rayanne Izabel Maciel; de Macedo Bernardino, Ítalo; Castro, Ricardo Dias; Cavalcanti, Alessandro Leite; Bento, Patricia Meira; d'Ávila, Sérgio

    2016-01-01

    The aim of this study was to characterize the profile of elderly Brazilians with injuries resulting from physical violence and identify victimization differences. A descriptive and exploratory study was conducted involving the analysis of medico-legal and social records of 259 elderly victims of physical violence treated at an Institute of Forensic Medicine and Dentistry over four years (from January 2008 to December 2011). The forensic service database was evaluated by researchers properly trained and calibrated to perform this function between January and March 2013. Socio-demographic variables of victims, aggression characteristics, aggressor's profile and types of lesions were evaluated. Descriptive and multivariate statistics using Multiple Correspondence Analysis (MCA) were performed. The prevalence of facial trauma was 42.9%. Based on the MCA results, two groups with different victimization profiles were identified: married men aged 70-79 years, victims of community violence at night, suffering facial injuries; and single, widowed or separated women aged 60-69 years, victims of domestic violence during the day, suffering trauma in other areas of the body. The results suggest that there is a high prevalence of facial injuries among elderly Brazilians victims of physical violence and there are important differences related to victimization characteristics according to gender. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Characteristics of maxillofacial injuries and safety of in-theater facial fracture repair in severe combat trauma.

    Science.gov (United States)

    Keller, Matthew W; Han, Peggy P; Galarneau, Michael R; Gaball, Curtis W

    2015-03-01

    The study objectives were to characterize maxillofacial injuries and assess the safety of in-theater facial fracture repair in U.S. military personnel with severe combat trauma from Iraq and Afghanistan. We performed a retrospective chart review of the Expeditionary Medical Encounter Database from 2004 to 2010. 1,345 military personnel with combat-related maxillofacial injuries were identified. Injury severity was quantified with the Abbreviated Injury Scale and Injury Severity Score. Service members with maxillofacial injury and severe combat trauma (Injury Severity Score ≥ 16) were included. The distribution of facial fractures, types, and outcomes of surgical repairs, incidence of traumatic brain injury, concomitant head and neck injuries, burn rate/severity, and rates of Acinetobacter baumannii colonization and surgical site infection were analyzed. The prevalence of maxillofacial injury in the Expeditionary Medical Encounter Database was 22.7%. The most common mechanism of injury was improvised explosive device (65.7%). Midface trauma and facial burns were common. Approximately 64% of the study sample sustained traumatic brain injury. Overall, 45.6% (109/239) had at least one facial bone fracture. Of those with facial fractures, 64.2% (n = 70) underwent surgical repair. None of the service members who underwent in-theater facial fracture repair developed A. baumannii facial wound infection or implant extrusion.

  9. Defining current facial fracture patterns in a quaternary institution following high-velocity blunt trauma

    Directory of Open Access Journals (Sweden)

    Senzwesihle C. Magagula

    2016-03-01

    Full Text Available Background: In the early 20th century, René Le Fort studied facial fractures resulting from blunt trauma and devised a classification system still in common use today. This classification, however, was based on low-velocity trauma. In modern practice, in a quaternary-level referral hospital, patients are often admitted following high-velocity injuries that mostly result from motor vehicle collisions.Objectives: A retrospective study to define facial bone fractures occurring subsequent to highvelocity trauma.Method: A retrospective study comprising the review of CT scans of 52 patients with highvelocity facial fractures was performed between April 2007 and March 2013. Injuries were classified using the Le Fort classification system. Deviations from the true Le Fort types, which are often depicted in the literature as occurring bilaterally and symmetrically, were documented; these included unilaterality, occurrence of several Le Fort fractures on one side of the face, occurrence of several Le Fort fractures on different levels and on different sides of the face, and occurrence of other fractures in addition to Le Fort fractures.Results: Of the 52 cases, 12 (23% had Le Fort injuries, with true Le Fort fractures occurring in only 1, and 11 deviating from the classic description. Nine patients had Le Fort fractures and additional fractures. Mandibular and zygomatic bone fractures were found to be common associations with Le Fort injuries, occurring in 58% and 33% of the cases respectively.Conclusion: Fractures occurring in modern practice often deviate from the traditional Le Fort classification. Precise recognition of these deviations and recognition of additional associated fractures is pivotal in their management, assisting the surgeon in determining the treatment plan, such as the surgical approach and the order in which to fix the various fractured components.

  10. SURGICAL TREATMENT OF UPPER AND MIDDLE FACIAL ZONE TRAUMAS IN PROGRESS OF CONCOMITANT TRAUMATIC CRANIOFACIAL INJURIES.

    Science.gov (United States)

    Lagvilava, G; Gvenetadze, Z; Toradze, G; Devidze, I; Gvenetadze, G

    2015-09-01

    In 2012-2015, 207 patients with concomitant craniofacial injuries, who underwent surgical treatment, were observed; among them 176 were men and 31- women. Age of the patients ranged from 16 to 60 years. According to localization and severity of trauma and a priority of surgical intervention, the patients conventionally were divided into 3 groups by the authors: I group (65 patients) - craniofacial injuries; the skull as well as upper and middle areas of face (subcranial and frontobasal fractures) were affected (fractured). II group (80 patients) - severe traumatic injuries of upper and especially middle zones of the face, accompanied with closed craniocerebral trauma, no need in neurosurgery. III group (62 patients) -on the background of serious head traumas, the injuries of face bones were less severe (injury of one or two anatomic areas with displacement of fractured fragments but without bone tissue defects) According to the obtained results a priority was always given to the neurosurgery (vital testimony).The reconstructive surgeries on face skeleton was conducted in combination involving neurosurgeons (I group patients). Reconstructive surgeries of facial bones were conducted in the patients of II group, immediately or at primary deferred period of time but in the patients of III group the surgical procedures for removal of early secondary or traumatic residual fractures have been performed. Reposition of the fractured facial bone fragments was performed in an open way and fixation was carried out by titanium plates and mesh cage (at bone tissue defect). For prevention and elimination of post-traumatic inflammatory processes, the final stage of surgical intervention was: sanation of nasal accessory sinuses and catheterization (5-7 days) of external carotid arteries for administration of antibiotics and other medical preparations. Early and differentiated approach to face injuries, worsening in the course of craniocephalic trauma was not revealed in any patient

  11. Facial trustworthiness perception bias elevated in individuals with PTSD compared to trauma exposed controls.

    Science.gov (United States)

    Fertuck, Eric A; Tsoi, Fai; Grinband, Jack; Ruglass, Lesia; Melara, Robert; Hien, Denise A

    2016-03-30

    Posttraumatic stress disorder (PTSD) research has focused largely on fear processing. However, interpersonal trauma exposure can also impact interpersonal functioning and the perception of the trustworthiness of others. The present study examined facial perceptions of fearfulness and trustworthiness in individuals with PTSD (n=29), trauma-exposed without PTSD (n=19), and healthy controls (n=18). The PTSD group was hypothesized to exhibit a bias to perceive more fear and untrustworthiness in faces relative to controls. Participants rated the level of fearfulness or trustworthiness of faces that were parametrically morphed along a fear or trustworthiness dimension. The PTSD group was biased to perceive faces as more trustworthy compared to the trauma-exposed healthy controls, yet there were no differences between groups in fear processing. A trustworthiness bias in PTSD may represent a vulnerability factor. Conversely, lower trustworthiness perception may represent a protective disposition in trauma-exposed individuals who do not develop PTSD. Differences in the perception of trustworthiness may be an aspect of social perception that is independent of the fear processing abnormalities observed in PTSD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Complex Perineal Trauma with Anorectal Avulsion

    Directory of Open Access Journals (Sweden)

    Adelina Maria Cruceru

    2016-01-01

    Full Text Available Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed. After 12 hours in the Intensive Care Unit, the abdominal ultrasonography revealed free peritoneal fluid. We decided emergency laparotomy, and massive hemoperitoneum due to intraperitoneal rupture of pelvic hematoma was confirmed. Pelvic packing controlled the ongoing diffuse bleeding. After 48 hours, the relaparotomy with packs removal and loop sigmoid colostomy was performed. The postoperative course was progressive favorable, with discharge after 70 days and colostomy closure after four months, with no long-term complications. Conclusions. Severe perineal injuries are associated with significant morbidity and mortality. Their management in high volume centers, with experience in colorectal and trauma surgery, allocating significant human and material resources, decreases the early mortality and long-term complications, offering the best quality of life for patients.

  13. EPIDEMIOLOGICAL PROFILE OF FACIAL TRAUMA TREATED AT FATHER MULLER HOSPITAL, THUMBAY

    Directory of Open Access Journals (Sweden)

    Asher George

    2014-12-01

    Full Text Available This is a study on the epidemiological profile of facial trauma in patients who visited Father Muller Hospital, Thumbay over a period of 16 months from May 2013 to September 2014. It is a descriptive study. MATERIALS AND METHODS: All patients with facial trauma who visited Father Muller Hospital, Thumbay during this specified time period were included in this study. Their records were analyzed retrospectively and the results are expressed in percentage and proportion. RESULTS: 75% of the subjects were male and 25% were female. This ratio of males to females, 3:1, is similar to previous reported ratios of 3:1 to 5.4:1.1-3 Majority of the patients belong to the age group between 20-40 years (56.6%. Results of studies done previously are consistent with this finding. 3-6 In this study, most of the injuries are attributed to road traffic accidents (RTA (47.1% which is similar to the findings of other researches.7,8 Falls were responsible for 42.6% of the cases and assault was responsible for 7.4% of the facial injuries. Lacerations of less than 3 cm were the most common type of injuries noted in all areas of the face. As far as the location is concerned, 47.8% of the injuries were at Bantwal, 23.5% at BC road and 19.9% at Thumbe. It was noted that 11 patients were under the influence of alcohol (8.1% and all 11 were victims of RTA. All the injuries belonged to the minor severity category. CONCLUSION: Hence, it can be concluded that most of the patients who sustained facial trauma were men, majority of the subjects were between the age group of 20-40 years and the most common etiological factor noted was road traffic accidents. All the injuries recorded were minor in severity. Future studies on this topic should focus on prevention of injuries in this age group and stringent measures to curtail the increasing incidence of road traffic accidents should be implemented.

  14. Tumor de Pindborg relacionado con trauma facial Pindborg's tumor in relationship with facial traumata

    Directory of Open Access Journals (Sweden)

    Niorgy Rodríguez Rodríguez

    2011-12-01

    Full Text Available El tumor de Pindborg es una neoplasia benigna, rara, con carácter invasivo local y tendencia a la recidiva, que representa entre el 0,17 y el 1,8 % de todos los tumores odontogénicos, del cual tan solo se han publicado unos 200 casos, con una media de 4 casos nuevos por año en el mundo. Se presentó el caso de un hombre de 39 años de edad que acudió a la consulta de cirugía maxilofacial remitido de neurocirugía postraumatismo craneofacial, por presentar un aumento de volumen en el ángulo mandibular derecho. Se tuvo como objetivo publicar la existencia de esta infrecuente neoplasia por lo interesantes que resultan estos tumores por su evolución, dificultad en el diagnóstico, variantes de tratamiento y tendencia a la recidiva. Después de realizar exámenes de laboratorio, radiografías, tomografía axial computarizada y biopsia de fragmento óseo, se obtuvo extensión y diagnóstico de tumor de Pindborg en hemimandíbula derecha. Se realizó la técnica quirúrgica de hemimandibulectomía derecha y reconstrucción con injerto óseo de cresta ilíaca. La evolución del paciente fue satisfactoria.The Pindborg's tumor is a benign and uncommon neoplasm with a local invasive character and a trend to relapse accounting for the 0.17 and the 1.8 % of all odontogenic tumors with only 200 cases published in the literature and a mean of four cases per year at world scale. This is the case of a man aged 39 came our consultation of Maxillofacial Surgery referred from Neurosurgery Service after a craniofacial trauma and an increase of volume in right mandibular angle with the aim to publish the existence of this uncommon neoplasm due to the interesting of this type of tumor by its evolution, difficulty for diagnosis, variants of treatment and trend to relapse. After carry out laboratory examinations, X-rays, axial tomography computerize and biopsy of bone fragment, it was possible the extension and diagnosis of Pindbog's tumor in right hemi

  15. Therapeutic Doll Making in Art Psychotherapy for Complex Trauma

    Science.gov (United States)

    Stace, Sonia M.

    2014-01-01

    Therapeutic doll making can hold diverse functions for clients in therapy, particularly for those clients who are working through complex trauma histories. Recent literature pertaining to the treatment of complex trauma suggests that talking treatments have their limits; supplementary therapeutic approaches that focus on sensory, physical,…

  16. Therapeutic Doll Making in Art Psychotherapy for Complex Trauma

    Science.gov (United States)

    Stace, Sonia M.

    2014-01-01

    Therapeutic doll making can hold diverse functions for clients in therapy, particularly for those clients who are working through complex trauma histories. Recent literature pertaining to the treatment of complex trauma suggests that talking treatments have their limits; supplementary therapeutic approaches that focus on sensory, physical,…

  17. Trauma Adapted Family Connections: Reducing Developmental and Complex Trauma Symptomatology to Prevent Child Abuse and Neglect

    Science.gov (United States)

    Collins, Kathryn S.; Strieder, Frederick H.; DePanfilis, Diane; Tabor, Maureen; Clarkson Freeman, Pamela A.; Linde, Linnea; Greenberg, Patty

    2011-01-01

    Families living in urban poverty, enduring chronic and complex traumatic stress, and having difficulty meeting their children's basic needs have significant child maltreatment risk factors. There is a paucity of family focused, trauma-informed evidence-based interventions aimed to alleviate trauma symptomatology, strengthen family functioning, and…

  18. The importance of oral examination facial trauma: recognition of the Guerin sign in Le Fort 1 injuries

    OpenAIRE

    Kassam, Karim; Kumar, Mahesh

    2014-01-01

    Key Clinical Message Facial Trauma is common. The emergency physician should conduct a thorough examination of the oral tissues. A laceration in the palate can be easily missed and should be elicited. Failure to identify a split palate can result in severe dentofacial deformity.

  19. The Turin Shroud face: the evidence of maxillo-facial trauma.

    Science.gov (United States)

    Majorana, A; Bardellini, E; Gulino, G; Conti, G; Farronato, G; Rodella, L

    2015-01-01

    The Turin Shroud (TS) is a linen cloth commonly associated with Jesus Christ, his crucifixion and burial. Several medical specialists have debated the injuries of the TS Man, nevertheless there are no detailed and quantitative data about the anatomy of the TS face. The purpose of this study was to analyse the cephalometric measurements of the face image of the TS. The TS face image was acquired by a picture and processed using a cephalometric software, Oris Ceph® (Up to date 2012). The image of the soft tissues was processed in order to obtain skeletal points and a cephalometric analysis of the soft and skeletal tissues was performed. Image processing of the TS face shows that the Man represented in it has undergone a maxillo-facial trauma, especially a left displacement of the mandible, probably due to temporo-mandibular joint lesions. This condition has not been described before, despite several studies on the subject.

  20. Caracterização funcional da mímica facial na paralisia facial em trauma de face: relato de caso clínico Functional characterization of facial mimicry in facial paralysis of face trauma: a clinical case report

    Directory of Open Access Journals (Sweden)

    Leila Bonfim de Jesus

    2012-10-01

    Full Text Available TEMA: mímica facial na paralisia facial ocasionada por trauma de face. PROCEDIMENTOS: estudo de caso da mímica facial de um paciente com paralisia facial periférica no lado direito com sequelas decorrente de trauma por projétil de arma de fogo, adulto jovem do sexo masculino, comerciante autônomo. Foi realizada análise documental e fotográfica por meio de anamnese, avaliação e escala de graduação de da paralisia facial House e Brackmann. RESULTADOS: na avaliação da paralisia facial em repouso encontrou-se no lado direito (lesado: desvio de comissura labial, desvio de filtro, narina mais elevada e olho mais aberto. Em movimento, ainda no lado da lesão, observou-se: abolição de rugas frontais, incompetência no fechamento ocular natural e fechamento completo ao forçar, ausência de elevação de narina, rima naso-labial mais pronunciada, protrusão labial desviada para este lado, pouca retração labial, eversão de lábio inferior, comissura labial elevada, desvio de filtro, reduzida capacidade de inflar bochechas. O paciente apresentou sincinesia de olho/lábios e contratura com hipertonia de frontal, prócero, levantador da asa do nariz, risório, zigomático maior, zigomático menor, levantador do lábio superior, depressor do lábio inferior, mentual no lado da lesão e a fratura ocorreu em côndilo direito e o paciente referiu dor orofacial ao dormir e ao mastigar no lado comprometido. CONCLUSÃO: a lesão do nervo facial associada ao trauma de face provocou a alteração da mímica facial no lado direito o que gerou desfiguramento e distúrbios da mastigação.BACKGROUND: facial mimicry in the paralysis of the face that occurs because of a trauma in the face. PROCEDURES: case study of facial mimicry of a patient with peripheral facial paralysis, on the right side of the face, with sequels that happened because of a trauma because of a fire gun projectile; a young man, a self-employed trader. A documental and photographical

  1. Measuring trauma: considerations for assessing complex and non-PTSD Criterion A childhood trauma.

    Science.gov (United States)

    McDonald, Molly K; Borntrager, Cameo F; Rostad, Whitney

    2014-01-01

    The current definition of a traumatic event in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013) may be too narrow to describe the myriad of difficult childhood experiences. Furthermore, youth may develop a distinct pattern of symptoms in relation to complex or multiple childhood trauma experiences, the proposed developmental trauma disorder (DTD; B. A. van der Kolk, 2005 ) We developed and utilized a new measure, the Potentially Traumatic Experiences Questionnaire (PTEQ), to assess patterns in childhood trauma exposure. We used 2 item formats (open ended vs. closed ended) in order to explore potential differences in reporting. Furthermore, we assessed for symptoms associated with DTD following exposure to complex childhood trauma in a sample of adolescents. Participants were 186 adolescents ages 18 and 19 years old who were asked to report retrospectively on their difficult childhood experiences. The results showed that participants reported multiple events that would not be considered traumatic according to DSM-5 Posttraumatic Stress Disorder Criterion A, and those who completed the PTEQ with closed-ended items reported more differentiated trauma types than participants who completed the open-ended questionnaire. Also, participants who reported multiple or chronic events were more likely to endorse symptoms associated with DTD. This study has implications for the diagnosis and treatment of complex trauma experiences in youth.

  2. [Orbital compartment syndrome. The most frequent cause of blindness following facial trauma].

    Science.gov (United States)

    Klenk, Gusztáv; Katona, József; Kenderfi, Gábor; Lestyán, János; Gombos, Katalin; Hirschberg, Andor

    2017-09-01

    Although orbital compartment syndrome is a rare condition, it is still the most common cause of blindness following simple or complicated facial fractures. Its pathomechanism is similar to the compartment syndrome in the limb. Little extra fluid (blood, oedema, brain, foreign body) in a non-space yielding space results with increasingly higher pressures within a short period of time. Unless urgent surgical intervention is performed the blocked circulation of the central retinal artery will result irreversible ophthalmic nerve damage and blindness. Aim, material and method: A retrospective analysis of ten years, 2007-2017, in our hospital among those patients referred to us with facial-head trauma combined with blindness. 571 patients had fractures involving the orbit. 23 patients become blind from different reasons. The most common cause was orbital compartment syndrome in 17 patients; all had retrobulbar haematomas as well. 6 patients with retrobulbar haematoma did not develop compartment syndrome. Compartment syndrome was found among patient with extensive and minimal fractures such as with large and minimal haematomas. Early lateral canthotomy and decompression saved 7 patients from blindness. We can not predict and do not know why some patients develop orbital compartment syndrome. Compartment syndrome seems independent from fracture mechanism, comminution, dislocation, amount of orbital bleeding. All patients are in potential risk with midface fractures. We have a high suspicion that orbital compartment syndrome has been somehow missed out in the recommended textbooks of our medical universities and in the postgraduate trainings. Thus compartment syndrome is not recognized. Teaching, training and early surgical decompression is the only solution to save the blind eye. Orv Hetil. 2017; 158(36): 1410-1420.

  3. Foster care and healing from complex childhood trauma.

    Science.gov (United States)

    Forkey, Heather; Szilagyi, Moira

    2014-10-01

    Children enter foster care with many forms of adversity and trauma beyond maltreatment that impact their short- and long-term physical, mental, and developmental health and their adaptation to their new care environment. Applying an understanding of the impact of toxic stress on the developing brain and body allows the health care provider to understand findings in this vulnerable population. Complex trauma alters immune response, neurodevelopment, and the genome, resulting in predictable and significant cognitive, behavioral, and physical consequences. Pediatric care of children in foster care must be trauma informed to meet their medical, mental health, and developmental needs. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Transmylohyoid Submental Intubation in complex maxillofacial trauma: The easiest method is also the safest method

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    Ashutosh Kumar Singh

    2016-08-01

    Full Text Available Background & Objectives: Complex maxillofacial trauma is a common occurrence with high velocity road traffic accidents. Multiple facial bone fracture with loss of reference point for bony reduction requires use of intra-operative intermaxillary fixation to obtain good occlusion which precludes oral intubation. Fractures of nasal bones and ethmoid bones with complex distorted anatomy lead to inability to perform a nasal intubation. In such cases sub-mental intubation can be a safe and easy method of securing the intra-operative airway thus avoiding  tracheotomy and its complications.Materials & Methods: Retrospective clinical analytical study was planned in which 25 patients were included. Patient’s age, sex, type of trauma, time taken for procedure and complications were taken as study variables. Results: Average time taken for the procedure was nine minutes and only four out of 25 cases had complications. Conclusion: Sub-mental intubation requires simple skills, less time and is relatively complication free compared to tracheotomy in securing intra-operative airway during surgeries for complex maxillofacial trauma.JCMS Nepal. 2016;12(2:55-9

  5. E-cigarette Blast Injury: Complex Facial Fractures and Pneumocephalus

    Directory of Open Access Journals (Sweden)

    Benjamin A. Archambeau

    2016-11-01

    Full Text Available Electronic cigarettes (also known as e-cigarettes or e-cigs are becoming a popular method of recreational nicotine use over recent years. The growth of new brands and devices has been outpacing the FDA’s ability to regulate them. As a result, some of these devices fail without warning, most likely from malfunction of the lithium-ion batteries that are in close proximity to volatile compounds within the device. Failures have occurred during both use and storage of the devices or their components. The subsequent injuries from several of these events, including full thickness burns requiring grafting and blast injuries, have been observed at Arrowhead Regional Medical Center, a regional trauma and burn center in southern California. One severe case resulted in several maxillofacial fractures, blurred vision, and pneumocephalus after a device failed catastrophically during use. The patient required close monitoring with serial imaging by neurosurgery in the intensive care unit and multiple procedures by oral maxillofacial surgery to reconstruct his facial bones and soft tissue. Ultimately, the patient recovered with minimal permanent damage, but the potential for further injury or even death was apparent. Cases such as this one are becoming more frequent. It is important to increase awareness of this growing problem for both medical professionals and the general public in order to curb this concerning new trend.

  6. E-cigarette Blast Injury: Complex Facial Fractures and Pneumocephalus

    Directory of Open Access Journals (Sweden)

    Benjamin Archambeau

    2016-11-01

    Full Text Available Electronic cigarettes (also known as e-cigarettes or e-cigs are becoming a popular method of recreational nicotine use over recent years. The growth of new brands and devices has been outpacing the FDA’s ability to regulate them. As a result, some of these devices fail without warning, most likely from malfunction of the lithium-ion batteries that are in close proximity to volatile compounds within the device. Failures have occurred during both use and storage of the devices or their components. The subsequent injuries from several of these events, including full thickness burns requiring grafting and blast injuries, have been observed at Arrowhead Regional Medical Center, a regional trauma and burn center in southern California. One severe case resulted in several maxillofacial fractures, blurred vision, and pneumocephalus after a device failed catastrophically during use. The patient required close monitoring with serial imaging by neurosurgery in the intensive care unit and multiple procedures by oral maxillofacial surgery to reconstruct his facial bones and soft tissue. Ultimately, the patient recovered with minimal permanent damage, but the potential for further injury or even death was apparent. Cases such as this one are becoming more frequent. It is important to increase awareness of this growing problem for both medical professionals and the general public in order to curb this concerning new trend.

  7. Complex trauma, dissociation, and the use of symbolism in therapy.

    Science.gov (United States)

    Spermon, Deborah; Gibney, Paul; Darlington, Yvonne

    2009-01-01

    As therapists are confronted with clients who have childhood histories of severe interpersonal trauma, the challenge is to understand how this trauma affects individuals developmentally and how healing might be facilitated. This article explores how integration might be understood in the context of complex posttraumatic stress disorder. It is proposed that the symbolic function is central both to the fracturing of selfhood due to early trauma and to its resolution. The article provides a detailed discussion of symbolism and therapeutic possibilities for the use of symbolism as an adjunct to therapy with sufferers of complex posttraumatic stress disorder. It is argued that symbols provide a potentially powerful means of assisting reintegration and that this can be used within a range of therapeutic traditions, including cognitive-behavioral, psychodynamic, psychopharmacological, and neurophysiological approaches. The work of the first author in this regard is illustrated by means of a case study.

  8. Complex Sequelae of Psychological Trauma Among Kosovar Civilian War Victims

    NARCIS (Netherlands)

    Morina, N.; Ford, J.D.

    2008-01-01

    Aims: The impact of war trauma on civilians may include, but also extend beyond, post-traumatic stress disorder (PTSD) to include complex sequelae such as those described by the syndrome of Disorders of Extreme Stress Not Otherwise Specified (DESNOS). Methods: In the present study, 102 civilian war

  9. The Complex Trauma Questionnaire (ComplexTQ:Development and preliminary psychometric properties of an instrument for measuring early relational trauma

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    Carola eMaggiora Vergano

    2015-09-01

    Full Text Available Research on the etiology of adult psychopathology and its relationship with childhood trauma has focused primarily on specific forms of maltreatment. This study developed an instrument for the assessment of childhood and adolescence trauma that would aid in identifying the role of co-occurring childhood stressors and chronic adverse conditions. The Complex Trauma Questionnaire (ComplexTQ, in both clinician and self-report versions, is a measure for the assessment of multi-type maltreatment: physical, psychological, and sexual abuse; physical and emotional neglect as well as other traumatic experiences, such rejection, role reversal, witnessing domestic violence, separations, and losses. The four-point Likert scale allows to specifically indicate with which caregiver the traumatic experience has occurred. A total of 229 participants, a sample of 79 nonclinical and that of 150 high-risk and clinical participants, were assessed with the ComplexTQ clinician version applied to Adult Attachment Interview (AAI transcripts. Initial analyses indicate acceptable inter-rater reliability. A good fit to a 6-factor model regarding the experience with the mother and to a 5-factor model with the experience with the father was obtained; the internal consistency of factors derived was good. Convergent validity was provided with the AAI scales. ComplexTQ factors discriminated normative from high-risk and clinical samples. The findings suggest a promising, reliable, and valid measurement of early relational trauma that is reported; furthermore, it is easy to complete and is useful for both research and clinical practice.

  10. Occurrence of dental avulsion and associated injuries in patients with facial trauma over a 9-year period.

    Science.gov (United States)

    Marchiori, Erica Cristina; Santos, Saulo Ellery; Asprino, Luciana; de Moraes, Márcio; Moreira, Roger William Fernandes

    2013-06-01

    This retrospective study aimed to assess the occurrence of dental avulsions in patients with facial trauma over a 9-year period. Data was collected from records of patients attended to at the Division of Oral and Maxillofacial Surgery at Piracicaba Dental School-State University of Campinas, Piracicaba (SP), Brazil. Two hundred three patients with 387 avulsed teeth were evaluated, the central incisors being the most common teeth involved (42 % of permanent and 61 % of primary teeth). Thirty-four percent of the cases occurred on weekends, mainly on Saturdays (20 %) and the distribution in relation to the time of year was similar with slight peaks in January. The most prevalent associated dentoalveolar injury was lateral luxation (26 %) and 19 % of the patients presented with an associated facial fracture. The most common sign presented was laceration (23 %), and the main symptoms found were pain (58 %). Associated general trauma was present in 139 patients (68 %), and the most prevalent was the upper limb (41 %). Special emphasis should be given not only to diagnosis and treatment of dental avulsion but for prevention, too. An understanding of the etiology, severity, and distribution of associated traumatic injuries can help for future studies and for an effective prevention of these injuries.

  11. Perfil epidemiológico do trauma de face dos pacientes atendidos no pronto socorro de um hospital público Epidemiology of facial trauma of patients admitted to a public hospital emergency department

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    Jefferson Lessa Soares de Macedo

    2008-02-01

    Full Text Available OBJETIVO: Avaliar os dados epidemiológicos e a localização dos traumas de face de pacientes atendidos no Hospital Regional da Asa Norte (HRAN, Brasília, Distrito Federal. MÉTODO: Trata-se de um estudo retrospectivo, realizado no pronto socorro do HRAN-DF, visando avaliar o perfil epidemiológico dos pacientes atendidos pela equipe da Unidade de Cirurgia Plástica vítimas de trauma de face no período de 1 de janeiro a 31 dezembro de 2004. RESULTADOS: O estudo compreendeu 711 pacientes, destacando-se o sexo masculino (72,8%. Quanto à causa, predominou a agressão física, seguida por acidente com veículos/motos. As quedas foram a causa predominante das lesões em crianças, mas verificou-se a participação cada vez maior da agressão física como mecanismo de trauma facial com o aumento da idade. A relação de homem:mulher foi de 3:1. A faixa etária mais atingida foi de 21 a 30 anos, representando 35,3% dos pacientes. As fraturas foram encontradas em 24,9% das lesões faciais. O nariz foi o local mais acometido nas fraturas de face (76,8%. CONCLUSÃO: A violência interpessoal foi a principal causa de trauma de face. A queda da própria altura mostrou-se como importante mecanismo de trauma nos extremos de idade.BACKGROUND: To evaluate the etiology, age, gender and location of the lesions of facial trauma in patients arriving at our hospital. METHODS: The data were evaluated through retrospective analysis of patient charts from January 1st to December 31st, 2004. RESULTS: The group comprised 711 patients with facial trauma. Blunt assault was the most common cause, followed by motor vehicle crashes. Falls were, by far, the predominant cause of injury in children, but with increasing age, assaults became more common. It was observed a male:female ratio of 3:1. The most frequent age group was the 21-30 years one, with 52%. Facial fractures were found in 24.9% of facial injuries. The most frequent fracture was nasal (76.8%. CONCLUSION

  12. Injerto autólogo de calota craneana para reconstrucción de piso de órbita en trauma facial : Reporte de caso

    OpenAIRE

    2014-01-01

    Las fracturas de órbita concomitantes con otras fracturas faciales tienen una prevalencia deentre 30-55% de todos los traumas faciales. Las indicaciones para el manejo abierto son:distopía, enoftalmos clínicamente evidente, limitación de movimientos oculares porinterrupción mecánica y diplopía por más de 15 días. Se presenta un caso de reconstrucciónde piso de órbita con injerto de calota craneana asociado con fracturas faciales múltiples y serealiza una revisión de la literatura.

  13. Complex trauma en complexe PTSS: Wat is het en wie heeft het?

    NARCIS (Netherlands)

    ter Heide, J.J.; Kleber, Rolf; Mooren, G.T.M.

    2014-01-01

    Er bestaat onder clinici veel onduidelijkheid over wat de concepten complex trauma en complexe posttraumatische stressstoornis (PTSS) behelzen. Dit heeft ongewenste consequenties voor de behandeling, omdat de behandelrichtlijnen voor complexe PTSS afwijken van die voor PTSS. In dit artikel wordt ver

  14. Branch facial nerve trauma after superficial temporal artery biopsy: a case report

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    Rison Richard A

    2011-01-01

    Full Text Available Abstract Introduction Giant cell arteritis is an emergency requiring prompt diagnosis and treatment. Superficial temporal artery biopsy is the gold diagnostic standard. Complications are few and infrequent; however, facial nerve injury has been reported, leaving an untoward cosmetic outcome. This case report is to the best of our knowledge only the fourth one presented in the available literature so far regarding facial nerve injury from superficial temporal artery biopsy. Case presentation A 73-year-old Caucasian woman presented for neurological evaluation regarding eyebrow and facial asymmetry after a superficial temporal artery biopsy for presumptive giant cell arteritis-induced cephalalgia. Conclusion Damage to branches of the facial nerve may occur after superficial temporal artery biopsy, resulting in eyebrow droop. Although an uncommon and sparsely reported complication, all clinicians of various specialties involved in the care of these patients should be aware of this given the gravity of giant cell arteritis and the widespread use of temporal artery biopsy.

  15. COMPLEX CLINICAL-STATISTICAL ANALYSIS OF THE LOCOMOTOR SYSTEM TRAUMAS

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    I. V. Grechukhin

    2011-01-01

    Full Text Available Complex clinico-statistical study of the rate, structure, dynamics and conditions of the locomotor apparatus traumas in ambulatoris patients (82207 children, 20351adolescents and 293798 adults, hospitalized ones (2359 children and 5796 adults and 439 died during 1998-2008 in Astrakhan has been cassied out. Age – sex groups of highes risk in getting traumas, most of whom are in the household and in streets under falling, due to antilaw actions and accidents have been formed. Possibility of getting injuries for adults increases in January and July, for children – in May and September, for adolescents – in April and October. Wide range of modem computer and telecommunication technologies as the new forms of preventive activity should be recommended.

  16. Reconstruction of Complex Facial Defects Using Cervical Expanded Flap Prefabricated by Temporoparietal Fascia Flap.

    Science.gov (United States)

    Zhang, Ling; Yang, Qinghua; Jiang, Haiyue; Liu, Ge; Huang, Wanlu; Dong, Weiwei

    2015-09-01

    Reconstruction of complex facial defects using cervical expanded flap prefabricated by temporoparietal fascia flap. Complex facial defects are required to restore not only function but also aesthetic appearance, so it is vital challenge for plastic surgeons. Skin grafts and traditional flap transfer cannot meet the reconstructive requirements of color and texture with recipient. The purpose of this sturdy is to create an expanded prefabricated temporoparietal fascia flap to repair complex facial defects. Two patients suffered severe burns on the face underwent complex facial resurfacing with prefabricated cervical flap. The vasculature of prefabricated flap, including the superficial temporal vessel and surrounding fascia, was used as the vascular carrier. The temporoparietal fascia flap was sutured underneath the cervical subcutaneous tissue, and expansion was begun in postoperative 1 week. After 4 to 6 months of expansion, the expander was removed, facial scars were excised, and cervical prefabricated flap was elevated and transferred to repair the complex facial defects. Two complex facial defects were repaired successfully by prefabricated temporoparietal fascia flap, and prefabricated flaps survived completely. On account of donor site's skin was thinner and expanded too fast, 1 expanded skin flap was rupture during expansion, but necrosis was not occurred after the 2nd operation. Venous congestion was observed in 1 patient, but after dressing, flap necrosis was not happened. Donor site was closed primarily. Postoperative follow-up 6 months, the color, texture of prefabricated flap was well-matched with facial skin. This method of expanded prefabricated flap may provide a reliable solution to the complex facial resurfacing.

  17. Multislice helical CT (MSCT) for mid-facial trauma: optimization of parameters for scanning and reconstruction; Mehrschicht-Spiral-CT (MSCT) beim Mittelgesichtstrauma: Optimierung der Aufnahme- und Rekonstruktionsparameter

    Energy Technology Data Exchange (ETDEWEB)

    Dammert, S.; Funke, M.; Obernauer, S.; Grabbe, E. [Abt. Roentgendiagnostik I, Georg-August-Univ. Goettingen (Germany); Merten, H.A. [Abt. fuer Mund-, Kiefer- und Gesichtschirurgie, Georg-August-Univ. Goettingen (Germany)

    2002-07-01

    Purpose: To determine the optimal scan parameters in multislice helical CT (MSCT) of the facial bone complex for both axial scanning and multiplanar reconstructions. Material and Methods: An anthropomorphic skull phantom was examined with a MSCT. Axial scans were performed with continuously increasing collimations (4 x 1.25 - 4 x 2.5 mm), tube current (20 - 200 mA) and table speeds (3.75 mm/rot. and 7.5 mm/rot.). Multiplanar reconstructions in coronal and parasagittal planes with different reconstruction increment and slice thickness were evaluated in terms of image noise, contour artifacts and visualisation of anatomical structures. Results: The best image quality was obtained with a collimation of 4 x 1.25 mm and a - table speed of 3.75 mm/rot. A reconstruction increment of 0.6 mm achieved the best time to image quality relation. With these parameters the bone structures were depicted in an optimal way without artifacts. The tube current could be reduced to 50 mA without significant loss of image quality. The optimized protocol was used for regular routine examinations in patients with facial trauma (n = 66). Conclusions: Low-dose MSCT using thin collimation, low table speed and small reconstruction increments provides excellent data for both axial images and multiplanar reconstructions in patients with facial trauma. An additional examination in coronal orientation is therefore no longer necessary. (orig.) [German] Zielsetzung: Verbesserung der Aufnahme- und Rekonstruktionsparameter in der Mehrschicht Spiral-CT (MSCT) zur Untersuchung des knoechernen Mittelgesichtes in verschiedenen Ebenen. Material und Methode: Ein anthropomorphes Schaedel-Phantom wurde in axialer Schichtfuehrung mit einem MSCT untersucht, wobei die Kollimation (1,25 - 2,5 mm), der Tischvorschubfaktor (Pitch 3 - 6) und der Roehrenstrom (20 - 200 mA) systematisch variiert wurden. Aus den Volumendatensaetzen wurden jeweils koronare und parasagittale Sekundaerreformationen mit unterschiedlichen

  18. The impact of mandatory helmet law on the outcome of maxillo facial trauma: a comparative study in kerala.

    Science.gov (United States)

    Usha, M; Ravindran, V; Soumithran, C S; Ravindran Nair, K S

    2014-06-01

    Motorcyclists comprise the majority of road-traffic victims in low and middle income countries,and consequently, the majority of the road-traffic victims globally. Simple measures can be taken to make safer on the roads, which include enforcement of safety measures like seat belt and helmets. The compulsory Helmet law was enforced in Kerala on 18/06/07. Resistance to legislation on motorcycle helmets still coexists world wide with debate on the effectiveness of helmets. In an attempt to analyze the protective effect of helmets on facial injuries a comparative study was conducted in Government Dental College, Calicut, which is a major trauma centre in northern Kerala. Data for the present study was obtained from the patients who have reported to the Emergency Department of Oral and Maxillofacial Surgery, Government Dental College, Calicut, for a period of 6 months immediately after the implementation of strict helmet rule in Kerala. For the study all patients with a history of nonfatal motor cycle accident sustaining facial injuries were included. The results were compared with the study conducted in the same institution in the pre law period. The study demonstrates the protective effect of motorcycle helmets in decreasing the morbidity of maxillofacial trauma.There was a marked decrease in incidence of motorcycle-related injuries, remarkable increase in helmet usage and better outcome in helmeted individuals in the post law period. Road traffic injury control is a public health problem. Health and medical professionals have an ethical responsibility to educate and arrange for the safety of individuals. Helmets are effective in preventing or reducing the severity of motorcycle-related injuries and in a developing country like India, enforced mandatory motor cycle helmet law is potentially one of the most cost effective interventions available.

  19. Dento-alveolar and maxillofacial injuries: a 5-year multi-center study. Part 1: general vs facial and dental trauma.

    Science.gov (United States)

    Lin, Shaul; Levin, Liran; Goldman, Sharon; Peleg, Kobi

    2008-02-01

    Maxillofacial injuries are a significant cause of morbidity and demand meticulously planned treatment. The aim of this present multi-center study was to evaluate the occurrence of dento-alveolar and maxillofacial injuries over a 5-year period. A retrospective cohort study of data from the Israel Trauma Registry was conducted for the years 2000-2004. The registry includes all trauma patients admitted and hospitalized due to an injury. Of the 111,010 hospitalized trauma patients, 5886 (5.3%) were diagnosed with maxillofacial or dental injuries. The main causes of injuries for hospitalized trauma patients were falls (48.1%) and motor vehicle accidents (25.2%), while the major causes of facial and dental injuries were vehicle accidents (39.6%, 56.8%, respectively) and falls (32.1%, 26.7%, respectively). High-risk age groups for dental and facial trauma were 10-18 years and 19-28 years, respectively, while for other trauma, ages for the greatest risk ranged from 0 to 9 years and over 59 years. Males were injured two to three times more frequently than females. A better understanding of the etiology of maxillofacial and dental injuries and identifying the high-risk groups should lead to appropriate prevention programs and treatment methods.

  20. Current concepts in the management of complex elbow trauma.

    Science.gov (United States)

    Morrey, B F

    2009-06-01

    Complex instability of the elbow, also known as fracture dislocation of the elbow, is one of the most challenging injuries of the musculoskeletal system. A clear understanding of the biomechanics of the joint with special focus on the relative contributions of the articular components and the ligamentous constraints is critical to the proper management of these injuries. The accurate recognition and implications of associated injuries offers a rationale for approaching these difficult problems by appropriately addressing the elements of the trauma. Further, doing so in a timely fashion enhances the outcome. Currently, even the most devastating of injuries are felt to have a more favourable prognosis than was present in the past if the principles contained herein are followed.

  1. Effect of Dermabrasion and ReCell® on Large Superficial Facial Scars Caused by Burn, Trauma and Acnes

    Institute of Scientific and Technical Information of China (English)

    Pan-xi Yu; Wen-qi Diao; Zuo-liang Qi; Jing-long Cai

    2016-01-01

    Objective To explore the effects of dermabrasion combined with ReCell® on large superficial facial scars caused by burn, trauma and acnes. Methods Nineteen patients with large superficial facial scars were treated by the same surgeon with dermabrasion combined with ReCell®. According to the etiology, patients were classified into post-burning group (n=5), post-traumatic group (n=7) and post-acne group (n=7). Fifteen patients completed the follow-ups, 5 patients in each group. Healing time, complication rate, the preoperative and 18-month-post-operative assessments using Patient Satisfaction Score (PSS), Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS) of each group were analyzed to compare the effect of the combined therapy on outcomes. Results The healing time of post-burning group (19.6±4.0 days), post-traumatic group (15.8±2.6 days), and post-acne group (11.4±3.1 days) varied remarkably (F=7.701,P=0.007). The complication rates were 60%, 20%, and 0 respectively. The post-operative POSAS improved significantly in all groups (P<0.05), where the most significant improvement was shown in the post-acne group (P<0.05). The post-operative PSS and VSS improved only in the post-traumatic group and post-acne group (allP<0.05), where the more significant improvement was also shown in the post-acne group (P<0.05). Conclusions The combined treatment of dermabrasion and ReCell® has remarkable effect on acne scars, moderate effect on traumatic scars and is not suggested for burn scars. POSAS should be applied to assess the therapeutic effects of treatments for large irregular scars.

  2. Complex Psychological Trauma and Self-Dysregulation: A Theory Synthesis for Nursing.

    Science.gov (United States)

    Choi, Kristen R

    2016-01-01

    Complex psychological trauma is a phenomenon resulting from severe interpersonal trauma that can negatively affect how individuals experience health care. However, few theories conceptualizing complex trauma exist, and it has received only limited attention in the nursing literature. The purpose of this theory synthesis was to organize two theories of (a) self-regulation and (b) self-dysregulation following complex psychological trauma into a single conceptual framework for use in nursing practice. This article used the theory synthesis approach described by Walker and Avant. The theory has potential to advance nursing science by helping nurses and other health professionals understand how trauma can alter self-regulatory processes and result in unique challenges in care delivery. It also has potential to prevent retraumatization of trauma survivors at the hands of health care providers.

  3. Bilateral abducens nerve and right facial nerve palsy occuring after head trauma

    Directory of Open Access Journals (Sweden)

    ismail Boyraz

    2016-06-01

    Full Text Available Lesions of the nervus abducens, the 6th cranial nerve tend to be rare, usually occur suddenly following head injuries. A 43-year-old male patient presented with a history of fall from a height due to an occupational accident on the date of 11.01.2014. Cranial tomography demonstrated bilateral epidural hematoma. The epidural hematoma was drained during the operation. After the surgery, eye examination showed no vision loss, except limited bilateral lateral gaze. When the patient was unable to walk due to diplopia, he was advised to close one eye. On the right side, there were findings suggesting central facial paralysis. There may be multiple cranial nerve damage following head injury. Therefore, all cranial nerves should be thoroughly examined. [J Contemp Med 2016; 6(2.000: 110-113

  4. The correlation between facial and eyelid demodicosis. Complex therapeutic approaches

    Directory of Open Access Journals (Sweden)

    D. Yu. Maychuk

    2015-01-01

    Full Text Available Aim. To assess the correlation between eyelid and facial demodicosis and to develop an optimal anti-parasitic treatment schedule for posterior blepharitis associated with eyelid demodicosis. Materials and methods. 100 patients with posterior blepharitis associated with eyelid demodicosis were enrolled in the study. The patients were divided into 2 groups depending on Demodex count. Demodex count less than 4 mites was considered normal while Demodex count more than 4 mites was considered pathological. 60 patients with Demodex count more than 4 mites were subdivided into 2 groups. Study group patients (n = 30 received anti-parasitic therapy with preceding anti-inflammatory treatment, eyelid hygiene and massage. Control group patients (n = 30 received antiparasitic therapy only. Patients with verified facial demodicosis received dermatological treatment as well. In all patients, integral indices of subjective discomfort and objective signs of posterior blepharitis were measured, Schirmer’s and Norn’s tests were performed, functional state of meibomian glands was evaluated (compressive test. Results. Eyelid demodicosis was associated with facial demodicosis in 48% of patients. In 10%, Demodex count was less than 4 mites. In 38%, Demodex count was more than 4 mites. Skin lesions were revealed in 1% of patients with Demodex count less than 4 mites and in 20% of patients with Demodex count more than 4 mites. Anti-parasitic therapy with preceding anti-inflammatory treatment, eyelid hygiene and massage improved functional state of meibomian glands and objective signs of posterior meibomian blepharitis. In 1.5 months after the treatment, Demodex was absent in 80% of study group patients and 56.6% of controls. Conclusion. Stepwise treatment of posterior blepharitis associated with eyelid demodicosis (anti-inflammatory and anti-parasitic therapy, eyelid hygiene is effective and provides prolonged remission. 

  5. The correlation between facial and eyelid demodicosis. Complex therapeutic approaches

    Directory of Open Access Journals (Sweden)

    D. Yu. Maychuk

    2015-03-01

    Full Text Available Aim. To assess the correlation between eyelid and facial demodicosis and to develop an optimal anti-parasitic treatment schedule for posterior blepharitis associated with eyelid demodicosis. Materials and methods. 100 patients with posterior blepharitis associated with eyelid demodicosis were enrolled in the study. The patients were divided into 2 groups depending on Demodex count. Demodex count less than 4 mites was considered normal while Demodex count more than 4 mites was considered pathological. 60 patients with Demodex count more than 4 mites were subdivided into 2 groups. Study group patients (n = 30 received anti-parasitic therapy with preceding anti-inflammatory treatment, eyelid hygiene and massage. Control group patients (n = 30 received antiparasitic therapy only. Patients with verified facial demodicosis received dermatological treatment as well. In all patients, integral indices of subjective discomfort and objective signs of posterior blepharitis were measured, Schirmer’s and Norn’s tests were performed, functional state of meibomian glands was evaluated (compressive test. Results. Eyelid demodicosis was associated with facial demodicosis in 48% of patients. In 10%, Demodex count was less than 4 mites. In 38%, Demodex count was more than 4 mites. Skin lesions were revealed in 1% of patients with Demodex count less than 4 mites and in 20% of patients with Demodex count more than 4 mites. Anti-parasitic therapy with preceding anti-inflammatory treatment, eyelid hygiene and massage improved functional state of meibomian glands and objective signs of posterior meibomian blepharitis. In 1.5 months after the treatment, Demodex was absent in 80% of study group patients and 56.6% of controls. Conclusion. Stepwise treatment of posterior blepharitis associated with eyelid demodicosis (anti-inflammatory and anti-parasitic therapy, eyelid hygiene is effective and provides prolonged remission. 

  6. Ear trauma.

    Science.gov (United States)

    Eagles, Kylee; Fralich, Laura; Stevenson, J Herbert

    2013-04-01

    Understanding basic ear anatomy and function allows an examiner to quickly and accurately identify at-risk structures in patients with head and ear trauma. External ear trauma (ie, hematoma or laceration) should be promptly treated with appropriate injury-specific techniques. Tympanic membrane injuries have multiple mechanisms and can often be conservatively treated. Temporal bone fractures are a common cause of ear trauma and can be life threatening. Facial nerve injuries and hearing loss can occur in ear trauma.

  7. Laser therapy in the management of dental and oro-facial trauma

    Science.gov (United States)

    Darbar, Arun A.

    2007-02-01

    This is a clinical presentation demonstrating the efficacy of laser therapy in the treatment of patients presenting with trauma to both the hard and soft tissue in the orofacial region. The use of laser therapy aids the management of these cases where the patients often present with anxiety and a low pain threshold. The outcomes in these cases indicate good patient acceptance of the treatment, enhanced repair and tissue response suggesting that this form of treatment can be indicated for these patients. A combination of hard and soft lasers are used for the comprehensive dental management and treatment of these cases. The lasers used are a 810nm diode and an Er.CrYSGG.

  8. Facial paralysis in temporal bone trauma%面神经减压术治疗颞骨外伤性面瘫的临床分析

    Institute of Scientific and Technical Information of China (English)

    黄新生; 戴春富; 王正敏

    2001-01-01

    Objective To study the cause and treatment of facial paralysis in temporal bone trauma. Methods A retrospective review of 28 patients with facial paralysis resulting from temporal bone trauma was conducted,House-Brackmann(H-B) system was used to evaluate the recovery of facial nerve function, U test was employed for statistic analysis. Results Twenty-six cases underwent following up facial nerve function of all patients was recovery partly after surgery,46% cases reached H-BⅡ,84% cases reached H-BⅢ,comparing facial nerve decompression within 4 months of injury to beyond 4 months of injury,recovery to H-BⅡ or more of facial nerve function was 60% and 0%, respectively. The difference was significant(P<0.05). Conclusion Surgery decompression is effective on facial nerve palsy caused by temporal bone trauma. It is recommended that surgery decompression be carried out as soon as possible since a better prognosis is obtained if it is performed within four months after injury.%目的探讨颞骨外伤性面瘫的处理。方法回顾性分析1989年9月~2000年4月间28例因颞骨外伤致面瘫而行面神经减压手术的病例资料,以House-Brackmann(H-B)分级法作为疗效评估标准,统计学方法采用U检验。结果随访26例发现:手术减压后所有病例面神经功能均有不同程度恢复,46%恢复至H-BⅡ级以上,84%恢复至Ⅲ级以上;在伤后4个月内和受伤4个月后行减压手术者,功能恢复至H-BⅡ级以上分别为60%和0%,差异有统计学意义(P<0.05)。结论颞骨外伤后面瘫病例,手术减压是一种有效的治疗手段;手术应尽早实施,外伤后4个月内手术面神经功能恢复较好。

  9. Narrative exposure therapy: an evidence-based treatment for multiple and complex trauma

    OpenAIRE

    Ruud A. Jongedijk

    2014-01-01

    Narrative exposure therapy (NET) is a recently developed, short-term treatment for patients with a posttraumatic stress disorder (PTSD) as a result of multiple trauma. NET can be applied very successfully in patients with complex trauma complaints (Jongedijk, 2014; Schauer, Neuner, & Elbert, 2011).An important feature of NET is that trauma processing is never an isolated event but is always embedded in the context of a traumatic event and in the life history as a whole. At the start, the ...

  10. Fusarium dimerum Species Complex (Fusarium penzigii) Keratitis After Corneal Trauma.

    Science.gov (United States)

    do Carmo, Anália; Costa, Esmeralda; Marques, Marco; Quadrado, Maria João; Tomé, Rui

    2016-12-01

    We report a case of a keratitis associated with a Fusarium penzigii-a Fusarium dimerum species complex (FDSC)-in a 81-year-old woman after a corneal trauma with a tree branch. At patient admittance, slit lamp biomicroscopy revealed an exuberant chemosis, an inferior corneal ulcer with an associated inflammatory infiltrate, a central corneal abscess, bullous keratopathy and posterior synechiae. Corneal scrapes were obtained for identification of bacteria and fungi, and the patient started antibiotic treatment on empirical basis. Few days later, the situation worsened with the development of hypopyon. By that time, Fusarium was identified in cultures obtained from corneal scrapes and the patient started topical amphotericin B 0.15 %. Upon the morphological identification of the Fusarium as a FDSC, and since there was no clinical improvement, the treatment with amphotericin B was suspended and the patient started voriconazole 10 mg/ml, eye drops, hourly and voriconazole 200 mg iv, every 12 h for 1 month. The hypopyon resolved and the inflammatory infiltrate improved, but the abscess persisted at the last follow-up visit. The molecular identification revealed that the FDSC was a F. penzigii.

  11. Facial triad modelling using ferrous pyridinyl prolinate complexes : synthesis and catalytic applications

    NARCIS (Netherlands)

    Moelands, Marcel A. H.; Schamhart, Daniel J.; Folkertsma, Emma; Lutz, Martin; Spek, Anthony L.; Klein Gebbink, Bert

    2014-01-01

    A series of new chiral pyridinyl prolinate (RPyProR) ligands and their corresponding Fe(II) triflate and chloride complexes are reported. The ligands possess an NN'O coordination motif, as found in the active site of non-heme iron enzymes with the so-called 2-His-1-carboxylate facial triad. The coor

  12. Trauma.

    Science.gov (United States)

    Cobb, A B

    1991-03-01

    The need for planning and development of statewide trauma prevention and trauma service systems is or should be a high priority--if one sets priorities on criteria that address important factors such as cost to benefits in reduction of life years lost and reduction of disability and costs of long-term rehab services, etc. Prevention of injury and first class trauma care will lessen our heavy human burdens (loss of life and disability) and reduce our long-term outlays for rehabilitation, etc. Obviously our first line of intervention should be prevention--all educational, regulatory and automatic protectors (seat belts, gun restrictions, air bags) that will lower injury rates. A state trauma system must be planned for the larger universe than individual institutions or communities. We must educate our public that the only practical way to provide services for major trauma is through regionalized systems that they somehow must help support. The recent emphasis on making the health services industry a "competitive market" has discouraged public interest and support for regionalized health systems. Our best chances for funding such systems are probably through user fees, sin taxes and surcharges on fines, etc. We need the elements or principles of a plan and present it to the public and to their representatives in the courthouses, city halls and state capital of our state. We need to generate public discussion and understanding on the problem, the potential for saving lives and preventing disability. To do any less would mean our failure to meet our duties as health professionals and public health officials.

  13. ‘Beweging in trauma’ : psychomotorische therapie in de stabilisatiefase van complex trauma

    NARCIS (Netherlands)

    Scheffers, Mia; Nissen, Ingrid; Verveld, Sjoukje; Berkel, Krista van; Hatzmann, Janneke; Busschbach, Jooske van

    2016-01-01

    Aanleiding tot het schrijven van deze module is het onderzoek 'Beweging in trauma' naar het effect van psychomotorische therapie (PMT) in de stabilisatiefase van complex trauma. Dit onderzoek werd uitgevoerd met financiering vanuit het RAAK-Publiek programma. Eén van de doelen van dit programma is h

  14. [Clinical-morphological and histometric characteristics of soft tissue wounds in maxilla-facial region of patients in different terms after trauma].

    Science.gov (United States)

    Fedorina, T A; Braĭlovskaia, T V

    2009-01-01

    504 patients with open traumas of face soft tissues which were given primary surgical wounds treatment with reconstructive operations in maxilla-facial surgical clinics of Samara State Medical University in 2005-2008 also received detailed description. The results of statistical analysis of patients' surgical treatment for the previous 5 year period were listed. It was noted that in the majority of cases (75,5%) patients turned to stomatological aid in first hours or first day and night after receiving the injury, more often there were isolated soft tissue injuries (73,3%), tear-contused and cut wounds put together 80,5%. Morphological and histometric studies of operational-biopsy material let determine the character of changes of leucocyte infiltration and of epithelium - stromal interrelation in different zones of wound edges in patients incoming in different terms after trauma. Objective criteria of tissue excision volumes were received in the process of surgical wound treatment. During last 3 years esthetic results of patient treatment with maxilla-facial traumas improved, the postoperative complications frequency was reduced by 8,1% if compared with the previous 5-year period.

  15. The role of multislice spiral computed tomography in the diagnosis and management of acute facial trauma in patients with multiple injuries.

    Science.gov (United States)

    Nemsadze, G; Urushadze, O

    2011-11-01

    Using of mutislice spiral CT as first line examination for the diagnosis of Acute Facial trauma in the setting of Polytrauma reduces both: valuable time and cost of patient treatment. After a brief clinical examination, MDCT was performed depending on the area of injury, using a slice thickness of 0.65 mm. The obtained data were analyzed using 3D, MIP and Standard axial with Bone reconstruction protocols. 64 polytrauma patients were evaluated with both Anterior and Lateral craniography (plain skull X ray: AP and Lateral) and Multi Slice CT. Craniography detected only 18 cases of traumatic injuries of facial bones, but exact range of dislocation and accurate management plan could not be established. In the same 64 cases, Multislice CT revealed localization of all existed fractures, range of fragment dislocation, soft tissue damage and status of Paranasal sinus in 62 cases (96.8%). In two cases MS CT missed the facial fracture, in one case the examination was complicated because of bone thinness and numerous fracture fragments, in another multiple foreign body artifacts complicated the investigation. The study results show that, CT investigation based on our MDCT polytrauma protocol, detects all more or less serious facial bone injuries.

  16. Treatment Outcomes for Women With Substance Abuse and PTSD Who Have Experienced Complex Trauma

    National Research Council Canada - National Science Library

    Cohen, Lisa R; Hien, Denise A

    2006-01-01

    OBJECTIVE: This study assessed the effect of cognitive-behavioral therapy on a range of problems associated with complex trauma in a sample of women with comorbid substance use disorders and posttraumatic stress disorder (PTSD). METHODS...

  17. A Case of Complex Facial Clefts Treated with Staged-tissue Expansion

    Directory of Open Access Journals (Sweden)

    Koichi Ueda, MD, PhD

    2014-12-01

    Full Text Available Summary: Craniofacial clefts involve all soft tissue and skeletal elements throughout the cleft. Usefulness of tissue expansion in craniofacial clefts is reported. Surgery for a complex type of facial clefts is more difficult and more extensive than for a simple one. We experienced a primary case of complex facial clefts (Tessier No. 2 and 12 on the right and 3, 11, and 5 on the left. Soft-tissue closure of all clefts could be completed by using 4 tissue expanders and 7 operations. Because multiple tissue deficiencies and abnormalities exist in craniofacial clefts, especially complex type, a planned, staged, sequential approach by tissue expansion is necessary to produce ideal results.

  18. Facial trauma in the largest city in Latin America, São Paulo, 15 years after the enactment of the compulsory seat belt law

    Directory of Open Access Journals (Sweden)

    Tarley Eloy Pessoa de Barros

    2010-01-01

    Full Text Available Traffic accidents are a reality throughout Brazil. The face is one of the anatomic parts most affected by these accidents, especially when a seat belt is not used. These accidents are costly for the public health system and have a significant impact on society and the lives of families involved. The compulsory use of seat belts in Brazil, especially in São Paulo, has decreased the rate of facial trauma. This suggests that the public health policies and measures adopted by the Brazilian authorities have benefited the population 15 years after the enactment of the law of compulsory seat belts in the city of São Paulo

  19. Analysis of Surgical Treatment of Different Types of Nasal Facial Trauma%不同类型鼻面部外伤手术疗效分析

    Institute of Scientific and Technical Information of China (English)

    邓伟; 李树华; 王杰

    2014-01-01

    Objective To discuss surgical treatment of different types of nasal facial trauma. Methods 85 patients of na-sal facial trauma, according to my department in 2002~2010, type I and type II(49cases)using traditional methods reset, type III and type IV(36 cases)diagnosis and treatment of early endoscopy combined with nasal surgery, postoperative follow-up of 0. 5~8 years. Results Patients’ effective rate with type I and type II nasal facial trauma is 100%, type III and type IV facial trauma pa-tients with Nasal Endoscopy combined with nasal surgery, effective rate is 91. 67%. Conclusion Type I and type II traditional surgery and type ⅢandⅣin the early joint surgery can do nose cone shape restoration and reconstruction of the nasal cavity to a-chieve a satisfactory outcome, and avoid the second-stage surgery in patients with type III and type IV.%目的:探讨不同类型鼻面部外伤手术疗效情况。方法根据我科室2002年至2010年85例患者鼻面部外伤,Ⅰ型和Ⅱ型(49例)采用传统方式复位,Ⅲ型和Ⅳ型(36例)型早期鼻内镜联合手术诊治情况,术后随访0.5~8年。结果Ⅰ型和Ⅱ型鼻面部外伤患者有效率为100%,Ⅲ型和Ⅳ型鼻面部外伤患者早期鼻内镜联合手术,有效率为91.67%。结论Ⅰ型和Ⅱ型传统手术及Ⅲ型和Ⅳ型早期联合手术使大多数鼻锥外形整复与鼻腔功能重建达到满意效果,避免了Ⅲ型和Ⅳ型患者二期手术。

  20. Developmental trauma, complex PTSD, and the current proposal of DSM-5

    Directory of Open Access Journals (Sweden)

    Vedat Sar

    2011-03-01

    Full Text Available This paper evaluates representation of clinical consequences of developmental psychological trauma in the current proposal of DSM-5. Despite intensive efforts by its proponents for two decades, it is not known yet if Complex PTSD will take a place in the final version of DSM-5. Recognition of dissociative character of several symptom dimensions and introduction of items about negative affects such as shame and guilt imply an indirect improvement toward better coverage of the consequences of developmental trauma in the existing category of PTSD. As disorders with highest prevalence of chronic traumatization in early years of life, dissociative disorders and personality disorder of borderline type are maintained as DSM-5 categories; however, recognition of a separate type of trauma-related personality disorder is unlikely. While a preschooler age variant of PTSD is under consideration, the proposed diagnosis of Developmental Trauma Disorder (child version of Complex PTSD has not secured a place in the DSM-5 yet. We welcome considerations of subsuming Adjustment Disorders, Acute Stress Disorder, PTSD, and Dissociative Disorders under one rubric, i.e., Section of Trauma, Stress, or Event Related Disorders. Given the current conceptualization of DSM-5, this paper proposes Complex PTSD to be a subtype of the DSM-5 PTSD. Composition of a trauma-related disorders section would facilitate integration of knowledge and expertise about interrelated and overlapping consequences of trauma.For the abstract or full text in other languages, please see Supplementary files under Reading Tools online

  1. Is there Complex Trauma Experience typology for Australian's experiencing extreme social disadvantage and low housing stability?

    Science.gov (United States)

    Keane, Carol A; Magee, Christopher A; Kelly, Peter J

    2016-11-01

    Traumatic childhood experiences predict many adverse outcomes in adulthood including Complex-PTSD. Understanding complex trauma within socially disadvantaged populations has important implications for policy development and intervention implementation. This paper examined the nature of complex trauma experienced by disadvantaged individuals using a latent class analysis (LCA) approach. Data were collected through the large-scale Journeys Home Study (N=1682), utilising a representative sample of individuals experiencing low housing stability. Data on adverse childhood experiences, adulthood interpersonal trauma and relevant covariates were collected through interviews at baseline (Wave 1). Latent class analysis (LCA) was conducted to identify distinct classes of childhood trauma history, which included physical assault, neglect, and sexual abuse. Multinomial logistic regression investigated childhood relevant factors associated with class membership such as biological relationship of primary carer at age 14 years and number of times in foster care. Of the total sample (N=1682), 99% reported traumatic adverse childhood experiences. The most common included witnessing of violence, threat/experience of physical abuse, and sexual assault. LCA identified six distinct childhood trauma history classes including high violence and multiple traumas. Significant covariate differences between classes included: gender, biological relationship of primary carer at age 14 years, and time in foster care. Identification of six distinct childhood trauma history profiles suggests there might be unique treatment implications for individuals living in extreme social disadvantage. Further research is required to examine the relationship between these classes of experience, consequent impact on adulthood engagement, and future transitions though homelessness.

  2. Developmental trauma, complex PTSD, and the current proposal of DSM-5.

    Science.gov (United States)

    Sar, Vedat

    2011-01-01

    This paper evaluates representation of clinical consequences of developmental psychological trauma in the current proposal of DSM-5. Despite intensive efforts by its proponents for two decades, it is not known yet if Complex PTSD will take a place in the final version of DSM-5. Recognition of dissociative character of several symptom dimensions and introduction of items about negative affects such as shame and guilt imply an indirect improvement toward better coverage of the consequences of developmental trauma in the existing category of PTSD. As disorders with highest prevalence of chronic traumatization in early years of life, dissociative disorders and personality disorder of borderline type are maintained as DSM-5 categories; however, recognition of a separate type of trauma-related personality disorder is unlikely. While a preschooler age variant of PTSD is under consideration, the proposed diagnosis of Developmental Trauma Disorder (child version of Complex PTSD) has not secured a place in the DSM-5 yet. We welcome considerations of subsuming Adjustment Disorders, Acute Stress Disorder, PTSD, and Dissociative Disorders under one rubric, i.e., Section of Trauma, Stress, or Event Related Disorders. Given the current conceptualization of DSM-5, this paper proposes Complex PTSD to be a subtype of the DSM-5 PTSD. Composition of a trauma-related disorders section would facilitate integration of knowledge and expertise about interrelated and overlapping consequences of trauma.

  3. Association of Childhood Complex Trauma and Dissociation With Complex Posttraumatic Stress Disorder Symptoms in Adulthood.

    Science.gov (United States)

    van Dijke, Annemiek; Ford, Julian D; Frank, Laurence E; van der Hart, Onno

    2015-01-01

    This study replicates and extends prior research on the relationship of childhood complex trauma (CCT) and complex posttraumatic stress disorder (cPTSD) in adulthood, examining the role of psychoform and somatoform dissociation as a potential mediator. CCT, dissociation, and cPTSD were assessed in a large sample of adult psychiatric inpatients. Almost two thirds of participants reported having experienced CCT. Path analyses with bootstrap confidence intervals demonstrated a relationship between CCT, psychoform (but not somatoform) dissociation, and cPTSD. In addition, psychoform dissociation partially mediated the relationship between CCT and adult cPTSD symptoms. Dissociation (pathological or nonpathological psychoform and somatoform symptoms) warrants further clinical and scientific study as a potential link between CCT and the presence of adult cPTSD symptoms and/or the dissociative subtype of PTSD.

  4. Defining trauma in complex care management: Safety-net providers' perspectives on structural vulnerability and time.

    Science.gov (United States)

    Thompson-Lastad, Ariana; Yen, Irene H; Fleming, Mark D; Van Natta, Meredith; Rubin, Sara; Shim, Janet K; Burke, Nancy J

    2017-08-01

    In this paper, we delineate how staff of two complex care management (CCM) programs in urban safety net hospitals in the United States understand trauma. We seek to (1) describe how staff in CCM programs talk about trauma in their patients' lives; (2) discuss how trauma concepts allow staff to understand patients' symptoms, health-related behaviors, and responses to care as results of structural conditions; and (3) delineate the mismatch between long-term needs of patients with histories of trauma and the short-term interventions that CCM programs provide. Observation and interview data gathered between February 2015 and August 2016 indicate that CCM providers define trauma expansively to include individual experiences of violence such as childhood abuse and neglect or recent assault, traumatization in the course of accessing health care and structural violence. Though CCM staff implement elements of trauma-informed care, the short-term design of CCM programs puts pressure on the staff to titrate their efforts, moving patients towards graduation or discharge. Trauma concepts enable clinicians to name structural violence in clinically legitimate language. As such, trauma-informed care and structural competency approaches can complement each other. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Trauma complexo e suas implicações diagnósticas Complex trauma and diagnostic implications

    Directory of Open Access Journals (Sweden)

    Thiago Wendt Viola

    2011-01-01

    Full Text Available A exposição prolongada a múltiplos eventos traumáticos de natureza interpessoal, sobretudo durante o desenvolvimento, tem demonstrado consequências e sintomas psiquiátricos não considerados pelo atual diagnóstico de transtorno de estresse pós-traumático (TEPT. Essas situações negativas e crônicas durante a infância e adolescência evidenciam a existência de uma síndrome psicopatológica associada a complexas (desadaptações a efeitos traumáticos diversos. A ausência de um diagnóstico coeso e fidedigno para essas vítimas interfere negativamente na identificação sintomatológica e no método de tratamento. O presente trabalho visa revisar a definição de trauma, apresentando o conceito de trauma complexo, explorando suas implicações clínicas, bem como as categorias diagnósticas derivadas desse constructo. Importantes questões são levantadas acerca das diferenças entre trauma complexo e TEPT, investigando os sintomas e transtornos comórbidos ao diagnóstico de TEPT, assim como as limitações inerentes a esse diagnóstico. Considerando o impacto psicopatológico relacionado ao trauma complexo, discute-se a possível inserção de uma nova categoria diagnóstica na 5ª versão do Manual Diagnóstico e Estatístico dos Transtornos Mentais, adjunta ao espectro de psicopatologias pós-traumáticas.Prolonged exposure to multiple traumatic events of an interpersonal nature, particularly during development, has shown psychological consequences and symptoms not included among the current diagnostic criteria of post-traumatic stress disorder (PTSD. These negative and chronic situations during childhood and adolescence provide further evidence of the existence of a psychopathological syndrome associated with complex (disadaptations to a number of traumatic effects. The absence of a cohesive and reliable diagnosis for these patients negatively affects symptom identification and treatment planning. The aim of the present study

  6. An Alternative Approach to the Effects of Multiple Traumas: Complex Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Taycan, Okan; Yildirim, Ahmet

    2015-09-01

    Exposure to multiple traumatic events, particularly in childhood, has been shown to result in more complex symptoms than those seen after exposure to a single traumatic event. In case of overlooking the link between trauma and psychopathology, patients with multiple traumatic experiences receive a variety of different diagnoses that are unable to completely cover the clinical picture. Misdiagnoses of genuine cases inevitably lead to mistreatment. A diagnosis of complex post-traumatic stress disorder has been proposed to cover the emerging psychopathology in survivors of multiple traumas. This present report aimed to discuss the construct and to increase the awareness of complex post-traumatic stress disorder diagnosis among mental health professionals.

  7. The Joint Facial and Invasive Neck Trauma (J-FAINT) Project, Iraq and Afghanistan 2003-2011

    Science.gov (United States)

    2013-01-01

    immediate vs delayed exploration of penetrating neck wounds was also developed through experience in OIF.10 These practices are now the standard...Facial nerve 35 0.14 Optic nerve 27 0.10 Nerve 14 0.05 Total 25,834 Abbreviation: TMJ, temporomandibular joint. Figure 1. Soft tissue injuries. TMJ... temporomandibular joint. Figure 2. Facial fractures. Feldt et al 405 at BROOKE ARMY MEDICAL CENTER on December 23, 2014oto.sagepub.comDownloaded from

  8. Surgical-Allogeneic Facial Reconstruction: Facial Transplants

    OpenAIRE

    Marcelo Coelho Goiato; Daniela Micheline Dos Santos; Lisiane Cristina Bannwart; Marcela Filié Haddad; Leonardo Viana Pereira; Aljomar José Vechiato Filho

    2014-01-01

    Several factors including cancer, malformations and traumas may cause large facial mutilation. These functional and aesthetic deformities negatively affect the psychological perspectives and quality of life of the mutilated patient. Conventional treatments are prone to fail aesthetically and functionally. The recent introduction of the composite tissue allotransplantation (CTA), which uses transplanted facial tissues of healthy donors to recover the damaged or non-existent facial tissue of mu...

  9. Trauma, innocence and the core complex of dissociation.

    Science.gov (United States)

    Kalsched, Donald E

    2017-09-01

    Trauma survivors often lament that they have lost their innocence or lost their souls and that something vulnerable and whole about themselves has been 'broken' or annihilated. Yet when the psychotherapeutic relationship begins, and symbolic material from dreams and the transference emerges, discernible patterns become apparent, indicating that a core of innocence and vitality has not been totally lost or annihilated. On the contrary, it has been 'saved' by dissociation and its system of inner objects and their protective and/or persecutory narrative 'scripts' or 'schemas'. The dissociative system splits off a wounded, orphaned 'child' in the psyche and clinging to this 'child' is a penumbra of innocence that apparently must be preserved at all costs. Unfortunately the costs of preservation are high because such encapsulated innocence becomes malignant, and the inner world turns perverse and destructive. Only when the wounded, orphaned, and innocent part of the personality is allowed to suffer experience again - this time with the promise of a new outcome - can true healing of trauma occur. How to facilitate this authentic suffering in the face of powerful resistances thrown up by the 'system', will be the focus of this paper. © 2017, The Society of Analytical Psychology.

  10. 面神经损伤吻合术手术时机研究%Optimal Timing for Repair of Facial Nerve Trauma

    Institute of Scientific and Technical Information of China (English)

    胡炯炯; 周梁; 马兆鑫

    2011-01-01

    目的:探讨面神经损伤后最佳的修复时机.方法:以行面神经即时吻合术和延迟吻合术后豚鼠的辣根过氧化物酶(HRP)标记神经元数、有髓纤维数/HRP标记神经元等为观察指标,评价面神经即时吻合和延迟不同时期吻合术后面神经再生的情况.结果:各组指标比较,延迟7d缝合组和即时缝合组的治疗效果最佳,此2组间差异无统计学意义;延迟60 d缝合组和延迟90 d缝合组治疗效果最差.结论:在无法即时行面神经吻合术的情况下,可在神经断伤后7d吻合面神经.尽量争取在神经离断伤后60 d内修补损伤的面神经.%Objective:To evaluate the curative effect of immediate nerve suture and delayed nerve suture more comprehensively and more impersonally with longer time course. Methods: All the guinea pigs were randomly assigned to one of eight groups, normal group, group of immediate FFA, group of delayed FFA for 7 days, group of delayed FFA for 14 days, group of delayed FFA for 21 days, group of delayed FFA for 30 days, group of delayed FFA for 60 days, and group of delayed FFA for 90 days by turns. Two months after nerve suture, from observing of HRβ-labeled neurons and axons per motoneuron ratio, we evaluate the curative effect of immediate facial-facial anastomosis (FFA) and FFA delayed for 7-90 days objectively. Results-. Delayed FFA for 7 days showed equal or even better curative effect than the group of immediate FFA did,the group of delayed FFA for 60days and 90 days showed apparenT1y poorer curative effect than the immediately sutured and other delayed sutured ones did. Conclusions: Repairing facial nerve 7 days after trauma could get as good curative effect as immediate suturing of the nerve. Facial nerve regenerates poorly if it is repaired 60-90 days after trauma. The result is of some value to clinical works, that is, if immediate repair of facial nerve is impossible, repairing it 7 days after trauma is also ideal. Meanwhile, we

  11. Emergency Plastic Surgery Treatment of 35 Cases with Seawater Immersed Facial Trauma%35例面部外伤合并海水浸泡的临床救治体会

    Institute of Scientific and Technical Information of China (English)

    丛斌; 张峰平; 张义敏; 姜群; 钟丽红

    2012-01-01

    目的:回顾35例面部外伤合并海水浸泡的治疗.方法:对35例病人采取包括清水、庆大霉素溶液清洗和抗感染等治疗.观察创面的感染情况和临床治疗结果.结果:35例患者外伤愈合良好,无感染、血肿,随访未发生瘢痕增生等并发症.结论:在面部损伤急诊处理中,应用整形外科技术对患者面部功能及形态的恢复有很大的帮助.%Objective: To review the 35 cases with Seawater Immersed Facial Trauma. Methods: A total of 35 cases with Seawater Immersed Facial Trauma underwent combined treatment including repeated wash of wounds with freshwater and Gentamicin solution, anti-infection. The infection of wounds and clinical treatment were observed. Results: 35 cases with Seawater Immersed Facial Trauma healed well, without infection, hematoma, follow-up without complications such as scar formation. Conclusion: In the emergency treatment of facial injuries with Seawater Immersion, it will be of great help to apply facial plastic surgery to restore function and morphology.

  12. Advanced trauma life support (ATLS) and facial trauma: can one size fit all? Part 2: ATLS, maxillofacial injuries and airway management dilemmas.

    Science.gov (United States)

    Perry, M; Morris, C

    2008-04-01

    Maxillofacial trauma poses an obvious threat to the patient's airway, which may not be immediately evident. In the multiply injured patient, the co-existence of actual or potential injuries elsewhere may complicate airway management, notably in the presence of full spinal immobilization. Following high-velocity trauma, injuries to the cervical spine must be assumed to be present. They also need to be ruled out in an appropriate and timely manner, as patients may wish to sit up. Assessment and management of the airway in maxillofacial trauma can be difficult, requiring a senior anaesthetist or other individual appropriately trained in emergency airway care. A number of management options may exist to protect the airway, each with advantages and drawbacks. Agitation and vomiting can occur unexpectedly and need to be managed safely with due consideration to the spine. Oral and maxillofacial surgeons need to be aware of these dilemmas and their early warning signs, and be skilled in emergency surgical airway procedures, especially if involved as part of the trauma team. Prolonged immobilization is associated with significant morbidity and mortality. A number of protocols currently exist for 'clearing' the spine. Imaging now plays a greater role, especially in the obtunded, unconscious or intubated patient, and this is discussed.

  13. Attachment-Focused Hypnosis in Psychotherapy for Complex Trauma: Attunement, Representation, and Mentalization.

    Science.gov (United States)

    Spiegel, Eric B

    2016-01-01

    The relational and psychological functions of attunement, representation, and mentalization are essential components of a secure attachment experience. Psychotherapeutic approaches informed by attachment theory have gained significant empirical and clinical support, particularly in the area of complex trauma. Despite these advances, attachment-informed trauma treatment could benefit greatly from the experiential wealth that clinical hypnosis has to offer. In its utilization of shared attention, tone of voice, pacing, representational imagery, and hypnotic language, clinical hypnosis as a state, relationship, and technique offers psychotherapists a way of introducing a healthy attachment experience and renewing appropriate developmental functioning in patients who are survivors of complex trauma. In this article, attunement, representation, and mentalization are reviewed from a hypnotherapeutic perspective.

  14. INTRA-ARTERIAL INFUSIONS AND DOPLEROGRAPIC CONTROL FOR COMPLEX TREATMENT OF UPPER AND MIDDLE FACIAL ZONES, CONCOMITANT WITH TRAUMATIC CRANIOCEREBRAL INJURIES.

    Science.gov (United States)

    Lagvilava, G; Gvenetadze, Z; Gibradze, E; Danelia, T; Gvenetadze, G

    2016-02-01

    Maxillofacial traumatic injuries concomitant with craniocerebral trauma are still considered as an actual problem in emergency medicine. For this category of patients one of the dangerous and severe complications is development of inflammatory process in the injured areas. Fracture lines of upper and middle facial zones pass through the accessory sinuses of the nose, maxillary/upper dental arch area and are considered to be open and infected fractures. Combination of these fractures with craniocerebral injuries and especially, with open traumas creates predisposition for development of inflammatory processes in CNS that can result in heavy outcome. 29 patients (among them 5-females and 24 -males) with severe and open craniofacial fractures were observed by the authors. For prevention of inflammatory complications in complex treatment of the patients, intra-arterial infusions of therapeutic agents (wide spectrum of antibiotics, Heparin) were used for stimulation of reparative regeneration in fractured fragments of facial bones. After the main surgical interventions (neurosurgery, surgery of facial bones) sanitation of infected centers (accessory sinuses of the nose, oral cavity) and catheterization of external carotid arteries through the temporal arteries were performed. According to the severity of the trauma and its preferential localization, catheterization of carotid arteries was conducted unilaterally (12 cases) or bilaterally (17 cases). Insertion depth through femoral artery was 6-8 cm. Catheter was stayed in the artery for 7-8 days. Intra-arterial infusions were carried out in the morning and evening. Therapeutic agents for arterial infusion included: antibiotic (Rocephin and its analogues), Heparin. To determine the effectiveness of vascular therapy dopplerography of external carotid artery, its branches and supratrochlear artery was performed. Dopplerography of supratrochlear artery, which is the branch of internal carotid artery, was conducted to detect

  15. Creating a Safe Space: A Case Study of Complex Trauma and a Call for Proactive Comprehensive Psychoeducational Assessments and Reviews

    Science.gov (United States)

    Mainwaring, Debra J.

    2015-01-01

    This article advocates for proactive, dynamic and comprehensive psycho-educational assessments for children and young people who have a history of complex trauma, because of its known effects on development and learning. A case study is shared of a young woman with a history of complex trauma because of exposure to parental neglect, multiple…

  16. Facial Recognition

    National Research Council Canada - National Science Library

    Mihalache Sergiu; Stoica Mihaela-Zoica

    2014-01-01

    .... From birth, faces are important in the individual's social interaction. Face perceptions are very complex as the recognition of facial expressions involves extensive and diverse areas in the brain...

  17. Is a black eye a useful sign of facial fractures in patients with minor head injuries? A retrospective analysis in a level I trauma centre over 10 years.

    Science.gov (United States)

    Büttner, Michael; Schlittler, Fabian Lukas; Michel, Chantal; Exadaktylos, Aris Konstantinos; Iizuka, Tateyuki

    2014-07-01

    Orbital blunt trauma is common, and the diagnosis of a fracture should be made by computed tomographic (CT) scan. However, this will expose patients to ionising radiation. Our objective was to identify clinical predictors of orbital fracture, in particular the presence of a black eye, to minimise unnecessary exposure to radiation. A 10-year retrospective study was made of the medical records of all patients with minor head trauma who presented with one or two black eyes to our emergency department between May 2000 and April 2010. Each of the patients had a CT scan, was over 16 years old, and had a Glasgow Coma Score (GCS) of 13-15. The primary outcome was whether the black eye was a valuable predictor of a fracture. Accompanying clinical signs were considered as a secondary outcome. A total of 1676 patients (mean (SD) age 51 (22) years) and minor head trauma with either one or two black eyes were included. In 1144 the CT scan showed a fracture of the maxillofacial skeleton, which gave an incidence of 68.3% in whom a black eye was the obvious symptom. Specificity for facial fractures was particularly high for other clinical signs, such as diminished skin sensation (specificity 96.4%), diplopia or occulomotility disorders (89.3%), fracture steps (99.8%), epistaxis (95.5%), subconjunctival haemorrhage (90.4%), and emphysema (99.6%). Sensitivity for the same signs ranged from 10.8% to 22.2%. The most striking fact was that 68.3% of all patients with a black eye had an underlying fracture. We therefore conclude that a CT scan should be recommended for every patient with minor head injury who presents with a black eye.

  18. 面部外伤的急诊整形外科治疗研究%Surgical treatment of facial trauma emergency orthopedic

    Institute of Scientific and Technical Information of China (English)

    张羽森

    2015-01-01

    Objective To study the clinical effect of facial plastic surgery on repairment of the emergency trauma.Methods Two hundred patients with facial trauma from March 2012 to June 2013 were selected,orthopedic emergency repair first assessment of the injury was given,and then depending on the choice of anesthesia and fix the situation and thoroughly cleaned before surgery,and given reasonable nursing post-operative.Patients were followed up for 1 year,and the postoperative complications,functional restoration and scar formation were observed.Results Operative incision of 200 cases were primary healing,with no significant complications.Six patients were lost to followed-up,of the rest 194 patients,63 patients (32.5%) without obvious scar tissue and no dislocation,the healing effect was satisfactory; 9 patients with obvious scar,need to repair again.Conclusions Emergency orthopedic treatment of facial trauma,can effectively restore the patient' s facial features,but also maximize the recovery form,function and aesthetics into account,it is worth promoting.%目的 研究整形外科急诊修复治疗面部外伤的临床效果.方法 随机抽取郑州人民医院颐和医院2012年3月至2013年6月收治的面部创伤患者200例,对其进行整形外科急诊修复,先评估伤情,再视情况选择麻醉和修复方法,并在术前彻底清创,术后合理护理.术后随访1年,观察患者的术后并发症、功能修复以及瘢痕增生情况.结果 200例患者术后切口Ⅰ期愈合,无一例出现明显并发症.随访中共6例失访,余194例患者中63例(32.5%)术后无明显瘢痕,且组织无错位现象,愈合效果满意,仅9例患者存在明显瘢痕,需行二期修复.结论 急诊整形外科治疗面部外伤,既能有效恢复患者的面部功能,又能最大程度地恢复期形态,功能和美观兼顾,值得推广.

  19. Organización en el tratamiento del traumatismo panfacial y de las fracturas complejas del tercio medio Organization of treatment in panfacial trauma and complex midfacial fractures

    Directory of Open Access Journals (Sweden)

    J. Muñoz i Vidal

    2009-03-01

    between 2005 and 2006. There were 14 patients with midface high energy trauma, 4 of those associated to mandible or upper face subunit fractures. Extraocular motility, air way, correct oclussal relationship, minimum aesthetic sequel and correct recreating of facial dimensions define our goals. A multidisciplinary approach to these patients is imperative. Due to the complexity of these cases, there is not place allowed for improvisation and a previous accurate anamnesis, exploration and order of treatment is absolutely required. This leads to a proper management, an anatomic bone threedimensional reconstruction, preservation of soft structures according to previous patient's anthropometry and minimum aesthetic sequel in a single surgery time.

  20. Enhanced retinal modeling for face recognition and facial feature point detection under complex illumination conditions

    Science.gov (United States)

    Cheng, Yong; Li, Zuoyong; Jiao, Liangbao; Lu, Hong; Cao, Xuehong

    2016-07-01

    We improved classic retinal modeling to alleviate the adverse effect of complex illumination on face recognition and extracted robust image features. Our improvements on classic retinal modeling included three aspects. First, a combined filtering scheme was applied to simulate functions of horizontal and amacrine cells for accurate local illumination estimation. Second, we developed an optimal threshold method for illumination classification. Finally, we proposed an adaptive factor acquisition model based on the arctangent function. Experimental results on the combined Yale B; the Carnegie Mellon University poses, illumination, and expression; and the Labeled Face Parts in the Wild databases show that the proposed method can effectively alleviate illumination difference of images under complex illumination conditions, which is helpful for improving the accuracy of face recognition and that of facial feature point detection.

  1. Changing characteristics of facial fractures treated at a regional, level 1 trauma center, from 2005 to 2010: an assessment of patient demographics, referral patterns, etiology of injury, anatomic location, and clinical outcomes.

    Science.gov (United States)

    Roden, Katherine S; Tong, Winnie; Surrusco, Matthew; Shockley, William W; Van Aalst, John A; Hultman, Charles S

    2012-05-01

    Despite improvements in automotive safety, motor vehicle collision (MVC)-related facial fractures remain common and represent preventable injuries. This study examines the changing characteristics of facial fractures treated at a regional, level I trauma center, from 2005 to 2010. We identified all patients with facial fractures admitted to our hospital, from 2005 to 2010, by querying the North Carolina Trauma Registry, using International Classification of Diseases, Ninth Revision codes. Prospectively collected data, sorted by year, were descriptively analyzed for demographics, referral patterns, etiology, anatomic location, and clinical outcomes. Number of patients with facial fractures increased from 201 per year to 263 per year (total n = 1508). Although transport distances remained constant at ∼85 miles, standard deviation increased from 37 to 68 miles. Transport time increased from 87 to 119 minutes. Referrals came from 28 surrounding counties in 2005 and 43 counties in 2010. Regarding etiology, MVCs decreased from 40% to 27%, all-terrain vehicle crashes decreased from 6% to 2%, falls increased from 8% to 19%, and bicycle accidents increased from 3% to 6%. Regarding anatomic location, frontal sinus fractures increased from 8% to 37%, zygomaticomaxillary fractures increased from 9% to 18%, nasoethmoid fractures decreased from 12% to 6%, orbital floor fractures decreased from 6% to 3%, and mandible fractures decreased from 28% to 18%. Single-site fractures increased from 75% to 90%. Length of intensive care unit and hospital stay remained stable at 3 and 7 days, respectively. Despite a decrease in MVC-related facial fractures, the overall increase in facial fractures referred to our trauma center is due to a growing number of patient transfers from rural hospitals, where a paucity of qualified surgeons may exist.

  2. Task difficulty and response complexity modulate affective priming by emotional facial expressions.

    Science.gov (United States)

    Sassi, Federica; Campoy, Guillermo; Castillo, Alejandro; Inuggi, Alberto; Fuentes, Luis J

    2014-05-01

    In this study we used an affective priming task to address the issue of whether the processing of emotional facial expressions occurs automatically independent of attention or attentional resources. Participants had to attend to the emotion expression of the prime face, or to a nonemotional feature of the prime face, the glasses. When participants attended to glasses (emotion unattended), they had to report whether the face wore glasses or not (the glasses easy condition) or whether the glasses were rounded or squared (the shape difficult condition). Affective priming, measured on valence decisions on target words, was mainly defined as interference from incongruent rather than facilitation from congruent trials. Significant priming effects were observed just in the emotion and glasses tasks but not in the shape task. When the key-response mapping increased in complexity, taxing working memory load, affective priming effects were reduced equally for the three types of tasks. Thus, attentional load and working memory load affected additively to the observed reduction in affective priming. These results cast some doubts on the automaticity of processing emotional facial expressions.

  3. Dorsal Cochlear Nucleus of the Rat: Representation of Complex Sounds in Ears Damaged by Acoustic Trauma.

    Science.gov (United States)

    Li, Yang; Ropp, Tessa-Jonne F; May, Bradford J; Young, Eric D

    2015-08-01

    Acoustic trauma damages the cochlea but secondarily modifies circuits of the central auditory system. Changes include decreases in inhibitory neurotransmitter systems, degeneration and rewiring of synaptic circuits, and changes in neural activity. Little is known about the consequences of these changes for the representation of complex sounds. Here, we show data from the dorsal cochlear nucleus (DCN) of rats with a moderate high-frequency hearing loss following acoustic trauma. Single-neuron recording was used to estimate the organization of neurons' receptive fields, the balance of inhibition and excitation, and the representation of the spectra of complex broadband stimuli. The complex stimuli had random spectral shapes (RSSs), and the responses were fit with a model that allows the quality of the representation and its degree of linearity to be estimated. Tone response maps of DCN neurons in rat are like those in other species investigated previously, suggesting the same general organization of this nucleus. Following acoustic trauma, abnormal response types appeared. These can be interpreted as reflecting degraded tuning in auditory nerve fibers plus loss of inhibitory inputs in DCN. Abnormal types are somewhat more prevalent at later times (103-376 days) following the exposure, but not significantly so. Inhibition became weaker in post-trauma neurons that retained inhibitory responses but also disappeared in many neurons. The quality of the representation of spectral shape, measured by sensitivity to the spectral shapes of RSS stimuli, was decreased following trauma; in fact, neurons with abnormal response types responded mainly to overall stimulus level, and not spectral shape.

  4. Microbial biofilms on silicone facial prostheses

    NARCIS (Netherlands)

    Ariani, Nina

    2015-01-01

    Facial disfigurements can result from oncologic surgery, trauma and congenital deformities. These disfigurements can be rehabilitated with facial prostheses. Facial prostheses are usually made of silicones. A problem of facial prostheses is that microorganisms can colonize their surface. It is hard

  5. [Surgical facial reanimation after persisting facial paralysis].

    Science.gov (United States)

    Pasche, Philippe

    2011-10-01

    Facial reanimation following persistent facial paralysis can be managed with surgical procedures of varying complexity. The choice of the technique is mainly determined by the cause of facial paralysis, the age and desires of the patient. The techniques most commonly used are the nerve grafts (VII-VII, XII-VII, cross facial graft), dynamic muscle transfers (temporal myoplasty, free muscle transfert) and static suspensions. An intensive rehabilitation through specific exercises after all procedures is essential to archieve good results.

  6. Management of a complex dentoalveolar trauma with multiple avulsions: a case report.

    Science.gov (United States)

    Sheroan, Marianne Mills; Roberts, Michael W

    2004-08-01

    Treatment of permanent tooth avulsions in an adolescent poses significant difficulties for the dental clinician. This case report gives details about the treatment of a complex dentoalveolar trauma involving multiple avulsions of primary molars, permanent incisors, permanent molars, and premolar toothbuds. Immediate treatment of the injury and short-term esthetic replacement of the dentition is described. A brief review of current research relative to the treatment of permanent tooth avulsions is provided.

  7. 3D PERSPECTIVE OF MAXILLOFACIAL TRAUMA

    Directory of Open Access Journals (Sweden)

    Surekha

    2016-03-01

    Full Text Available AIM Role of 3 Dimensional Computed Tomography in facial fractures. METHODS AND MATERIALS 133 patients with history of head trauma were scanned using multi slice CT for a period of 2 yrs. Data acquisition was performed using - 16 Slice GE Bright Speed Elite CT Scanner. The datasets were transferred to workstation and VR post-processing protocols were applied. RESULTS 122 patients were male and 11 were female. The mean age of patients with fractures was 32.3 years old. Fractures included the mandible, the maxilla, the frontal bone, the zygomatic arch and the nasal bone. CONCLUSION Continuing advances in computer software algorithms and improved precision in the acquisition of radiographic data makes 3D reformatted CT imaging a necessary complement to traditional 2D CT imaging in the management of complex facial trauma. CT is the investigation of choice in the evaluation of patients with maxillofacial trauma.

  8. Maxillofacial trauma resulting from terror in Israel.

    Science.gov (United States)

    Ringler, Doron; Einy, Shmuel; Giveon, Adi; Goldstein, Liab; Peleg, Kobi

    2007-01-01

    During a 33 month period, maxillofacial injuries resulting from terrorist attacks in Israel were compared with non-terror trauma maxillofacial injuries. Files of patients hospitalized from October 1, 2000 to June 30, 2003 were obtained from the Israel National Trauma Registry. Data were evaluated and compared with a hospitalized non-terror related trauma population within the same period. A literature survey was also conducted. Terror casualties totaled 1,811. In 493 patients with facial injuries, 322 had soft facial tissue injuries (excluding eyes and ears), and 104 had hard tissue injuries of the maxillofacial complex. A significantly higher prevalence was found in terror casualties (explosions and gunshots) compared with non-terror related casualties. Most suffered multiple injuries. Maxillofacial terror casualties experience a unique epidemiology, with more severe injuries and higher prevalence of soft and hard tissue injuries. Preparedness and awareness to the unique pattern of injuries are needed when terrorists strike.

  9. Comparing Treatment Outcome of Guided Imagery and Music and Psychodynamic Imaginative Trauma Therapy for Women with Complex PTSD

    DEFF Research Database (Denmark)

    Maack, Carola

    2013-01-01

    To investigate whether the use of recorded music enhances therapy outcome in psychodynamic trauma therapy for women with Complex PTSD, outcome measures of three groups of patients were compared. One group received 50 hours of outpatient trauma therapy with the Bonny Method of Guided Imagery...... and Music (GIM), another group received 50 hours of outpatient trauma therapy with Psychodynamic Imaginative Trauma Therapy (PITT). The third group was a waiting-list control group of women who had to wait at least nine months for therapy. The participants filled out questionnaires measuring symptoms....... Participants treated with GIM showed significantly better outcome in all measurements than participants treated with PITT. This indicates that the use of music is beneficial for women with Complex PTSD treated with psychodynamic trauma therapy....

  10. Narrative exposure therapy: an evidence-based treatment for multiple and complex trauma.

    Science.gov (United States)

    Jongedijk, Ruud A

    2014-01-01

    Narrative exposure therapy (NET) is a recently developed, short-term treatment for patients with a posttraumatic stress disorder (PTSD) as a result of multiple trauma. NET can be applied very successfully in patients with complex trauma complaints (Jongedijk, 2014; Schauer, Neuner, & Elbert, 2011). An important feature of NET is that trauma processing is never an isolated event but is always embedded in the context of a traumatic event and in the life history as a whole. At the start, the lifeline is laid. The lifeline is made up of a rope, with flowers (happy events), stones (traumatic events), sometimes candles (grief), or recently also sticks for aggressive acts (NET for offenders; see Stenmark, Cuneyt Guzey, Elbert, & Holen, 2014). These symbols are laid down along the rope, in chronological order. Subsequently, in the subsequent therapy sessions the lifeline is processed in chronological order, giving attention to all the important events a person has experienced in his or her life, both the adverse as well as the pleasurable ones. The narration ends with a written testimony. To date, there is good evidence NET is effective in the treatment of PTSD patients, with support from 18 RCTs (N=950). For culturally diverse populations, NET is recommended as the most evidence-based trauma treatment, besides culturally adapted CBT. NET has been investigated in different populations in Africa, Europe, and Asia. In Asia, research has been carried out in Sri Lanka as well as in China. In China, NET was conducted and investigated with survivors of the Sichuan earthquake (Zang, Hunt, & Cox, 2013, 2014). NET is understandable, even appealing and also supportive for patients with multiple trauma. In this presentation, the treatment principles and the practice of NET will be explained.

  11. Narrative exposure therapy: an evidence-based treatment for multiple and complex trauma

    Directory of Open Access Journals (Sweden)

    Ruud A. Jongedijk

    2014-12-01

    Full Text Available Narrative exposure therapy (NET is a recently developed, short-term treatment for patients with a posttraumatic stress disorder (PTSD as a result of multiple trauma. NET can be applied very successfully in patients with complex trauma complaints (Jongedijk, 2014; Schauer, Neuner, & Elbert, 2011.An important feature of NET is that trauma processing is never an isolated event but is always embedded in the context of a traumatic event and in the life history as a whole. At the start, the lifeline is laid. The lifeline is made up of a rope, with flowers (happy events, stones (traumatic events, sometimes candles (grief, or recently also sticks for aggressive acts (NET for offenders; see Stenmark, Cuneyt Guzey, Elbert, & Holen, 2014. These symbols are laid down along the rope, in chronological order. Subsequently, in the subsequent therapy sessions the lifeline is processed in chronological order, giving attention to all the important events a person has experienced in his or her life, both the adverse as well as the pleasurable ones. The narration ends with a written testimony.To date, there is good evidence NET is effective in the treatment of PTSD patients, with support from 18 RCTs (N=950. For culturally diverse populations, NET is recommended as the most evidence-based trauma treatment, besides culturally adapted CBT. NET has been investigated in different populations in Africa, Europe, and Asia. In Asia, research has been carried out in Sri Lanka as well as in China. In China, NET was conducted and investigated with survivors of the Sichuan earthquake (Zang, Hunt, & Cox, 2013, 2014. NET is understandable, even appealing and also supportive for patients with multiple trauma. In this presentation, the treatment principles and the practice of NET will be explained.

  12. Facial anatomy.

    Science.gov (United States)

    Marur, Tania; Tuna, Yakup; Demirci, Selman

    2014-01-01

    Dermatologic problems of the face affect both function and aesthetics, which are based on complex anatomical features. Treating dermatologic problems while preserving the aesthetics and functions of the face requires knowledge of normal anatomy. When performing successfully invasive procedures of the face, it is essential to understand its underlying topographic anatomy. This chapter presents the anatomy of the facial musculature and neurovascular structures in a systematic way with some clinically important aspects. We describe the attachments of the mimetic and masticatory muscles and emphasize their functions and nerve supply. We highlight clinically relevant facial topographic anatomy by explaining the course and location of the sensory and motor nerves of the face and facial vasculature with their relations. Additionally, this chapter reviews the recent nomenclature of the branching pattern of the facial artery.

  13. Complex trauma and intimate relationships: the impact of shame, guilt and dissociation.

    Science.gov (United States)

    Dorahy, Martin J; Corry, Mary; Shannon, Maria; Webb, Kevin; McDermott, Brian; Ryan, Margaret; Dyer, Kevin F W

    2013-05-01

    This study examined dissociation, shame, guilt and intimate relationship difficulties in those with chronic and complex PTSD. Little is known about how these symptom clusters interplay within the complex PTSD constellation. Dissociation was examined as a principle organizing construct within complex PTSD. In addition, the impact of shame, guilt and dissociation on relationship difficulties was explored. Sixty five treatment-receiving adults attending a Northern Irish service for conflict-related trauma were assessed on measures of dissociation, state and trait shame, behavioral responses to shame, state and trait guilt, complex PTSD symptom severity and relationship difficulties. Ninety five percent (n=62) of participants scored above cut-off for complex PTSD. Those with clinical levels of dissociation (n=27) were significantly higher on complex PTSD symptom severity, state and trait shame, state guilt, withdrawal in response to shame and relationship preoccupation than subclinical dissociators (n=38). Dissociation and state and trait shame predicted complex PTSD. Fear of relationships was predicted by dissociation, complex PTSD and avoidance in response to shame, while complex PTSD predicted relationship anxiety and relationship depression. The study was limited to a relatively homogeneous sample of individuals with chronic and complex PTSD drawn from a single service. Complex PTSD has significant consequences for intimate relationships, and dissociation makes an independent contribution to these difficulties. Dissociation also has an organizing effect on complex PTSD symptoms. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. Surgical-allogeneic facial reconstruction: facial transplants.

    Directory of Open Access Journals (Sweden)

    Marcelo Coelho Goiato

    2014-12-01

    Full Text Available Several factors including cancer, malformations and traumas may cause large facial mutilation. These functional and aesthetic deformities negatively affect the psychological perspectives and quality of life of the mutilated patient. Conventional treatments are prone to fail aesthetically and functionally. The recent introduction of the composite tissue allotransplantation (CTA, which uses transplanted facial tissues of healthy donors to recover the damaged or non-existent facial tissue of mutilated patients, resulted in greater clinical results. Therefore, the present study aims to conduct a literature review on the relevance and effectiveness of facial transplants in mutilated subjects. It was observed that the facial transplants recovered both the aesthetics and function of these patients and consequently improved their quality of life.

  15. Surgical treatment of facial paralysis.

    Science.gov (United States)

    Mehta, Ritvik P

    2009-03-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (facial paralysis (3 weeks to 2 yr) and chronic facial paralysis (>2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy.

  16. Clinical research on the application of minimally invasive plastic surgery to repair facial fresh trauma%应用微创整形外科技术修复颜面部新鲜创伤的临床研究

    Institute of Scientific and Technical Information of China (English)

    丛占中; 赵志强; 刘金富

    2014-01-01

    Objective:To study the effect of the clinical research on the application of minimally invasive plastic surgery to repair facial fresh trauma.Methods:65 patients with fresh facial trauma were selected.All of them were used minimally invasive orthopedic surgical techniques,stitching and repair original mouth treatment.Results:65 cases of facial fresh wound were repaired.59 cases were followed up for more than half a year,among which 57 cases(96.6%)were slight scar and 2 cases(3.4%)were slightly obvious scar.Conclusion:The application of minimally invasive techniques of plastic surgery to repair facial trauma,the scar is slight,and it has no deformity,good effect.It is easy to master and extension.%目的:探讨应用微创整形外科技术修复颜面部新鲜创伤的临床效果。方法:收治颜面部新鲜创伤患者65例,均应用微创整形外科手术技术缝合和修复原创口进行治疗。结果:修复颜面新鲜创伤伤口65例,术后随访半年以上59例,其中瘢痕轻微57例(96.6%),瘢痕稍明显2例(3.4%)。结论:应用微创整形外科技术修复颜面创伤瘢痕轻微、无畸形、效果好,此技术易掌握,宜推广。

  17. Dental fragment embedded in the lower lip after facial trauma: Brief review literature and report of a case

    Directory of Open Access Journals (Sweden)

    Dorina Lauritano

    2012-01-01

    Full Text Available Upper incisors are the most frequently involved teeth in traumatic dental injuries. Soft tissues (lips and/or oral mucosa adjacent to incisal edge can receive direct and/or indirect traumas. Laceration of the lower lip is a not rare eventuality and teeth fragments could be embedded in labial soft tissue. The reattachment of these fragments, if possible, is the elective treatment choice, thanks to the modern adhesive and restorative techniques. The authors present a case of a white Caucasian 10-year-old child, who attended the dental clinic for the treatment of both upper central incisors′ crown fractures. The fragment of the left incisor was retrieved embedded in the lower lip. It was successfully surgically removed and reattached using a composite adhesive technique. A careful clinical and radiographic examination with the surgical removal of tooth fragments could prevent undesirable foreign body reaction, infection and scarring. The authors also reviewed the most relevant literature concerning tooth fragment reattachment after removal from oral soft tissues.

  18. Validation of post-traumatic stress disorder (PTSD) and complex PTSD using the International Trauma Questionnaire.

    Science.gov (United States)

    Hyland, P; Shevlin, M; Brewin, C R; Cloitre, M; Downes, A J; Jumbe, S; Karatzias, T; Bisson, J I; Roberts, N P

    2017-09-01

    The 11th version of the International Classification of Diseases (ICD-11) has proposed two related trauma diagnoses: Post-traumatic stress disorder (PTSD) and Complex PTSD (CPTSD). Using a newly developed, disorder-specific measure of PTSD and CPTSD called the International Trauma Questionnaire (ITQ) the current study will (i) assess the factorial validity of ICD-11 PTSD and CPTSD; (ii) provide the first test of the discriminant validity of these constructs; and (iii) provide the first comparison of ICD-11, and Diagnostic and Statistical Manual, Fifth Edition (DSM-5), PTSD diagnostic rates using disorder-specific measures. ICD-11 and DSM-5 PTSD-specific measures were completed by a British clinical sample of trauma-exposed patients (N = 171). The structure and validity of ICD-11 PTSD and CPTSD were assessed by means of factor analysis and assessing relationships with criterion variables. Diagnostic rates under ICD-11 were significantly lower than those under DSM-5. A two-factor second-order model reflecting the distinction between PTSD and CPTSD best represented the data from the ITQ; and the PTSD and CPTSD factors differentially predicted multiple psychological variables. The factorial and discriminant validity of ICD-11 PTSD and CPTSD was supported, and ICD-11 produces fewer diagnostic cases than DSM-5. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Trust-Based Relational Intervention (TBRI): A Systemic Approach to Complex Developmental Trauma.

    Science.gov (United States)

    Purvis, Karyn B; Cross, David R; Dansereau, Donald F; Parris, Sheri R

    2013-10-01

    Children and youth who have experienced foster care or orphanage-rearing have often experienced complex developmental trauma, demonstrating an interactive set of psychological and behavioral issues. Trust-Based Relational Intervention (TBRI) is a therapeutic model that trains caregivers to provide effective support and treatment for at-risk children. TBRI has been applied in orphanages, courts, residential treatment facilities, group homes, foster and adoptive homes, churches, and schools. It has been used effectively with children and youth of all ages and all risk levels. This article provides the research base for TBRI and examples of how it is applied.

  20. MEDICATION AND APPROPRIATE PHYSICAL THERAPY OF COMPLEX REGIONAL PAIN SYNDROME PATIENTS AFTER TRAUMA

    Directory of Open Access Journals (Sweden)

    P Elizabeta

    2013-05-01

    Full Text Available Objective: Treatment of patients with complex regional pain syndrome (CRPS after trauma needs a complex physical and medical therapy, according of the stage of condition. The patient with trauma is coming to rehabilitation department, after surgery treatment. The aim of our study is to represent the effect of complexity physical therapy and medical support in treatment of patients with CRPS with evaluation of decrease of pain and increase of function in affected region.Method: we are treating 35 patients overage 35-70 years with 2 including criteria, clinical reaction of CRPS and radiologicalchanges of osteoporosis. Medication includes non steroidal anti-inflammatory drugs, tricycle antidepressants, vasoactive drugs and calcitonin. Physical therapy is consisting of electro therapy, sonophoresis and paraffin.Results: The evaluation was made with observation and measurement of pain, swelling and color of skin and movements of the joint.Conclusion: the goodness of the condition with whole time of rehabilitation 3-6 months was significant p < 0.01.

  1. Dentoalveolar trauma.

    Science.gov (United States)

    Olynik, Christopher R; Gray, Austin; Sinada, Ghassan G

    2013-10-01

    Dentoalveolar injuries are an important and common component of craniomaxillofacial trauma. The dentition serves as a vertical buttress of the face and fractures to this area may result in malalignment of facial subunits. Furthermore, the dentition is succedaneous with 3 phases-primary dentition, mixed dentition, and permanent dentition-mandating different treatment protocols. This article is written for nondental providers to diagnose and treat dentoalveolar injuries.

  2. 整形美容外科技术在急诊面部外伤中的应用%Application of Cosmetic Plastic Surgery Technique on Emergency Facial Trauma

    Institute of Scientific and Technical Information of China (English)

    杨光智; 杨咏梅

    2014-01-01

    Objective:To summarize the application experience of cosmetic plastic surgery technique on emergency facial trauma. Methods:Selecting 47 patients using methods and techniques of plastic surgery in the hospital. Results:Patients were all cured in stage I healing period, with no complications. Conclusion:Cosmetic plastic surgery technique on emergency facial trauma has great help on facial morphology and function.%目的:总结整形美容外科技术在急诊面部外伤中的应用经验。方法:选择我院47例患者,利用整形外科手术的方法和技术来治疗患者,在处理急诊面部的过程中。结果:所有患者均I期愈合,随访期间无并发症发生。结论:使用整形美容外科的技术来处理面部有创伤对恢复患者面部的形态和功能是有很大帮助的。

  3. [Comparative efficiency of nootropic drugs in complex treatment of patients with remote consequences of closed craniocereberal trauma].

    Science.gov (United States)

    Hliebova, O S; Tkachenko, O V

    2008-01-01

    Main data of the research were data obtained after a complex treatment of 120 persons with late consequences of closed craniocereberal trauma (CCRCT). The treatment included administration of one of nootropic agents (noophen, aminolon or entropil), magnesium sulfate, group B vitamins. All patients have passed a complex examination: specially developed questionnaire, anamnesis gathering, neurologic status, neuropsychological status with the use of multiple-aspect scales and questionnaires, examination of fundus of eye, rheoencephalography, echoencephalography, brain MRT. Results of a complex examination proved positive effect of the use of nootropic agents, in particular noophen, entropil and aminolon in complex treatment of late consequences of closed craniocereberal trauma. For optimisation of the use of nootropic agents in the treatment of late consequences of closed craniocereberal trauma it is recommended to consider features of influence of nootropic agents on certain clinical aspects of the disease.

  4. 面部创伤在急症中的整形美容处理思路研究%Facial Trauma in the Plastic Surgery of Emergency Treatment

    Institute of Scientific and Technical Information of China (English)

    黄白云

    2014-01-01

    目的:探讨面部创伤的早期急诊整形美容修复处理经验。方法:回顾分析128例急诊面部创伤接受整形美容修复患者的临床资料,总结其急诊处理经验。结果:本组128例患者中,1例患者发生感染,经对症处理后缓解,术后创面均Ⅰ期愈合,外观形态恢复满意。结论:整形美容技术应用于急诊面部创伤处理,可有效修复患者的面部外观及功能,值得推广应用。%Objective:To investigate the experience of early repair of facial trauma emergency surgery. Methods:Doing retrospective analysis of 128 cases of emergency facial trauma undergoing plastic surgery repair in patients with clinical data,and summarizing the experience of emergency treatment. Results:Among 128 patients,infection occurred in 1 patient,and the infection relieved by symptomatic treatment. The wound healed well after operation,with satisfactory appearance. Conclusion:Application of plastic surgery technique on emergency facial trauma treatment can effectively repair the appearance and function of patients,and it is worthy of popularization and application.

  5. Biomechanics of Cranio-Maxillofacial Trauma

    National Research Council Canada - National Science Library

    Pappachan, Biju; Alexander, Mohan

    .... This has got implications as facial fractures are associated with head injury. Understanding the biomechanics of craniomaxillofacial trauma gives an insight in understanding the pattern of injury...

  6. Comparing Treatment Outcome of Guided Imagery and Music and Psychodynamic Imaginative Trauma Therapy for Women with Complex PTSD

    DEFF Research Database (Denmark)

    Maack, Carola

    2013-01-01

    To investigate whether the use of recorded music enhances therapy outcome in psychodynamic trauma therapy for women with Complex PTSD, outcome measures of three groups of patients were compared. One group received 50 hours of outpatient trauma therapy with the Bonny Method of Guided Imagery...... of Complex PTSD, structural and somatoform dissociation, interpersonal problems, and factors promoting health before treatment and after 50 therapy hours or before and after waiting. Results showed significant differences in all scores when either of the treatment conditions was compared to the control group....... Participants treated with GIM showed significantly better outcome in all measurements than participants treated with PITT. This indicates that the use of music is beneficial for women with Complex PTSD treated with psychodynamic trauma therapy....

  7. Clinical analysis of the facial nerve paralysis after the temporal bone fracture with the craniocerebral trauma%颅脑外伤伴颞骨骨折合并周围性面瘫15例

    Institute of Scientific and Technical Information of China (English)

    姜岚; 秦兆冰

    2009-01-01

    Objective To disscuse the management of facial nerve paralysis after the temporal bone fracture with the craniocerebral trauma.Methods The study design was a retrospective review of fifteen patients who underwent facial nerve paralysis after the temporal bone fracture with the craniocere-bral trauma.They all received the treatment of the neurosurgery.Results The follow up period was ran-ging from 2 months to 4 years.Two patients showed Ⅰ score of House-Brackmann recovery of facial nerve function in follow-up,eleven patients showed Ⅱ score and the last 2 showed Ⅲ score.Conclusions For the patients who underwent facial nerve paralysis after the temporal bone fracture with the craniocere-bral trauma,late facial nerve decompression may have still beneficial effects.%目的 探讨严重颅脑外伤患者的面瘫治疗时机、手术方法 及治疗效果.方法 回顾性分析2004年12月至2008年2月在我院治疗的颅脑外伤伴颞骨骨折合并周围性面瘫的病例15例,均经神经外科治疗后至我科进一步治疗周围性面瘫,进行术前评估、术中对照及术后随访的对比.结果 进行全面专科检查并综合患者全身情况,选择合适术式行面神经减压,术后随访2个月~4年,面神经功能恢复至I级2例,Ⅱ级11例,Ⅲ级2例.结论 对于颅脑外伤伴颞骨骨折合并周围性面瘫的患者,颅脑外伤急诊处理且生命体征平稳后,全面术前评估,积极进行面神经手术减压仍不失为积极有效的治疗措施.

  8. Treatment outcomes for women with substance abuse and PTSD who have experienced complex trauma.

    Science.gov (United States)

    Cohen, Lisa R; Hien, Denise A

    2006-01-01

    This study assessed the effect of cognitive-behavioral therapy on a range of problems associated with complex trauma in a sample of women with comorbid substance use disorders and posttraumatic stress disorder (PTSD). A total of 107 women with current or subthreshold PTSD and a current substance use disorder from an urban, low-income area were recruited from both community and clinical populations. Participants were recruited between 1997 and 2000. A quasi-experimental design was used, and participants who received cognitive-behavioral therapy (N=75) were compared with those in a control group who received no active study treatment (N=32). All participants were given the same list of community treatment resources and told that they could pursue services while participating in the study if they wished. At the end of treatment (three months postbaseline), compared with participants in the control group, those in the active treatment group showed significant reductions in symptoms of PTSD and alcohol use disorders, with a trend toward reductions in symptoms of drug use disorders. No significant differences were found between the groups on depression, dissociation, and social and sexual functioning outcomes. These findings underscore the challenge and necessity of addressing the unique and wide-ranging needs of women with substance use disorder who have been exposed to early and multiple interpersonal traumas.

  9. Aberrant Functional Connectivity of the Amygdala Complexes in PTSD during Conscious and Subconscious Processing of Trauma-Related Stimuli.

    Science.gov (United States)

    Rabellino, Daniela; Densmore, Maria; Frewen, Paul A; Théberge, Jean; McKinnon, Margaret C; Lanius, Ruth A

    2016-01-01

    Post-traumatic stress disorder (PTSD) is characterized by altered functional connectivity of the amygdala complexes at rest. However, amygdala complex connectivity during conscious and subconscious threat processing remains to be elucidated. Here, we investigate specific connectivity of the centromedial amygdala (CMA) and basolateral amygdala (BLA) during conscious and subconscious processing of trauma-related words among individuals with PTSD (n = 26) as compared to non-trauma-exposed controls (n = 20). Psycho-physiological interaction analyses were performed using the right and left amygdala complexes as regions of interest during conscious and subconscious trauma word processing. These analyses revealed a differential, context-dependent responses by each amygdala seed during trauma processing in PTSD. Specifically, relative to controls, during subconscious processing, individuals with PTSD demonstrated increased connectivity of the CMA with the superior frontal gyrus, accompanied by a pattern of decreased connectivity between the BLA and the superior colliculus. During conscious processing, relative to controls, individuals with PTSD showed increased connectivity between the CMA and the pulvinar. These findings demonstrate alterations in amygdala subregion functional connectivity in PTSD and highlight the disruption of the innate alarm network during both conscious and subconscious trauma processing in this disorder.

  10. A new prospect on the approach to open, complex, craniofacial trauma.

    Science.gov (United States)

    Robotti, E; Forcht Dagi, T; Ravegnani, M; Bocchiotti, G

    1992-01-01

    Complex craniofacial trauma has been traditionally managed in three stages: urgent craniotomy, secondary orbitofacial repair and delayed cranioplasty. Departing from this conventional approach, we employ an early single-stage neuro and plastic-surgical reconstruction for patients presenting open cranial wounds of the frontobasilar region coexisting with orbitofacial fractures. Neurological outcome does not seem to be affected by the additional operating time, nor is the incidence of infection raised, although bone fragments are repositioned, primary bone grafting is employed, and metallic material is used for fixation. Adequate direct exposure followed by reduction and rigid internal fixation results in primary bone healing and permits to avoid the difficult complications related to soft tissue contracture over misaligned bone. Compared with the conventional staged approach, immediate reconstruction appears functionally and aesthetically preferable, as well as technically easier.

  11. Surgical Treatment of Facial Paralysis

    OpenAIRE

    Mehta, Ritvik P.

    2009-01-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (2 yr). For acute facial paralysis, the main surgi...

  12. 整形外科技术用于面部外伤急诊修复疗效观察%Clinical efficacy of facial plastic surgery techniques in the trauma emergency repair

    Institute of Scientific and Technical Information of China (English)

    张连生

    2014-01-01

    目的:探讨整形外科技术对面部外伤急诊修复的临床疗效。方法选取36例面部外伤患者作为研究对象,使其接受皮肤间断缝合、皮内间断缝合、真皮内连续缝合及邻近皮瓣转移四种整形外科技术治疗,观察愈合结果和术后6个月随访结果。结果所选36例患者在接受整形外科技术治疗后未出现感染、血肿及皮片或皮瓣坏死等现象,经手术治疗后伤口及创面均能愈合。术后对36例患者进行随访6个月,随访结果为采用皮肤间断缝合无瘢痕增生,皮内间断缝合及真皮内连续缝合均有少量瘢痕增生,邻近皮瓣转移无错位畸形及面部功能障碍;治疗前根据创伤面积及受创原因判断Ⅰ期修复35例,Ⅱ期修复1例;治疗过程Ⅰ期修复28例,Ⅱ期修复8例,治疗前后比较,差异具有统计学意义(χ2=4.64、4.75,均P<0.05)。结论在面部外伤急症修复中采用整形外科技术治疗能使面部创伤功能得到很好的恢复,治疗效果好。%Objective To investigate the clinical efficacy of plastic surgery techniques for facial trauma emergency repair.Methods 36 patients with facial trauma were chosen as the research subjects ,all accepted the skin sutured,intradermal continuous suture and adjacent flap four kinds of plastic surgery in the treatment ,and the healing was observed after 6 month follow-up.Results 36 patients which were selected receiving orthopedic treatment tech-nology didn′t appear after infection,hematoma,and skin graft or flap necrosis and other phenomena ,after surgery wounds and wounds could heal .After 36 patients were followed up for 6 months,the following-up results for the intro-duction of the skin was sutured no scar ,skin and dermis sutured continuous suture had a small amount of scar near the flap dislocation-facial deformity and dysfunction;according to trauma treatment area and the reasons for judgment Ⅰhit stage repair

  13. Complex Childhood Trauma and School Responses: A Case Study of the Impact of Professional Development in One Elementary School

    Science.gov (United States)

    VanderWegen, Terrie A.

    2013-01-01

    The purpose of this qualitative case study was to examine one public elementary school in Spokane, Washington that has received significant complex trauma professional development training provided by Washington State University Area Health Education Center (WSU-AHEC). The study explored teachers', specialists', and the principal's perceptions of…

  14. Complex Childhood Trauma and School Responses: A Case Study of the Impact of Professional Development in One Elementary School

    Science.gov (United States)

    VanderWegen, Terrie A.

    2013-01-01

    The purpose of this qualitative case study was to examine one public elementary school in Spokane, Washington that has received significant complex trauma professional development training provided by Washington State University Area Health Education Center (WSU-AHEC). The study explored teachers', specialists', and the principal's perceptions of…

  15. "Am I Safe Here and Do You Like Me?" Understanding Complex Trauma and Attachment Disruption in the Classroom

    Science.gov (United States)

    O'Neill, Linda; Guenette, Francis; Kitchenham, Andrew

    2010-01-01

    Elementary and special education teachers and school counsellors currently provide support to children presenting learning disabilities and behavioural problems symptomatic of the more hidden diagnosis of complex trauma resulting from abuse or severe attachment disruption. Specific disorders such as attention deficit/hyperactivity disorder (AD/HD)…

  16. 面部软组织外伤中西医结合美容修复%Emergency Cosmetic Repair of Facial Soft Tissue Trauma with the Combination of Traditional Chinese Medicine and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    张威; 王雪山; 刘明珠; 马艳

    2014-01-01

    目的:研究面部软组织外伤中西医结合修复效果,总结治疗经验。方法:选取86例面部软组织外伤患者作为研究对象,行急诊手术治疗后,给予对照组患者术后西医护理,给予观察组患者术后中西医结合护理,对比两组患者对治疗效果满意程度。结果:对照组患者总满意率79.69%,观察组患者总满意率94.59%,差异具有统计学意义(P<0.05)。结论:采用中西医结合护理方式对面部软组织创伤修复具有良好的促进作用,值得临床推广。%Objective:To study the facial soft tissue trauma Integrative repair effect,and summarize the treatment experience. Methods:86 cases with facial soft tissue trauma were research subjects. After emergency surgery,the control group were given Western postoperative care,and the observation group were given integrative care. Then ttreatment satisfaction in two groups was compared. Results:The overall satisfaction rate of the control group was 79.69%,and that of the observation group was 94.59%,with statistically significant difference(P<0.05). Conclusion:Integrative care for facial soft way is to promote wound healing with good effect,and is worthy of promotion.

  17. Complex trauma of war captivity: a prospective study of attachment and post-traumatic stress disorder.

    Science.gov (United States)

    Solomon, Z; Dekel, R; Mikulincer, M

    2008-10-01

    Victims of war captivity sometimes suffer from complex post-traumatic stress disorder (PTSD), a unique form of PTSD that entails various alterations in personality. These alterations may involve changes in attachment orientation. The sample comprised two groups of veterans from the 1973 Yom Kippur War: 103 ex-prisoners of war (ex-POWs) and 106 comparable control veterans. They were assessed at two points in time, 18 years and 30 years after the war. Ex-POWs suffered from more post-traumatic symptoms than controls at both measurements points and these symptoms increased only among ex-POWs from Time 1 to Time 2. In addition, both attachment anxiety and attachment avoidance increased with time among ex-POWs, whereas they decreased slightly or remained stable among controls. Finally, the increases in attachment anxiety and avoidance were positively associated with the increase in post-traumatic symptoms among both study groups. Further analyses indicated that early PTSD symptoms predicted later attachment better than early attachment predicted later PTSD symptoms. The results suggest that: (1) complex traumas are implicated in attachment orientations and PTSD symptoms even many years after captivity; (2) there is an increase in attachment insecurities (anxiety, avoidance) and an increase in PTSD symptoms decades after the captivity; (3) and post-traumatic stress symptoms predict attachment orientations better than attachment orientations predict an increase in PTSD symptoms.

  18. 整形清创美容缝合术处理面部外伤的研究%Study on the treatment of facial trauma by plastic surgery and cosmetic surgery

    Institute of Scientific and Technical Information of China (English)

    周明; 安杏星; 孙同祖; 胡尧; 李章; 李凯

    2015-01-01

    Objective To explore the effect of the treatment of plastic surgery for the treatment of facial trauma patients. Methods 122 patients with facial trauma were treated in our hospital from January 2014 to January in.The patients were divided into conventional group and beauty group according to the random method,61 cases in each group.The conventional group was treated with routine debridement and suture,and the patients were treated with plastic surgery and cosmetic surgery. Results The treatment effect of the patients in the beauty group was significantly higher than that of the conventional group,and the difference between the two groups was statistically significant( P<0.05). Conclusion The treatment of facial trauma patients with plastic surgery and cosmetic surgery can obtain better results,improve the quality of treatment and meet the aesthetic needs of patients.%目的:探究对面部外伤患者应用整形清创美容缝合术治疗的效果.方法:选取本院2014年1月-2015年1月收治的面部外伤患者122例,依照随机方式将其分为常规组与美容组,每组均为61例.对常规组患者实施常规清创缝合处理,对美容组患者采用整形清创美容缝合术治疗.结果:美容组患者的治疗效果明显比常规组患者好,且两组差异具有统计学意义(P<0.05).结论:对面部外伤患者采用整形清创美容缝合术治疗可获取较好效果,提升治疗质量,满足患者的美观需求.

  19. 整形外科缝合技术I期修复面部外伤的84例体会%Plastic surgeons suture technology I repair experience of 84 cases of facial trauma

    Institute of Scientific and Technical Information of China (English)

    郭崴

    2014-01-01

    目的:探讨整形外科缝合技术应用于面部外伤Ⅰ期修复的效果。方法收集2011年1月至2013年1月,我院收治的面部外伤患者84例,应用整形外科缝合技术进行修复治疗,总结治疗效果及经验。结果本组84例患者均经整形外科技术修复,创面Ⅰ期愈合,经皮瓣或皮片修复者均成活,且颜色基本接近正常肤色。随访1~3年未见组织错位、增生性瘢痕形成、功能障碍以及面部器官移位等。结论整形外科缝合技术应用于面部软组织损伤修复可实现外观及功能的良好恢复,为Ⅱ期修复提供有利条件。%Objective to study the plastic surgeons suture technique is applied to facial trauma Ⅰ repair effect. Methods collected from January 2011 to January 2011, our hospital 84 cases of patients with facial trauma and orthopedic surgical suture technique was used to repair treatment, summarizes the treatment effect and experience. Results 84 patients were repaired by plastic surgery technique, Ⅰ healing of the wound, the skin flap or skin repair are survival, and basic close to normal skin color. follow-up of 1 ~ 3 years did not see dislocation, hyperplastic scar formation, dysfunction and facial organs shift, etc. Conclusion the orthopedic surgical suture technique is applied to repair of facial soft tissue injuries can achieve good recovery of appearance and function, provide favorable conditions for Ⅱ phase.

  20. Topical Treatment With Liposomal Sodium Copper Chlorophyllin Complex in Subjects With Facial Redness and Erythematotelangiectatic Rosacea: Case Studies.

    Science.gov (United States)

    Vasily, David B

    2015-10-01

    Physicians are often presented with patients complaining of facial redness and difficult to control rosacea. The water soluble sodium copper chlorophyllin complex has been shown to have anti-oxidant, anti-inflammatory, and anti-bacterial activities in vitro and anti-redness, pore reduction, and anti-acne activities in pilot clinical studies. In these case studies, the safety and efficacy of a topical gel containing a liposomal suspension of sodium copper chlorophyllin complex was assessed in subjects with facial redness and erythematotelangiectatic rosacea.

  1. Complex Trauma and Mental Health in Children and Adolescents Placed in Foster Care: Findings from the National Child Traumatic Stress Network

    Science.gov (United States)

    Greeson, Johanna K. P.; Briggs, Ernestine C.; Kisiel, Cassandra L.; Layne, Christopher M.; Ake, George S., III; Ko, Susan J.; Gerrity, Ellen T.; Steinberg, Alan M.; Howard, Michael L.; Pynoos, Robert S.; Fairbank, John A.

    2011-01-01

    Many children in the child welfare system (CWS) have histories of recurrent interpersonal trauma perpetrated by caregivers early in life often referred to as "complex trauma". Children in the CWS also experience a diverse range of reactions across multiple areas of functioning that are associated with such exposure. Nevertheless, few CWSs…

  2. Complex Trauma and Mental Health in Children and Adolescents Placed in Foster Care: Findings from the National Child Traumatic Stress Network

    Science.gov (United States)

    Greeson, Johanna K. P.; Briggs, Ernestine C.; Kisiel, Cassandra L.; Layne, Christopher M.; Ake, George S., III; Ko, Susan J.; Gerrity, Ellen T.; Steinberg, Alan M.; Howard, Michael L.; Pynoos, Robert S.; Fairbank, John A.

    2011-01-01

    Many children in the child welfare system (CWS) have histories of recurrent interpersonal trauma perpetrated by caregivers early in life often referred to as "complex trauma". Children in the CWS also experience a diverse range of reactions across multiple areas of functioning that are associated with such exposure. Nevertheless, few CWSs…

  3. 皮下蒂鼻唇沟皮瓣在36例面部急诊外伤修复中的临床分析%Clinical Analysis of 36 Cases of Facial Emergency Trauma Repair With Subcutaneous Pedicle Nasolabial Flap

    Institute of Scientific and Technical Information of China (English)

    张翠兰

    2016-01-01

    结合36例面部急诊外伤患者行皮下蒂鼻唇沟皮瓣修复治疗后的随访结果,进行皮下蒂鼻唇沟皮瓣在面部急诊外伤修复治疗中的临床应用的探讨,可以发现术后没有明显瘢痕,患者面部没有出现继发畸形,面部外伤缺损即时整形的效果较好。%36 cases of facial trauma patients in emergency subcutaneous pedicle flap nasolabial follow-up treatment after subcutaneous pedicle nasolabial lfap in the face of emergency investigate the clinical application in the treatment of trauma repair, can be found after no scar, patients face no secondary deformity, facial trauma defect instant shaping better.

  4. Effect of thorough debridement on the healing of facial trauma infections%彻底清创术对面部外伤感染愈合的影响

    Institute of Scientific and Technical Information of China (English)

    苟红兵; 潘调茹; 何颖; 李雅洁; 杨珊

    2013-01-01

    目的 分析彻底清创术对面部外伤感染及伤口愈合的影响,为临床提高彻底清创术对面部外伤的感染愈合效率提供参考.方法 随机选取2008-2011年收治的380例面部外伤患者作为研究对象,在对患者彻底清创前、后均做细菌培养试验,统计培养后细菌的种类、阳性率及伤口愈合情况.结果 清创术前共检出病原菌372株,检出阳性率为97.8%,清创术后检出病原菌21株,检出阳性率为5.5%,清创术后阳性率明显低于术前,差异有统计学意义(P<0.05);伤口Ⅰ期愈合364例,占95.8%,Ⅱ期愈合16例,占4.2%.结论 采取彻底清创术能够降低面部外伤的感染,并对于伤口愈合有促进作用.%OBJECTIVE To analyze the effect of thorough debridement on the healing of facial trauma infections so as to raise the effective rate of healing of facial trauma infections through thorough debridement.METHODS From 2008 to 2011,A total of 380 cases of facial trauma patients from 2008 to 2011 in the hospital were randomly selected as the research objects,the bacterial culture was performed before and after the thorough debridement,then the bacterial species,the positive rate,and the status of wound healing were taken for statistics.RESULTS A total of 372 strains of pathogens were isolated before the debridement with the positive rate of 97.8%,and 21 strains of pathogens were isolated after the debridement with the positive rate of 5.5%,the positive rate was significantly lower after the debridement than before the debridement,the difference was statistically significant (P<0.05).There were 364 (95.8%) cases with Ⅰ stage wound healing and 16 (4.2%) cases with phase Ⅱ healing.CONCLUSION The thorough debridement can reduce the incidence of the facial trauma infections and promote the wound healing.

  5. [Chest trauma].

    Science.gov (United States)

    Freixinet Gilart, Jorge; Ramírez Gil, María Elena; Gallardo Valera, Gregorio; Moreno Casado, Paula

    2011-01-01

    Chest trauma is a frequent problem arising from lesions caused by domestic and occupational activities and especially road traffic accidents. These injuries can be analyzed from distinct points of view, ranging from consideration of the most severe injuries, especially in the context of multiple trauma, to the specific characteristics of blunt and open trauma. In the present article, these injuries are discussed according to the involvement of the various thoracic structures. Rib fractures are the most frequent chest injuries and their diagnosis and treatment is straightforward, although these injuries can be severe if more than three ribs are affected and when there is major associated morbidity. Lung contusion is the most common visceral lesion. These injuries are usually found in severe chest trauma and are often associated with other thoracic and intrathoracic lesions. Treatment is based on general support measures. Pleural complications, such as hemothorax and pneumothorax, are also frequent. Their diagnosis is also straightforward and treatment is based on pleural drainage. This article also analyzes other complex situations, notably airway trauma, which is usually very severe in blunt chest trauma and less severe and even suitable for conservative treatment in iatrogenic injury due to tracheal intubation. Rupture of the diaphragm usually causes a diaphragmatic hernia. Treatment is always surgical. Myocardial contusions should be suspected in anterior chest trauma and in sternal fractures. Treatment is conservative. Other chest injuries, such as those of the great thoracic and esophageal vessels, are less frequent but are especially severe.

  6. Osmium and cobalt complexes incorporating facially coordinated N,N,O donor azo-imine ligands: Redox and catalytic properties

    Indian Academy of Sciences (India)

    Poulami Pattanayak; Debprasad Patra; Jahar Lal Pratihar; Andrew Burrows; Mary F Mahon; Surajit Chattopadhyay

    2013-01-01

    Reactions of 1-{[2-(arylazo)phenyl]iminomethyl}-2-phenol, HL [where H represents the dissociable phenolic protons of ligands and aryl groups of HL are C6H5 (HL1), -CH3C6H5 (HL2), -ClC6H5 (HL3)] with Os(H)(CO)(Br)(PPh3)3 in toluene and with Co(ClO4)3.6H2O in methanol afforded new facially coordinated complexes of composition [(L)Os(CO)(Br)(PPh3)] and [(L)2Co]ClO4. The anionic ligand (L)−, binds the metal in tridentate (N, N, O) manner in [(L)Os(CO)(Br)(PPh3)] and [(L)2Co]ClO4 complexes. All the Os(II) and Co(III) complexes are diamagnetic and show characteristic 1H NMR signals and intense MLCT transitions in the visible region. The cyclic voltammograms exhibited one quasi reversible oxidative response near 0.10 V vs SCE for [(L)Os(CO)(Br)(PPh3)] and [(L)2Co]ClO4 complexes displayed serial reductive responses within −0.06 to −1.61 V vs SCE. Single point DFT calculation was carried out to examine the nature of redox orbitals. Conversion of ketones to corresponding alcohols has been studied using [(L)Os(CO)(Br)(PPh3)] as catalyst.

  7. The face of conflict: Significant sharp force trauma to the mid-facial skeleton in an individual of probable 16th-17th century date excavated from Byczyna, Poland.

    Science.gov (United States)

    Cieślik, Agata Izabela; Dąbrowski, Paweł; Przysiężna-Pizarska, Magdalena Anita

    2017-06-01

    A variety of injuries have always been associated with violence, consequences of which people had to deal with. In this paper we present a complex of craniofacial and dental injuries resulted from sharp force trauma. The basis of our study was historical skeletal material excavated from archeological site in Byczyna (11th-17th century), Poland. An individual whose skeleton was exhumed from the grave No. 610 exhibited healed, oblique trauma of the left maxilla, damage to the crowns of right central and lateral incisors and concomitant luxation of the right maxillary central incisor. We describe the mechanism of this trauma and complications that resulted from damage to the masticatory apparatus. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Anatomic research of suboccipito-retrosigmoidal approach for minimally invasive exposure of facial-acoustic nerve complex utilizing virtual reality skill

    Directory of Open Access Journals (Sweden)

    Ke TANG

    2014-06-01

    Full Text Available Objective To discuss microanatomy features of facial-acoustic nerve complex in suboccipito-retrosigmoidal minimally invasive approach based on virtual reality image model. Methods CT and MRI scans were performed to 5 adult cadaver heads, and then, image data was inputted into Vitrea virtual reality system to establish three-dimensional anatomy model of facial-acoustic nerve complex. Suboccipito-retrosigmoidal approach was simulated by selecting osseous landmark points on the calvaria and skull base. Anatomic exposures in surgical trajectory were observed and measured following minimally invasive design. Statistical comparison was launched by paired t test. Results Routes simulating suboccipito-retrosigmoidal approach for exposure of facial-acoustic nerve complex passed under the inferior edge of transverse sinus. Spacial sequence of nerves and vessels in the route was displayed clearly. Vertebral artery and posterior inferior cerebellar artery did not show in the route. Cerebella, lower cranial nerves, anterior inferior cerebellar artery, facial-acoustic nerve complex were exposed successively in route before minimally invasive design. Then, lower cranial nerves pierced the jugular foramen at the site between the jugular bulb and inferior petrosal sinus. Minimally invasive route was higher than that before minimally invasive design and involved cerebella, anterior inferior cerebellar artery and facial-acoustic nerve complex successively. Lower cranial nerves and jugular bulb were not shown in minimally invasive route. Measure and comparative analysis showed that volumes of route (t = 36.331, P = 0.000 and cerebella (t = 16.775, P = 0.000 involved before minimally invasive design were more than that after minimally invasive design with statistically significant difference. Comparison did not show significant differences for the volumes of facial-acoustic nerve complex (t = 1.680, P = 0.127 and anterior inferior cerebellar artery (t = 1.278, P = 0

  9. Pattern of maxillofacial fractures in severe multiple trauma patients: a 7-year prospective study.

    Science.gov (United States)

    Alves, La-Salete; Aragão, Irene; Sousa, Maria-José Carneiro; Gomes, Ernestina

    2014-01-01

    The incidence of facial trauma is high. This study has the primary objective of documenting and cataloging maxillofacial fractures in polytrauma patients. From a total of 1229 multiple trauma cases treated at the Emergency Room of the Santo Antonio Hospital - Oporto Hospital Center, Portugal, between August 2001 and December 2007, 251 patients had facial wounds and 209 had maxillofacial fractures. Aged ranged form 13 to 86 years. The applied selective method was based on the presence of facial wound with Abbreviated Injury Scale ≥1. Men had a higher incidence of maxillofacial fractures among multiple trauma patients (86.6%) and road traffic accidents were the primary cause of injuries (69.38%). Nasoorbitoethmoid complex was the most affected region (67.46%) followed by the maxilla (57.42%). The pattern and presentation of maxillofacial fractures had been studied in many parts of the world with varying results. Severe multiple trauma patients had different patterns of maxillofacial injuries. The number of maxillofacial trauma is on the rise worldwide as well as the incidence of associated sequelae. Maxillofacial fractures on multiple trauma patients were more frequent among males and in road traffic crashes. Knowing such data is elementary. The society should have a key role in the awareness of individuals and in prevention of road traffic accidents.

  10. [Complex PTSD following early-childhood trauma: emotion-regulation training as addition to the PTSD guideline].

    Science.gov (United States)

    Thomaes, K; Dorrepaal, E; van Balkom, A J L M; Veltman, D J; Smit, J H; Hoogendoorn, A W; Draijer, N

    2015-01-01

    Posttraumatic stress disorder (PTSD) symptoms in individuals who have experienced repeated trauma (sexual and/or physical) in early childhood can lead to problems associated with emotion regulation, interpersonal functioning and self-image. This so-called complex PTSD is often accompanied by a comorbid personality disorder. Although ptsd is associated with structural and functional abnormalities in emotion-regulation areas in the brain, it is not known whether complex PTSD shows similar abnormalities. Experts take the view that before individuals with complex PTSD are given appropriate therapy they should receive a course of emotion-regulation therapy such as the one tested by Zlotnick e.a. (1997) in a randomised controlled trial (RCT).   To replicate Zlotnick's RCT in the Netherlands and to find out whether complex PTSD patients show specific structural and functional brain abnormalities and whether psychological recovery is linked to the 'normalisation' of these abnormalities. In a RCT with complex PTSD patients (n = 71) who had experienced trauma in early childhood, we compared normal individual treatment with treatment supported by 'Before and beyond', which consists of emotion-regulation therapy combined with cognitive group therapy. In a subsample (n= 33) we also performed an mri (repeated, n = 9) in which individuals were required to execute an emotional memory and attention task. In complex PTSD, structural abnormalities in the brain seemed to be more extensive than in PTSD and brain activity in complex PTSD seemed to be strikingly different from the brain activity seen in PTSD patients who had experienced only single trauma. The results of the RCT indicate that 'Before and beyond' is a clinically meaningful treatment (with minimal drop-out) for complex PTSD patients with a variety of personality disorders. The psychological recovery of patients who received the emotion regulation and cognitive group treatment was associated with normalisation of brain

  11. Leveraging Trauma Lessons from War to Win in a Complex Global Environment.

    Science.gov (United States)

    Remick, Kyle N

    2016-01-01

    The US military has made great strides in combat casualty care since 2001. As the Army concludes combat operations in Iraq and Afghanistan, it faces new operational challenges in trauma care. The military medical community must stay ahead of the curve through sustaining current investments in combat casualty care research. This article describes lessons learned at war from a Joint Trauma System perspective in order to place in context how we should proceed in order to provide optimal care for our Warfighters in the future.

  12. Advanced Implant-Prosthetic Rehabilitation: How to Obtain a Correct Restoration of Both Functions and Aesthetics in Patients with Complex Combined Dental and Maxillofacial Trauma: A Case Report and Topical Review of the Literature

    Science.gov (United States)

    Fortunato, L.

    2017-01-01

    Aim. This study aims to explain the main steps that characterize the implant-prosthetic rehabilitation in complex combined dental and maxillofacial trauma. Material and Methods. A 20-year-old patient reported an extensive facial trauma which also involved the alveolar process of the maxillary bone. The patient reported a maxillofacial fracture and the loss of teeth 1.3, 1.2, 1.1, and 2.1. A “Le Fort” type 2 fracture was also reported, with the malar bone involvement. After reduction and containment of bone fractures, through appropriate mounting plates, appropriate functional and aesthetic rehabilitation of the patient were replaced thanks to a temporary removable prosthesis. After 6 months, the patient performed numerous clinical investigations, aimed at a proper planning of implant-prosthetic rehabilitation of the upper dental arch. Conclusion. With the planning of the case, as well as respecting the surrounding biological structures, the surgery of implants can be carried out with the most appropriate procedure. Lastly, new dental implants with highly bioactive surfaces have been developed, providing an excellent and rapid bone integration. PMID:28392948

  13. The Complexity of Trauma Response: A 4-Year Follow-up of Adolescent Cambodian Refugees

    Science.gov (United States)

    Rousseau, Cecile; Drapeau, Aline; Rahimi, Sadeq

    2003-01-01

    Objective: The objective of this study was to document the psychosocial adjustment of young refugees during their adolescence and its association with the war-related trauma experienced by their family before migration. Method: Data were collected on 57 young Khmer resettled in Montreal and followed from early to late adolescence. The associations…

  14. Contralateral reinnervation of midline muscles in nonidiopathic facial palsy.

    NARCIS (Netherlands)

    Gilhuis, H.J.; Beurskens, C.H.G.; Vries, J. de; Marres, H.A.M.; Hartman, E.H.M.; Zwarts, M.J.

    2003-01-01

    The purpose of this study was to analyze contralateral reinnervation of the facial nerve in eight patients with complete facial palsy after surgery or trauma and seven healthy volunteers. All patients had contralateral reinnervation of facial muscles as demonstrated by electrical nerve stimulation v

  15. Facial paralysis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003028.htm Facial paralysis To use the sharing features on this page, please enable JavaScript. Facial paralysis occurs when a person is no longer able ...

  16. 改良组织胶水黏合法在治疗面部创伤中的应用%Application of modified tissue adhesive in clinical treatment of facial trauma

    Institute of Scientific and Technical Information of China (English)

    刘金玲; 周忠友; 刘欢; 江新利; 苗慧鹏; 张晓融

    2015-01-01

    目的 探讨改良N-丁基-2-氰基丙烯酸酯组织胶水黏合法在面部创伤中的应用效果.方法 回顾性分析687例单纯组织胶水手法复位或单纯缝线缝合难以达到解剖复位的面部创伤患者,采用改良组织胶水黏合法(点涂法、分解法、胶线结合法)对位黏合面部创伤伤口,并评介临床治疗效果和并发症.结果 687例采用改良组织胶水黏合法治疗面部伤口均解剖对位黏合.除2例(0.29%)出现创面感染外.其余685例均未出现感染、开裂及其他并发症.术后随访3个月,临床效果满意.结论 改良组织胶水黏合法进行面部创伤的处理,具有术后并发症少、美观满意度高、经济、安全可靠等优点.%Objective To analyze the clinical results of modified N-butyl 2-cyanoacrylate skin adhesive in the application of facial trauma.Methods A total of 687 patients had been analyzed retrospectively from August 2009 to July 2014,and all the wounds of these patients had not obtained the anatomical repositioning after pure manual reduction with tissue glue or pure stitches.Improved tissue adhesive method was as follows:point coating,decomposition and glue with stitches.Results Anatomical repositioning was obtained in 685 wounds of 687 cases with improved tissue adhesive method.Infection occurred in the wounds of 2 cases (0.29%),but no other complications occurred in all patients.During postoperative 3 months of follow-up,clinical results were satisfactory for all patients.Conclusions The improved method of tissue glue has fewer postoperative complications,beautiful and more satisfatory appearance,economic,safer and reliable in the application of facial trauma.

  17. Facial Recognition

    Directory of Open Access Journals (Sweden)

    Mihalache Sergiu

    2014-05-01

    Full Text Available During their lifetime, people learn to recognize thousands of faces that they interact with. Face perception refers to an individual's understanding and interpretation of the face, particularly the human face, especially in relation to the associated information processing in the brain. The proportions and expressions of the human face are important to identify origin, emotional tendencies, health qualities, and some social information. From birth, faces are important in the individual's social interaction. Face perceptions are very complex as the recognition of facial expressions involves extensive and diverse areas in the brain. Our main goal is to put emphasis on presenting human faces specialized studies, and also to highlight the importance of attractiviness in their retention. We will see that there are many factors that influence face recognition.

  18. Performance improvement through best practice team management: human factors in complex trauma.

    Science.gov (United States)

    Mercer, Simon; Arul, G S; Pugh, H E J

    2014-06-01

    Human factors or non-technical skills are now commonplace in the medical literature, having taken the lead from the airline and nuclear industries and more recently Formula One motor racing. They have been suggested as playing a vital role in the success of the trauma teams in recent conflicts. This article outlines the background to human factors, referring to early papers and reports and also outlines high profile cases that highlight their importance. We then describe the importance of human factors in the deployed setting and some of the lessons that have been learnt from current conflicts.

  19. [Facial palsy].

    Science.gov (United States)

    Cavoy, R

    2013-09-01

    Facial palsy is a daily challenge for the clinicians. Determining whether facial nerve palsy is peripheral or central is a key step in the diagnosis. Central nervous lesions can give facial palsy which may be easily differentiated from peripheral palsy. The next question is the peripheral facial paralysis idiopathic or symptomatic. A good knowledge of anatomy of facial nerve is helpful. A structure approach is given to identify additional features that distinguish symptomatic facial palsy from idiopathic one. The main cause of peripheral facial palsies is idiopathic one, or Bell's palsy, which remains a diagnosis of exclusion. The most common cause of symptomatic peripheral facial palsy is Ramsay-Hunt syndrome. Early identification of symptomatic facial palsy is important because of often worst outcome and different management. The prognosis of Bell's palsy is on the whole favorable and is improved with a prompt tapering course of prednisone. In Ramsay-Hunt syndrome, an antiviral therapy is added along with prednisone. We also discussed of current treatment recommendations. We will review short and long term complications of peripheral facial palsy.

  20. Facial nerve paralysis in children.

    Science.gov (United States)

    Ciorba, Andrea; Corazzi, Virginia; Conz, Veronica; Bianchini, Chiara; Aimoni, Claudia

    2015-12-16

    Facial nerve palsy is a condition with several implications, particularly when occurring in childhood. It represents a serious clinical problem as it causes significant concerns in doctors because of its etiology, its treatment options and its outcome, as well as in little patients and their parents, because of functional and aesthetic outcomes. There are several described causes of facial nerve paralysis in children, as it can be congenital (due to delivery traumas and genetic or malformative diseases) or acquired (due to infective, inflammatory, neoplastic, traumatic or iatrogenic causes). Nonetheless, in approximately 40%-75% of the cases, the cause of unilateral facial paralysis still remains idiopathic. A careful diagnostic workout and differential diagnosis are particularly recommended in case of pediatric facial nerve palsy, in order to establish the most appropriate treatment, as the therapeutic approach differs in relation to the etiology.

  1. Facial Paralysis Reconstruction.

    Science.gov (United States)

    Razfar, Ali; Lee, Matthew K; Massry, Guy G; Azizzadeh, Babak

    2016-04-01

    Facial nerve paralysis is a devastating condition arising from several causes with severe functional and psychological consequences. Given the complexity of the disease process, management involves a multispecialty, team-oriented approach. This article provides a systematic approach in addressing each specific sequela of this complex problem.

  2. 整形外科技术在急诊面部外伤Ⅰ期修复中的应用%Applicatiopn of Plastic Techniques in I Stage Restoration of Emergency Facial Trauma

    Institute of Scientific and Technical Information of China (English)

    张杰; 王秀岩; 徐指斌

    2013-01-01

    目的:探讨整形外科技术在急诊面部外伤I期修复中的临床疗效。方法将120例急诊面部外伤患者随机分为两组各60例,对照组采用传统的外科清创缝合治疗,实验组遵循整形外科原则进行Ⅰ期清创缝合,强调早期彻底清创、解剖复位、缺损修复、无张力分层缝合、应用皮瓣、留置引流管等技术,根据不同伤情设计不同的修复方法。比较两种方法的临床疗效、患者住院时间、住院费用等。结果两组患者治疗效果差异显著(P <0.05)。实验组患者无感染、血肿以及皮瓣坏死发生;且绝大多数患者可避免进行Ⅱ期整复手术。结论在急诊面部外伤I期修复治疗中采用整形外科原则和技术与普通修复相比疗效显著,既能获得面部功能恢复、减少Ⅱ期整形美容修复,又能达到美容效果,值得临床推广。%Objective To explore the clinical effect of the principles and technology of plastic surgery used in I Stage Restoration of Emergency Facial Treuma. Methods 120 cases of patients with facial trauma were randomly divided into two groups, each group of 60 cases, marked as experimental group and control group respectively. While the experimental group adopts flexible plastic surgical repair through debride in early period, anatomical reposition, repair of defects, suture without tension, application of flaps and place of drainage tube were also performed. The control group given traditional repair. Result The difference in two groups was statistically significant(P <0.05). Patients in plastic surgical repair group all healed without postoperative infection, haematoma and necrosis of skin flap,and most of them avoided simple stage Ⅱ plastic surgery. Conclusion The result of plastic surgical repair is better than common in I Stage Restoration of Emergency Facial Treuma. Not only can it recover the facial function and decrease the occurence of the stageII plastic surgery, but

  3. Facial and Dental Injuries Facial and Dental Injuries in Karate.

    Science.gov (United States)

    Vidovic-Stesevic, Vesna; Verna, Carlalberta; Krastl, Gabriel; Kuhl, Sebastian; Filippi, Andreas

    2015-01-01

    Karate is a martial art that carries a high trauma risk. Trauma-related Swiss and European karate data are currently unavailable. This survey seeks to increase knowledge of the incidence of traumatic facial and dental injuries, their emergency management, awareness of tooth rescue boxes, the use of mouthguards and their modifications. Interviews were conducted with 420 karate fighters from 43 European countries using a standardized questionnaire. All the participants were semi-professionals. The data were evaluated with respect to gender, kumite level (where a karate practitioner trains against an adversary), and country. Of the 420 fighters interviewed, 213 had experienced facial trauma and 44 had already had dental trauma. A total of 192 athletes had hurt their opponent by inflicting a facial or dental injury, and 290 knew about the possibility of tooth replantation following an avulsion. Only 50 interviewees knew about tooth rescue boxes. Nearly all the individuals interviewed wore a mouthguard (n = 412), and 178 of them had made their own modifications to the guard. The results of the present survey suggest that more information and education in wearing protective gear are required to reduce the incidence of dental injuries in karate.

  4. Clinical observation of the plastic surgery techniques applied in facial trauma treatment%急诊应用整形外科学技术处理面部外伤的临床观察

    Institute of Scientific and Technical Information of China (English)

    李建忠; 付研; 马炳辰; 司晔巍

    2012-01-01

    Objective To investigate and evaluate the effectiveness of plastic surgery application in facial trauma treatment in emergency room (ER), pursuing an optimal treatment for facial soft tissue laceration. Methods 60 patients with facial trauma visited ER between June and December, 2010 were randomly divided into two groups, experiment group and control group with 30 patients equally in each group. Plastic surgery combined with debridement and suture was performed to the experiment group while conventional debridement and suture was provided to the control group. An analysis on wound healing, scar including its width and color, medical expenses, levels of patients satisfaction was conducted in both groups. Results Despite patients in both groups reached primary level of healing, according to the results of Visual Analogue Scale/Score (VAS) and Visual Analog Cosmesis Scale (VACS), the differences in between the experiment group and the control group reflected as follows: VAS and VACS, score and width of the scar, and medical costs, VAS: 84.03±4.66 to 79.53± 6.39, VACS (doctor 1): 83.87±8.23 to 76.67±10.21; VACS (doctor 2): 82.97±5.52 to 76.5±9.68; score of the scar: 0.56±0.50 to 1.63±0.89; width of the scar (mm): 0.64±0.31 to 0.92±0.32; medical costs (yuan): 225.23±1.48 to 170.19 ± 0.96, P<0.05 or P<0.01. Conclusion Application of plastic surgery principle and technology combined with debridement and suture in facial trauma treatment may effectively reduce scar formation and maximize patients' satisfaction.%目的 研究和评价在急诊面部外伤的手术中应用整形外科学技术的疗效,寻找颜面部软组织裂伤的最佳修复治疗方法.方法 选取2010年6月~2010年12月于北京同仁医院急诊外科就诊的面部外伤患者60例,随机分为实验组(30例)与对照组(30例),分别采用整形外科技术清创缝合和普通急诊清创缝合.分析两组患者伤口愈合情况、伤口愈合后瘢痕(宽度、颜色),医疗

  5. Facial swelling

    Science.gov (United States)

    ... help reduce facial swelling. When to Contact a Medical Professional Call your health care provider if you have: Sudden, painful, or severe facial ... or if you have breathing problems. The health care provider will ask about your medical and personal history. This helps determine treatment or ...

  6. Progressive facial hemiatrophy : a complex disorder not only affecting the face. A report in a monozygotic male twin pair

    NARCIS (Netherlands)

    Hulzebos, C V; de Vries, T W; Armbrust, W; Sauer, P J J; Kerstjens-Frederikse, W S

    2004-01-01

    Progressive facial hemiatrophy (PFH) is a ubiquitous disease, characterized by hyperpigmentation of the skin followed by unilateral craniofacial atrophy of subcutaneous tissues, including fat, muscle and bone. Hereditary factors have been postulated to be involved in the aetiology of PFH. Yet, the o

  7. Dental Trauma Guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva; Gerds, Thomas Alexander

    2012-01-01

    Diagnosis and treatment for traumatic dental injuries are very complex owing to the multiple trauma entities represented by six luxation types and nine fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and luxation injuries are often...... combined, the result is that more than 100 trauma scenarios exist, when the two dentitions are combined. Each of these trauma scenarios has a specific treatment demand and prospect for healing. With such a complexity in diagnosis and treatment, it is obvious that even experienced practitioners may have...... problems in selecting proper treatment for some of these trauma types. To remedy this situation, an Internet-based knowledge base consisting of 4000 dental trauma cases with long-term follow up is now available to the public and the professions on the Internet using the address http://www.DentalTrauma...

  8. The role of objective facial analysis using FDNA in making diagnoses following whole exome analysis. Report of two patients with mutations in the BAF complex genes.

    Science.gov (United States)

    Gripp, Karen W; Baker, Laura; Telegrafi, Aida; Monaghan, Kristin G

    2016-07-01

    The genetic basis of numerous intellectual disability (ID) syndromes has recently been identified by applying exome analysis on a research or clinical basis. There is significant clinical overlap of biologically related syndromes, as exemplified by Nicolaides-Baraitser (NCBRS) and Coffin-Siris (CSS) syndrome. Both result from mutations affecting the BAF (mSWI/SNF) complex and belong to the growing category of BAFopathies. In addition to the notable clinical overlap between these BAFopathies, heterogeneity exists for patients clinically diagnosed with one of these conditions. We report two teenagers with ID whose molecular diagnosis of a SMARC2A or ARID1B mutation, respectively, was established through clinical exome analysis. Interestingly, using only the information provided in a single clinically obtained facial photograph from each patient, the facial dysmorphology analysis detected similarities to facial patterns associated with NCBRS as the first suggestion for both individuals, followed by CSS as the second highest ranked in the individual with the ARID1B mutation. Had this information been available to the laboratory performing the exome analysis, it could have been utilized during the variant analysis and reporting process, in conjunction with the written summary provided with each test requisition. While the available massive parallel sequencing technology, variant calling and variant interpretation are constantly evolving, clinical information remains critical for this diagnostic process. When trio analysis is not feasible, additional diagnostic tools may become particularly valuable. Facial dysmorphology analysis data may supplement the clinical phenotype summary and provide data independent of the clinician's personal experience and bias. © 2016 Wiley Periodicals, Inc.

  9. 特殊行为患者分类在面部创伤临床教学中的应用%Application of patients with specific behaviors in the facial trauma clinical teaching

    Institute of Scientific and Technical Information of China (English)

    杨震; 亓发芝; 顾建英

    2010-01-01

    Objective To detect the feasibility of patients with specific behaviors in the facial trauma clinical teaching. Method 47 medical students were randomly divided into experimental group ( n = 22 ) and control group(n=25). Students from experimental group at least dealed with 5 ~ 10 facial trauma patients with specific behaviors, while specific behaviors patients in control group were not more than 2. Teaching results were compared. Results There was no significant difference in operation test scores between the two groups ( (84.68 ±3.41 ) vs ( 83.96 ± 3.46 ), P = 0. 476 ). Composite score of teachers in the experimental group was significantly higher than that in control group( (90.09 ± 5.69 ) vs (83.48 ± 5.19), P < 0.01 ). The results of questionnaire survey showed that two in five self-assessment results were higher in the experimental group(P < 0. 01 ). Conclusion Medical students are more appropriately involved in treating special behaviors patients, which can improve the overall quality of students. Teaching with special behaviors patients has good effect, and is feasible.%目的 探讨在面部创伤临床教学中应用特殊行为患者分类教学法的可行性.方法 将47名学生分为试验组(n=22)和对照组(n=25),试验组实习中每位学生参与救治的面部创伤病例中必须包括5~10例特殊行为患者,对照组每位学生参与救治的面部创伤救治病例中特殊行为患者不超过2例,比较两组的教学效果.结果 两组间的操作考试成绩差异无显著性[(84.68±3.41)分,(83.96±3.46)分,P=0.476],试验组的带教老师综合评分显著高于对照组[(90.09±5.69)分,(83.48±5.19)分,P<0.01].问卷调查显示,在5项自我评定结果 中,试验组有2项高于对照组(P<0.01),其他3项调查内容两组无明显差异.结论 采取特殊行为患者分类教学法,让医学生适当参与处理具有特殊行为的创伤患者,可以提高学生的综合素质.

  10. Three-Dimensional Analysis of Zygomatic-Maxillary Complex Fracture Patterns

    OpenAIRE

    2010-01-01

    Zygomatic-maxillary (ZMC) complex fractures are a common consequence of facial trauma. In this retrospective study, we present a novel method of ZMC fracture pattern analysis, utilizing three-dimensional visualization of computed tomography (CT) images to record displacement of the malar eminence in a three-dimensional coordinate plane. The pattern of fracture was then correlated with treatment outcome. Facial CT scans were obtained from 29 patients with unilateral ZMC fractures and 30 subjec...

  11. Complex PTSD as Proposed for ICD-11: Validation of a New Disorder in Children and Adolescents and Their Response to Trauma-Focused Cognitive Behavioral Therapy

    Science.gov (United States)

    Sachser, Cedric; Keller, Ferdinand; Goldbeck, Lutz

    2017-01-01

    Background: To evaluate whether the symptoms of children and adolescents with clinically significant posttraumatic stress symptoms (PTSS) form classes consistent with the diagnostic criteria of complex PTSD (CPTSD) as proposed for the ICD-11, and to relate the emerging classes with treatment outcome of Trauma-Focused Cognitive Behavioral Therapy…

  12. Complex PTSD as Proposed for ICD-11: Validation of a New Disorder in Children and Adolescents and Their Response to Trauma-Focused Cognitive Behavioral Therapy

    Science.gov (United States)

    Sachser, Cedric; Keller, Ferdinand; Goldbeck, Lutz

    2017-01-01

    Background: To evaluate whether the symptoms of children and adolescents with clinically significant posttraumatic stress symptoms (PTSS) form classes consistent with the diagnostic criteria of complex PTSD (CPTSD) as proposed for the ICD-11, and to relate the emerging classes with treatment outcome of Trauma-Focused Cognitive Behavioral Therapy…

  13. Emergency management of major bleeding in a case of maxillofacial trauma and anticoagulation: utility of prothrombin complex concentrates in the shock room

    Directory of Open Access Journals (Sweden)

    Alessandro Morotti

    2015-03-01

    Full Text Available Life-threatening bleeding in anticoagulation with Warfarin is an emergency challenging issue. Several approaches are available to treat bleeding in either over-anticoagulation or propeanticoagulation, including vitamin K, fresh frozen plasma and prothrombin complex concentrates (PCC administration. In coexisting trauma-induced bleeding and anticoagulation, reversal of anticoagulation must be a rapid and highly effective procedure. Furthermore the appropriate treatment must be directly available in each shock rooms to guarantee the rapid management of the emergency. PCC require a simple storage, rapid accessibility, fast administration procedures and high effectiveness. Here we report the utility of PCC in management of a craniofacial trauma in proper-anticoagulation.

  14. The Definition of Complex Trauma in Psychological Medicine (review)%精神医学中复杂创伤的概念①

    Institute of Scientific and Technical Information of China (English)

    单敬; 陈登峰; 冯孟哲

    2013-01-01

    Identification of complex traumatic stress disorders has beyond the traditional definition of trauma and experimentally diag-nostic statement of post-traumatic stress disorder (PTSD) in Diagnostic and Statistical Manual of Mental Disorders (DSM-Ⅳ-TR). Because of the disturbance of complex trauma, traumatic stress symptoms and its hurt results, it is difficult to make accurate diagnosis and effective treatment. This article began with the reasons why it was hard to define complex trauma, viewed from clinical diagnosis and treatment, dis-cussed the importance of defining complex trauma, its multiple effects on individuals and the psychological and social factors aggravating complex trauma.%  复杂创伤应激障碍的鉴定已经超出了创伤的经典定义范畴以及精神疾病诊断和统计手册(DSM-Ⅳ-TR)中对创伤性应激障碍(PTSD)的经验性诊断描述。由于复杂创伤的干扰,以及创伤应激的症状和伤害等因素的影响,使得复杂创伤应激障碍的准确诊断和有效治疗十分困难。本文从复杂创伤难以定义的原因出发,并从临床诊疗的角度,探讨对复杂创伤定义的重要性,复杂创伤对个体的多重影响,以及加重复杂创伤的心理和社会因素。

  15. Trauma typology as a risk factor for aggression and self-harm in a complex PTSD population: the mediating role of alterations in self-perception.

    Science.gov (United States)

    Dyer, Kevin F W; Dorahy, Martin J; Shannon, Maria; Corry, Mary

    2013-01-01

    This study examined the role of prolonged, repeated traumatic experiences such as childhood and sectarian trauma in the development of posttraumatic aggression and self-harm. Forty-four adult participants attending therapy for complex trauma in Northern Ireland were obtained via convenience sampling. When social desirability was controlled, childhood emotional and physical neglect were significant correlates of posttraumatic hostility and history of self-harm. These relationships were mediated by alterations in self-perception (e.g., shame, guilt). Severity of sectarian-related experiences was not related to self-destructive behaviors. Moreover, none of the trauma factors were related to overt aggressive behavior. The findings have implications for understanding risk factors for posttraumatic aggression and self-harm, as well as their treatment.

  16. Facial tics

    Science.gov (United States)

    Tic - facial; Mimic spasm ... Tics may involve repeated, uncontrolled spasm-like muscle movements, such as: Eye blinking Grimacing Mouth twitching Nose wrinkling Squinting Repeated throat clearing or grunting may also be ...

  17. Mentalization of complex emotions in borderline personality disorder: The impact of parenting and exposure to trauma on the performance in a novel cartoon-based task.

    Science.gov (United States)

    Brüne, Martin; Walden, Sarah; Edel, Marc-Andreas; Dimaggio, Giancarlo

    2016-01-01

    Borderline personality disorder (BPD) is characterized by a range of interpersonal difficulties, which are, in part, related to adverse experiences during childhood. Unresponsive parenting and traumatization may cause functional impairment of mentalization, i.e. the ability to reflect upon own and others' mental states. However, the relationship of poor parenting, trauma and mentalization in BPD has not exhaustively been studied. Thirty patients diagnosed with BPD and 30 matched control subjects were asked to sequence a novel cartoon-based mentalization task involving complex emotions such as jealousy, shame, guilt etc. In addition, they were required to reason about cognitive and affective mental states of the cartoon characters. The quality of parental care was assessed using a self-report measure for recalled parental rearing style, and childhood trauma was measured in retrospect using the Childhood Trauma Questionnaire. Patients with BPD performed more poorly in all aspects of the cartoon task. Mentalizing skills, particularly relating to affective mental states, were uniquely associated with the quality of recalled parental care and childhood trauma. Together, the quality of parental care and the experience of childhood trauma negatively impact on mentalization in BPD, even in an experimental "offline" task.

  18. Facial and oral injuries in Brazilian children aged 5-17 years: 5-year review.

    Science.gov (United States)

    Cavalcanti, A L; Melo, T R

    2008-06-01

    This was to assess causes of maxillofacial trauma using a retrospective study in Paraiba, Brazil. Records of 256 patients with maxillofacial injuries aged 5-17 years treated between January 2002 to May 2006 were analyzed according to sex, age, cause of injury, frequency of dentoalveolar trauma, intraoral soft tissue injury, frequency and site of facial fracture. Chi-square and Fisher's Exact Tests were used at a significance level of 5%; odds ratio (OR) with confidence intervals to 95% were calculated (IC95%). Facial injuries were most frequent in males (78.1%) and in 13-17 year olds (60.9%); they tended to be more frequent during weekends (48%). Commonest causes were falls (37.9%) and traffic accidents (21.1%). Nasal fractures were most common (51.3%), followed by the zygomatic-orbital complex (25.4%); dentoalveolar injuries were present in 25.8% of cases. There was a positive association between facial fracture and dentoalveolar trauma, alveolar and tooth fracture, avulsion and intraoral soft tissue injury. Accidental falls were found to be the leading cause of maxillofacial fractures, affecting males 3 times more than females.

  19. Facial Data Field

    Institute of Scientific and Technical Information of China (English)

    WANG Shuliang; YUAN Hanning; CAO Baohua; WANG Dakui

    2015-01-01

    Expressional face recognition is a challenge in computer vision for complex expressions. Facial data field is proposed to recognize expression. Fundamentals are presented in the methodology of face recognition upon data field and subsequently, technical algorithms including normalizing faces, generating facial data field, extracting feature points in partitions, assigning weights and recog-nizing faces. A case is studied with JAFFE database for its verification. Result indicates that the proposed method is suitable and eff ective in expressional face recognition con-sidering the whole average recognition rate is up to 94.3%. In conclusion, data field is considered as a valuable alter-native to pattern recognition.

  20. Management of duodenal trauma

    Institute of Scientific and Technical Information of China (English)

    CHEN Guo-qing; YANG Hua

    2011-01-01

    Duodenal trauma is uncommon but nowadays seen more and more frequently due to the increased automobile accidents and violent events. The management of duodenal trauma can be complicated, especially when massive injury to the pancreatic-duodenal-biliary complex occurs simultaneously. Even the patients receive surgeries in time, multiple postoperative complications and high mortality are common. To know and manage duodenal trauma better, we searched the recent related literature in PubMed by the keywords of duodenal trauma, therapy, diagnosis and abdomen. It shows that because the diagnosis and management are complicated and the mortality is high,duodenal trauma should be treated in time and tactfully.And application of new technology can help improve the management. In this review, we discussed the incidence,diagnosis, management, and complications as well as mortality of duodenal trauma.

  1. Recognition of the neurobiological insults imposed by complex trauma and the implications for psychotherapeutic interventions.

    Science.gov (United States)

    Corrigan, Frank M; Hull, Alastair M

    2015-04-01

    Considerable research has been conducted on particular approaches to the psychotherapy of post-traumatic stress disorder (PTSD). However, the evidence indicates that modalities tested in randomised controlled trials (RCTs) are far from 100% applicable and effective and the RCT model itself is inadequate for evaluating treatments of conditions with complex presentations and frequently multiple comorbidities. Evidence at levels 2 and 3 cannot be ignored. Expert-led interventions consistent with the emerging understanding of affective neuroscience are needed and not the unthinking application of a dominant therapeutic paradigm with evidence for PTSD but not complex PTSD. The over-optimistic claims for the effectiveness of cognitive-behavioural therapy (CBT) and misrepresentation of other approaches do not best serve a group of patients greatly in need of help; excluding individuals with such disorders as untreatable or treatment-resistant when viable alternatives exist is not acceptable.

  2. Recognition of the neurobiological insults imposed by complex trauma and the implications for psychotherapeutic interventions †

    OpenAIRE

    Corrigan, Frank M.; Hull, Alastair M

    2015-01-01

    Considerable research has been conducted on particular approaches to the psychotherapy of post-traumatic stress disorder (PTSD). However, the evidence indicates that modalities tested in randomised controlled trials (RCTs) are far from 100% applicable and effective and the RCT model itself is inadequate for evaluating treatments of conditions with complex presentations and frequently multiple comorbidities. Evidence at levels 2 and 3 cannot be ignored. Expert-led interventions consistent with...

  3. Evidence of Complex Posttraumatic Stress Disorder (CPTSD) across populations with prolonged trauma of varying intensity and ages of exposure

    DEFF Research Database (Denmark)

    Palic, Sabina; Zerach, G; Shevlin, Mark

    2016-01-01

    , with a "Dissociative PTSD-subtype" class. ICD-11's CPTSD was not exclusively associated with childhood abuse, but also with exposure to adulthood trauma of severe interpersonal intensity. Furthermore, all types of prolonged trauma were equally associated with the "Anxiety symptoms" class. Finally, of all the classes...

  4. Childhood trauma and complex posttraumatic stress disorder symptoms in older adults: A study of direct effects and social-interpersonal factors as potential mediators.

    Science.gov (United States)

    Krammer, Sandy; Kleim, Birgit; Simmen-Janevska, Keti; Maercker, Andreas

    2016-01-01

    Childhood traumatic events may lead to long-lasting psychological effects and contribute to the development of complex posttraumatic sequelae. These might be captured by the diagnostic concept of complex posttraumatic stress disorder (CPTSD) as an alternative to classic posttraumatic stress disorder (PTSD). CPTSD comprises a further set of symptoms in addition to those of PTSD, namely, changes in affect, self, and interpersonal relationships. Previous empirical research on CPTSD has focused on middle-aged adults but not on older adults. Moreover, predictor models of CPTSD are still rare. The current study investigated the association between traumatic events in childhood and complex posttraumatic stress symptoms in older adults. The mediation of this association by 2 social-interpersonal factors (social acknowledgment as a survivor and dysfunctional disclosure) was investigated. These 2 factors focus on the perception of acknowledgment by others and either the inability to disclose traumatic experiences or the ability to do so only with negative emotional reactions. A total of 116 older individuals (age range = 59-98 years) who had experienced childhood traumatic events completed standardized self-report questionnaires indexing childhood trauma, complex trauma sequelae, social acknowledgment, and dysfunctional disclosure of trauma. The results showed that traumatic events during childhood were associated with later posttraumatic stress symptoms but with classic rather than complex symptoms. Social acknowledgment and dysfunctional disclosure partially mediated this relationship. These findings suggest that childhood traumatic stress impacts individuals across the life span and may be associated with particular adverse psychopathological consequences.

  5. Pediatric facial injuries: It's management

    Science.gov (United States)

    Singh, Geeta; Mohammad, Shadab; Pal, U. S.; Hariram; Malkunje, Laxman R.; Singh, Nimisha

    2011-01-01

    Background: Facial injuries in children always present a challenge in respect of their diagnosis and management. Since these children are of a growing age every care should be taken so that later the overall growth pattern of the facial skeleton in these children is not jeopardized. Purpose: To access the most feasible method for the management of facial injuries in children without hampering the facial growth. Materials and Methods: Sixty child patients with facial trauma were selected randomly for this study. On the basis of examination and investigations a suitable management approach involving rest and observation, open or closed reduction and immobilization, trans-osseous (TO) wiring, mini bone plate fixation, splinting and replantation, elevation and fixation of zygoma, etc. were carried out. Results and Conclusion: In our study fall was the predominant cause for most of the facial injuries in children. There was a 1.09% incidence of facial injuries in children up to 16 years of age amongst the total patients. The age-wise distribution of the fracture amongst groups (I, II and III) was found to be 26.67%, 51.67% and 21.67% respectively. Male to female patient ratio was 3:1. The majority of the cases of facial injuries were seen in Group II patients (6-11 years) i.e. 51.67%. The mandibular fracture was found to be the most common fracture (0.60%) followed by dentoalveolar (0.27%), mandibular + midface (0.07) and midface (0.02%) fractures. Most of the mandibular fractures were found in the parasymphysis region. Simple fracture seems to be commonest in the mandible. Most of the mandibular and midface fractures in children were amenable to conservative therapies except a few which required surgical intervention. PMID:22639504

  6. Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples

    Directory of Open Access Journals (Sweden)

    Ask Elklit

    2014-05-01

    Full Text Available Background: The International Classification of Diseases, 11th version (ICD-11, proposes two related stress and trauma-related disorders, posttraumatic stress disorder (PTSD and complex PTSD (CPTSD. A diagnosis of CPTSD requires that in addition to the PTSD symptoms, an individual must also endorse symptoms in three major domains: (1 affective dysregulation, (2 negative self-concepts, and (3 interpersonal problems. This study aimed to determine if the naturally occurring distribution of symptoms in three groups of traumatised individuals (bereavement, sexual victimisation, and physical assault were consistent with the ICD-11, PTSD, and CPTSD specification. The study also investigated whether these groups differed on a range of other psychological problems. Methods and Results: Participants completed self-report measures of each symptom group and latent class analyses consistently found that a three class solution was best. The classes were “PTSD only,” “CPTSD,” and “low PTSD/CPTSD.” These classes differed significantly on measures of depression, anxiety, dissociation, sleep disturbances, somatisation, interpersonal sensitivity, and aggression. The “CPTSD” class in the three samples scored highest on all the variables, with the “PTSD only” class scoring lower and the “low PTSD/CPTSD” class the lowest. Conclusion: This study provides evidence to support the diagnostic structure of CPTSD and indicted that CPTSD is associated with a broad range of other psychological problems.

  7. Dental Trauma Guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva Fejerskov; Christensen, Søren Steno Ahrensburg

    2012-01-01

    Diagnose and treatment of traumatic dental injuries is very complex due to the multiple trauma entities represented by 6 lunation types and 9 fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and lunation injuries are often combined......, the result is, that more than 100 trauma scenario exist when the two dentitions are combined. Each of these trauma scenarios have a specific treatment demand and prospect for healing. With such a complexity in diagnose and treatment it is obvious that even experienced practitioners may have problems may have...... problems in selecting proper treatment for some of these trauma types. To remedy this situation, an internet based knowledge base consisting of 4000 dental trauma cases with long term follow up is now available to the public and professionals, on the internet using the address www...

  8. High resolution CT of temporal bone trauma

    Energy Technology Data Exchange (ETDEWEB)

    Youn, Eun Kyung [Korea General Hospital, Seoul (Korea, Republic of)

    1986-10-15

    Radiographic studies of the temporal bone following head trauma are indicated when there is cerebrospinal fluid otorrhea or rhinorrhoea, hearing loss, or facial nerve paralysis. Plain radiography displays only 17-30% of temporal bone fractures and pluridirectional tomography is both difficult to perform, particularly in the acutely ill patient, and less satisfactory for the demonstration of fine fractures. Consequently, high resolution CT is the imaging method of choice for the investigation of suspected temporal bone trauma and allows special resolution of fine bony detail comparable to that attainable by conventional tomography. Eight cases of temporal bone trauma examined at Korea General Hospital April 1985 through May 1986. The results were as follows: Seven patients (87%) suffered longitudinal fractures. In 6 patients who had purely conductive hearing loss, CT revealed various ossicular chain abnormality. In one patient who had neuro sensory hearing loss, CT demonstrated intract ossicular with a fracture nearing lateral wall of the lateral semicircular canal. In one patient who had mixed hearing loss, CT showed complex fracture.

  9. Facial Sports Injuries

    Science.gov (United States)

    ... Find an ENT Doctor Near You Facial Sports Injuries Facial Sports Injuries Patient Health Information News media interested in ... should receive immediate medical attention. Prevention Of Facial Sports Injuries The best way to treat facial sports injuries ...

  10. Facial Cosmetic Surgery

    Science.gov (United States)

    ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  11. Facial Scar Revision: Understanding Facial Scar Treatment

    Science.gov (United States)

    ... a facial plastic surgeon Facial Scar Revision Understanding Facial Scar Treatment When the skin is injured from a cut or tear the body heals by forming scar tissue. The appearance of the scar can range from ...

  12. Tracking facial features with occlusions

    Institute of Scientific and Technical Information of China (English)

    MARKIN Evgeny; PRAKASH Edmond C.

    2006-01-01

    Facial expression recognition consists of determining what kind of emotional content is presented in a human face.The problem presents a complex area for exploration, since it encompasses face acquisition, facial feature tracking, facial expression classification. Facial feature tracking is of the most interest. Active Appearance Model (AAM) enables accurate tracking of facial features in real-time, but lacks occlusions and self-occlusions. In this paper we propose a solution to improve the accuracy of fitting technique. The idea is to include occluded images into AAM training data. We demonstrate the results by running ex periments using gradient descent algorithm for fitting the AAM. Our experiments show that using fitting algorithm with occluded training data improves the fitting quality of the algorithm.

  13. Facial blindsight

    Directory of Open Access Journals (Sweden)

    Marco eSolcà

    2015-09-01

    Full Text Available Blindsight denotes unconscious residual visual capacities in the context of an inability to consciously recollect or identify visual information. It has been described for color and shape discrimination, movement or facial emotion recognition. The present study investigates a patient suffering from cortical blindness whilst maintaining select residual abilities in face detection. Our patient presented the capacity to distinguish between jumbled/normal faces, known/unknown faces or famous people’s categories although he failed to explicitly recognize or describe them. Conversely, performance was at chance level when asked to categorize non-facial stimuli. Our results provide clinical evidence for the notion that some aspects of facial processing can occur without perceptual awareness, possibly using direct tracts from the thalamus to associative visual cortex, bypassing the primary visual cortex.

  14. Rejuvenecimiento facial

    Directory of Open Access Journals (Sweden)

    L. Daniel Jacubovsky, Dr.

    2010-01-01

    Full Text Available El envejecimiento facial es un proceso único y particular a cada individuo y está regido en especial por su carga genética. El lifting facial es una compleja técnica desarrollada en nuestra especialidad desde principios de siglo, para revertir los principales signos de este proceso. Los factores secundarios que gravitan en el envejecimiento facial son múltiples y por ello las ritidectomías o lifting cérvico faciales descritas han buscado corregir los cambios fisonómicos del envejecimiento excursionando, como se describe, en todos los planos tisulares involucrados. Esta cirugía por lo tanto, exige conocimiento cabal de la anatomía quirúrgica, pericia y experiencia para reducir las complicaciones, estigmas quirúrgicos y revisiones secundarias. La ridectomía facial ha evolucionado hacia un procedimiento más simple, de incisiones más cortas y disecciones menos extensas. Las suspensiones musculares han variado en su ejecución y los vectores de montaje y resección cutánea son cruciales en los resultados estéticos de la cirugía cérvico facial. Hoy estos vectores son de tracción más vertical. La corrección de la flaccidez va acompañada de un interés en reponer el volumen de la superficie del rostro, en especial el tercio medio. Las técnicas quirúrgicas de rejuvenecimiento, en especial el lifting facial, exigen una planificación para cada paciente. Las técnicas adjuntas al lifting, como blefaroplastias, mentoplastía, lipoaspiración de cuello, implantes faciales y otras, también han tenido una positiva evolución hacia la reducción de riesgos y mejor éxito estético.

  15. Peripheral facial weakness (Bell's palsy).

    Science.gov (United States)

    Basić-Kes, Vanja; Dobrota, Vesna Dermanović; Cesarik, Marijan; Matovina, Lucija Zadro; Madzar, Zrinko; Zavoreo, Iris; Demarin, Vida

    2013-06-01

    Peripheral facial weakness is a facial nerve damage that results in muscle weakness on one side of the face. It may be idiopathic (Bell's palsy) or may have a detectable cause. Almost 80% of peripheral facial weakness cases are primary and the rest of them are secondary. The most frequent causes of secondary peripheral facial weakness are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immune disorders, drugs, degenerative diseases of the central nervous system, etc. The diagnosis relies upon the presence of typical signs and symptoms, blood chemistry tests, cerebrospinal fluid investigations, nerve conduction studies and neuroimaging methods (cerebral MRI, x-ray of the skull and mastoid). Treatment of secondary peripheral facial weakness is based on therapy for the underlying disorder, unlike the treatment of Bell's palsy that is controversial due to the lack of large, randomized, controlled, prospective studies. There are some indications that steroids or antiviral agents are beneficial but there are also studies that show no beneficial effect. Additional treatments include eye protection, physiotherapy, acupuncture, botulinum toxin, or surgery. Bell's palsy has a benign prognosis with complete recovery in about 80% of patients, 15% experience some mode of permanent nerve damage and severe consequences remain in 5% of patients.

  16. Trauma renal Renal trauma

    Directory of Open Access Journals (Sweden)

    Gerson Alves Pereira Júnior

    1999-02-01

    Full Text Available Apresentamos uma revisão sobre trauma renal, com ênfase na avaliação radiológica, particularmente com o uso da tomografia computadorizada, que tem se tornado o exame de eleição, ao invés da urografia excretora e arteriografia. O sucesso no tratamento conservador dos pacientes com trauma renal depende de um acurado estadiamento da extensão da lesão, classificado de acordo com a Organ Injury Scaling do Colégio Americano de Cirurgiões. O tratamento conservador não-operatório é seguro e consiste de observação contínua, repouso no leito, hidratação endovenosa adequada e antibioti- coterapia profilática, evitando-se uma exploração cirúrgica desnecessária e possível perda renal. As indicações para exploração cirúrgica imediata são abdome agudo, rápida queda do hematócrito ou lesões associadas determinadas na avaliação radiológica. Quando indicada, a exploração renal após controle vascular prévio é segura, permitindo cuidadosa inspeção do rim e sua reconstrução com sucesso, reduzindo a probabilidade de nefrectomia.We present a revision of the renal trauma with emphasis in the radiographic evaluation, particularly CT scan that it has largely replaced the excretory urogram and arteriogram in the diagnostic worh-up and management of the patient with renal trauma. The successful management of renal injuries depends upon the accurate assessment of their extent in agreement with Organ Injury Scaling classification. The conservative therapy managed by careful continuous observation, bed rest, appropriate fluid ressuscitation and prophylactic antibiotic coverage after radiographic staging for severely injured kidneys can yield favorable results and save patients from unnecessary exploration and possible renal loss. The indications for immediate exploratory laparotomy were acute abdomen, rapidly dropping hematocrit or associated injuries as determinated from radiologic evaluation. When indicated, renal exploration

  17. Tumor de Pindborg relacionado con trauma facial

    Directory of Open Access Journals (Sweden)

    Niorgy Rodríguez Rodríguez

    2011-12-01

    Full Text Available El tumor de Pindborg es una neoplasia benigna, rara, con carácter invasivo local y tendencia a la recidiva, que representa entre el 0,17 y el 1,8 % de todos los tumores odontogénicos, del cual tan solo se han publicado unos 200 casos, con una media de 4 casos nuevos por año en el mundo. Se presentó el caso de un hombre de 39 años de edad que acudió a la consulta de cirugía maxilofacial remitido de neurocirugía postraumatismo craneofacial, por presentar un aumento de volumen en el ángulo mandibular derecho. Se tuvo como objetivo publicar la existencia de esta infrecuente neoplasia por lo interesantes que resultan estos tumores por su evolución, dificultad en el diagnóstico, variantes de tratamiento y tendencia a la recidiva. Después de realizar exámenes de laboratorio, radiografías, tomografía axial computarizada y biopsia de fragmento óseo, se obtuvo extensión y diagnóstico de tumor de Pindborg en hemimandíbula derecha. Se realizó la técnica quirúrgica de hemimandibulectomía derecha y reconstrucción con injerto óseo de cresta ilíaca. La evolución del paciente fue satisfactoria.

  18. FACIAL FRACTURES AND RELATED INJURIES IN DEPARTMENT OF MAXILLO-FACIAL SURGERY, UNIVERSITY HOSPITAL ‘ST. ANNA’, SOFIA, BULGARIA.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-04-01

    Full Text Available Maxillofacial fractures often occur with serious concomitant injury in trauma patients, and knowledge of the type and severity of associated injuries can assist in rapid assessment and treatment. The objective was to identify the most commonly occurring injuries associated with facial fractures in severely injured trauma patients.

  19. Trauma-induced coagulopathy.

    Science.gov (United States)

    Katrancha, Elizabeth D; Gonzalez, Luis S

    2014-08-01

    Coagulopathy is the inability of blood to coagulate normally; in trauma patients, it is a multifactorial and complex process. Seriously injured trauma patients experience coagulopathies during the acute injury phase. Risk factors for trauma-induced coagulopathy include hypothermia, metabolic acidosis, hypoperfusion, hemodilution, and fluid replacement. In addition to the coagulopathy induced by trauma, many patients may also be taking medications that interfere with hemostasis. Therefore, medication-induced coagulopathy also is a concern. Traditional laboratory-based methods of assessing coagulation are being supported or even replaced by point-of-care tests. The evidence-based management of trauma-induced coagulopathy should address hypothermia, fluid resuscitation, blood components administration, and, if needed, medications to reverse identified coagulation disorders.

  20. Synthesis and characterization of Fe(II) β-diketonato complexes with relevance to acetylacetone dioxygenase: insights into the electronic properties of the 3-histidine facial triad.

    Science.gov (United States)

    Park, Heaweon; Baus, Jacob S; Lindeman, Sergey V; Fiedler, Adam T

    2011-12-05

    A series of high-spin iron(II) β-diketonato complexes have been prepared and characterized with the intent of modeling the substrate-bound form of the enzyme acetylacetone dioxygenase (Dke1). The Dke1 active site features an Fe(II) center coordinated by three histidine residues in a facial geometry--a departure from the standard 2-histidine-1-carboxylate (2H1C) facial triad dominant among nonheme monoiron enzymes. The deprotonated β-diketone substrate binds to the Fe center in a bidentate fashion. To better understand the implications of subtle changes in coordination environment for the electronic structures of nonheme Fe active sites, synthetic models were prepared with three different supporting ligands (L(N3)): the anionic (Me2)Tp and (Ph2)Tp ligands ((R2)Tp = hydrotris(pyrazol-1-yl)borate substituted with R-groups at the 3- and 5-pyrazole positions) and the neutral (Ph)TIP ligand ((Ph)TIP = tris(2-phenylimidazol-4-yl)phosphine). The resulting [(L(N3))Fe(acac(X))](0/+) complexes (acac(X) = substituted β-diketonates) were analyzed with a combination of experimental and computational methods, namely, X-ray crystallography, cyclic voltammetry, spectroscopic techniques (UV-vis absorption and (1)H NMR), and density functional theory (DFT). X-ray diffraction results for complexes with the (Me2)Tp ligand revealed six-coordinate Fe(II) centers with a bound MeCN molecule, while structures of the (Ph2)Tp and (Ph)TIP complexes generally exhibited five-coordinate geometries. Each [(L(N3))Fe(acac(X))](0/+) complex displays two broad absorption features in the visible region that arise from Fe(II)→acac(X) charge transfer and acac(X)-based transitions, consistent with UV-vis data reported for Dke1. These absorption bands, along with the Fe redox potentials, are highly sensitive to the identity of L(N3) and substitution of the β-diketonates. By interpreting the experimental results in conjunction with DFT calculations, detailed electronic-structure descriptions of the

  1. Man-machine collaboration using facial expressions

    Science.gov (United States)

    Dai, Ying; Katahera, S.; Cai, D.

    2002-09-01

    For realizing the flexible man-machine collaboration, understanding of facial expressions and gestures is not negligible. In our method, we proposed a hierarchical recognition approach, for the understanding of human emotions. According to this method, the facial AFs (action features) were firstly extracted and recognized by using histograms of optical flow. Then, based on the facial AFs, facial expressions were classified into two calsses, one of which presents the positive emotions, and the other of which does the negative ones. Accordingly, the facial expressions belonged to the positive class, or the ones belonged to the negative class, were classified into more complex emotions, which were revealed by the corresponding facial expressions. Finally, the system architecture how to coordinate in recognizing facil action features and facial expressions for man-machine collaboration was proposed.

  2. Results of psychodynamically oriented trauma-focused inpatient treatment for women with complex posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD).

    Science.gov (United States)

    Sachsse, Ulrich; Vogel, Christina; Leichsenring, Falk

    2006-01-01

    In a naturalistic outcome study, the authors evaluated the results of a specific psychodynamically oriented trauma-focused inpatient treatment for women with complex posttraumatic stress disorder and concomitant borderline personality disorder, self-mutilating behavior, and depression. At admission, the frequency of self-mutilating behavior and the amount of inpatient treatment (an average of 68 days annually) of the sample was high, characterizing this patient group as "previously therapy resistant." Treatment outcome was assessed both at the end of treatment and in a 1-year follow-up. In comparison with a treatment-as-usual control group, the treatment program brought about significant and stable improvements both in trauma-specific symptoms (e.g. dissociation, intrusion, avoidance) and in general psychiatric symptoms (e.g., general symptom distress, frequency of self-mutilating behavior, number of hospitalizations). The frequency of inpatient treatments (hospitalizations) decreased dramatically (< 10 days annually; effect size: d = 2.88).

  3. Facial fractures with concomitant open globe injury: mechanisms and fracture patterns associated with blindness.

    Science.gov (United States)

    Vaca, Elbert E; Mundinger, Gerhard S; Kelamis, Joseph A; Dorafshar, Amir H; Christy, Michael R; Manson, Paul N; Rodriguez, Eduardo D

    2013-06-01

    Treatment of facial fractures in the setting of open-globe injuries poses a management dilemma because of the often disparate treatment priorities of multidisciplinary trauma teams and the lack of prognostic data regarding visual outcomes. Patients in the University of Maryland Shock Trauma Registry sustaining facial fractures with concomitant open-globe injuries from January of 1998 to August of 2010 were identified. Odds ratios were calculated to identify demographic and clinical variables associated with blindness, and multivariate regression analysis was performed. A total of 99 patients were identified with 105 open-globe injuries. Seventy-nine percent of injuries were blinding, whereas 4.8 percent of globes achieved a final visual acuity greater than or equal to 20/400. Blindness was associated with penetrating injury, increasing number of facial fractures, zygomaticomaxillary complex fracture, admission Glasgow Coma Scale score less than or equal to 8, and globe injury spanning all three eye zones. Fracture repair was performed more frequently (62.5 percent) and more quickly (average time to fracture repair, 4.5 days) in cases of primary globe enucleation/evisceration when compared with complete (21.2 percent; 8 days; p=0.35) or incomplete (42.9 percent; 11 days; p=0.058) primary globe repair. Penetrating injury mechanism and zone of eye injury appear to be better indicators of visual prognosis than facial fracture patterns. Given the high rates of blindness, secondary enucleation, and delay of fracture repair in patients that were not primarily enucleated, the authors recommend that orbital fracture repair not be delayed in the hopes of eventual visual recovery in cases of high-velocity projectile trauma. Risk, III.

  4. Systemic trauma.

    Science.gov (United States)

    Goldsmith, Rachel E; Martin, Christina Gamache; Smith, Carly Parnitzke

    2014-01-01

    Substantial theoretical, empirical, and clinical work examines trauma as it relates to individual victims and perpetrators. As trauma professionals, it is necessary to acknowledge facets of institutions, cultures, and communities that contribute to trauma and subsequent outcomes. Systemic trauma-contextual features of environments and institutions that give rise to trauma, maintain it, and impact posttraumatic responses-provides a framework for considering the full range of traumatic phenomena. The current issue of the Journal of Trauma & Dissociation is composed of articles that incorporate systemic approaches to trauma. This perspective extends conceptualizations of trauma to consider the influence of environments such as schools and universities, churches and other religious institutions, the military, workplace settings, hospitals, jails, and prisons; agencies and systems such as police, foster care, immigration, federal assistance, disaster management, and the media; conflicts involving war, torture, terrorism, and refugees; dynamics of racism, sexism, discrimination, bullying, and homophobia; and issues pertaining to conceptualizations, measurement, methodology, teaching, and intervention. Although it may be challenging to expand psychological and psychiatric paradigms of trauma, a systemic trauma perspective is necessary on both scientific and ethical grounds. Furthermore, a systemic trauma perspective reflects current approaches in the fields of global health, nursing, social work, and human rights. Empirical investigations and intervention science informed by this paradigm have the potential to advance scientific inquiry, lower the incidence of a broader range of traumatic experiences, and help to alleviate personal and societal suffering.

  5. Blood levels of histone-complexed DNA fragments are associated with coagulopathy, inflammation and endothelial damage early after trauma

    DEFF Research Database (Denmark)

    Johansson, Pär I; Windeløv, Nis A; Rasmussen, Lars S

    2013-01-01

    Tissue injury increases blood levels of extracellular histones and nucleic acids, and these may influence hemostasis, promote inflammation and damage the endothelium. Trauma-induced coagulopathy (TIC) may result from an endogenous response to the injury that involves the neurohumoral, inflammatory...

  6. Allometry of facial mobility in anthropoid primates: implications for the evolution of facial expression.

    Science.gov (United States)

    Dobson, Seth D

    2009-01-01

    Body size may be an important factor influencing the evolution of facial expression in anthropoid primates due to allometric constraints on the perception of facial movements. Given this hypothesis, I tested the prediction that observed facial mobility is positively correlated with body size in a comparative sample of nonhuman anthropoids. Facial mobility, or the variety of facial movements a species can produce, was estimated using a novel application of the Facial Action Coding System (FACS). I used FACS to estimate facial mobility in 12 nonhuman anthropoid species, based on video recordings of facial activity in zoo animals. Body mass data were taken from the literature. I used phylogenetic generalized least squares (PGLS) to perform a multiple regression analysis with facial mobility as the dependent variable and two independent variables: log body mass and dummy-coded infraorder. Together, body mass and infraorder explain 92% of the variance in facial mobility. However, the partial effect of body mass is much stronger than for infraorder. The results of my study suggest that allometry is an important constraint on the evolution of facial mobility, which may limit the complexity of facial expression in smaller species. More work is needed to clarify the perceptual bases of this allometric pattern.

  7. Pediatric facial nerve rehabilitation.

    Science.gov (United States)

    Banks, Caroline A; Hadlock, Tessa A

    2014-11-01

    Facial paralysis is a rare but severe condition in the pediatric population. Impaired facial movement has multiple causes and varied presentations, therefore individualized treatment plans are essential for optimal results. Advances in facial reanimation over the past 4 decades have given rise to new treatments designed to restore balance and function in pediatric patients with facial paralysis. This article provides a comprehensive review of pediatric facial rehabilitation and describes a zone-based approach to assessment and treatment of impaired facial movement.

  8. Associated injuries in patients with facial fractures: a review of 604 patients.

    Science.gov (United States)

    Béogo, Rasmané; Dakouré, Patrick; Savadogo, Léon Blaise; Coulibaly, Antoine Toua; Ouoba, Kampadilemba

    2013-01-01

    Facial fractures may be associated with concomitant lesions of other parts of body with some of these injuries being life-threatening. This retrospective study reports the types of associated injury and the factors influencing their occurrence, in patients with facial fractures. In 18.2% of 604 patients, one associated injury at least was recorded. The most common associated injury was cranial trauma (9.9%), followed by limbs fractures (9.1%), chest trauma (2%), spine injury (0.5%) and eye ball rupture (0.5%). A poly trauma was recorded in 3.2% of the patients who had sustained a cerebral trauma, a spinal injury or a thoracic trauma. Death occurred in two patients (0.3%) who had respectively a spinal injury and a chest trauma. The occurrence of associated injuries correlated significantly with the fracture type with solitary mandibular fracture being a significant predictor of associated injuries. Although not statistically significant, multiple facial fractures and violence were more associated with concomitant injuries. The findings of this study recall the need for initial full examination of the trauma patients particularly victims of violence, patients presenting with multiple facial fractures or single facial bone fracture involving the mandible, the trauma patients? multidisciplinary management as well as trauma prevention.

  9. Associated injuries in patients with facial fractures: a review of 604 patients

    Science.gov (United States)

    Béogo, Rasmané; Dakouré, Patrick; Savadogo, Léon Blaise; Coulibaly, Antoine Toua; Ouoba, Kampadilemba

    2013-01-01

    Facial fractures may be associated with concomitant lesions of other parts of body with some of these injuries being life-threatening. This retrospective study reports the types of associated injury and the factors influencing their occurrence, in patients with facial fractures. In 18.2% of 604 patients, one associated injury at least was recorded. The most common associated injury was cranial trauma (9.9%), followed by limbs fractures (9.1%), chest trauma (2%), spine injury (0.5%) and eye ball rupture (0.5%). A poly trauma was recorded in 3.2% of the patients who had sustained a cerebral trauma, a spinal injury or a thoracic trauma. Death occurred in two patients (0.3%) who had respectively a spinal injury and a chest trauma. The occurrence of associated injuries correlated significantly with the fracture type with solitary mandibular fracture being a significant predictor of associated injuries. Although not statistically significant, multiple facial fractures and violence were more associated with concomitant injuries. The findings of this study recall the need for initial full examination of the trauma patients particularly victims of violence, patients presenting with multiple facial fractures or single facial bone fracture involving the mandible, the trauma patients? multidisciplinary management as well as trauma prevention. PMID:24778756

  10. Facial Scar Revision: Understanding Facial Scar Treatment

    Science.gov (United States)

    ... more to fully heal and achieve maximum improved appearance. Facial plastic surgery makes it possible to correct facial flaws that can undermine self-confidence. Changing how your scar looks can help change ...

  11. Facial attractiveness: General patterns of facial preferences

    National Research Council Canada - National Science Library

    Kościński, Krzysztof

    2007-01-01

    This review covers universal patterns in facial preferences. Facial attractiveness has fascinated thinkers since antiquity, but has been the subject of intense scientific study for only the last quarter of a century...

  12. Transtympanic Facial Nerve Paralysis: A Review of the Literature.

    Science.gov (United States)

    Schaefer, Nathan; O'Donohue, Peter; French, Heath; Griffin, Aaron; Elliott, Devlin; Gochee, Peter

    2015-05-01

    Facial nerve paralysis because of penetrating trauma through the external auditory canal is extremely rare, with a paucity of published literature. The objective of this study is to review the literature on transtympanic facial nerve paralysis and increase physician awareness of this uncommon injury through discussion of its clinical presentation, management and prognosis. We also aim to improve patient outcomes in those that have sustained this type of injury by suggesting an optimal management plan. In this case report, we present the case of a 46-year-old white woman who sustained a unilateral facial nerve paresis because of a garfish penetrating her tympanic membrane and causing direct damage to the tympanic portion of her facial nerve. On follow-up after 12 months, her facial nerve function has largely returned to normal. Transtympanic facial nerve paralysis is a rare injury but can have a favorable prognosis if managed effectively.

  13. Periocular Reconstruction in Patients with Facial Paralysis.

    Science.gov (United States)

    Joseph, Shannon S; Joseph, Andrew W; Douglas, Raymond S; Massry, Guy G

    2016-04-01

    Facial paralysis can result in serious ocular consequences. All patients with orbicularis oculi weakness in the setting of facial nerve injury should undergo a thorough ophthalmologic evaluation. The main goal of management in these patients is to protect the ocular surface and preserve visual function. Patients with expected recovery of facial nerve function may only require temporary and conservative measures to protect the ocular surface. Patients with prolonged or unlikely recovery of facial nerve function benefit from surgical rehabilitation of the periorbital complex. Current reconstructive procedures are most commonly intended to improve coverage of the eye but cannot restore blink.

  14. Guiding atypical facial growth back to normal. Part 1: Understanding facial growth.

    Science.gov (United States)

    Galella, Steve; Chow, Daniel; Jones, Earl; Enlow, Donald; Masters, Ari

    2011-01-01

    Many practitioners find the complexity of facial growth overwhelming and thus merely observe and accept the clinical features of atypical growth and do not comprehend the long-term consequences. Facial growth and development is a strictly controlled biological process. Normal growth involves ongoing bone remodeling and positional displacement. Atypical growth begins when this biological balance is disturbed With the understanding of these processes, clinicians can adequately assess patients and determine the causes of these atypical facial growth patterns and design effective treatment plans. This is the first of a series of articles which addresses normal facial growth, atypical facial growth, patient assessment, causes of atypical facial growth, and guiding facial growth back to normal.

  15. Facial porokeratosis.

    Science.gov (United States)

    Carranza, Dafnis C; Haley, Jennifer C; Chiu, Melvin

    2008-01-01

    A 34-year-old man from El Salvador was referred to our clinic with a 10-year history of a pruritic erythematous facial eruption. He reported increased pruritus and scaling of lesions when exposed to the sun. He worked as a construction worker and admitted to frequent sun exposure. Physical examination revealed well-circumscribed erythematous to violaceous papules with raised borders and atrophic centers localized to the nose (Figure 1). He did not have lesions on the arms or legs. He did not report a family history of similar lesions. A biopsy specimen was obtained from the edge of a lesion on the right ala. Histologic examination of the biopsy specimen showed acanthosis of the epidermis with focal invagination of the corneal layer and a homogeneous column of parakeratosis in the center of that layer consistent with a cornoid lamella (Figure 2). Furthermore, the granular layer was absent at the cornoid lamella base. The superficial dermis contained a sparse, perivascular lymphocytic infiltrate. No evidence of dysplasia or malignancy was seen. These findings supported a diagnosis of porokeratosis. The patient underwent a trial of cryotherapy with moderate improvement of the facial lesions.

  16. Peripheral facial nerve palsy after therapeutic endoscopy.

    Science.gov (United States)

    Kim, Eun Jeong; Lee, Jun; Lee, Ji Woon; Lee, Jun Hyung; Park, Chol Jin; Kim, Young Dae; Lee, Hyun Jin

    2015-03-01

    Peripheral facial nerve palsy (FNP) is a mononeuropathy that affects the peripheral part of the facial nerve. Primary causes of peripheral FNP remain largely unknown, but detectable causes include systemic infections (viral and others), trauma, ischemia, tumor, and extrinsic compression. Peripheral FNP in relation to extrinsic compression has rarely been described in case reports. Here, we report a case of a 71-year-old man who was diagnosed with peripheral FNP following endoscopic submucosal dissection. This case is the first report of the development of peripheral FNP in a patient undergoing therapeutic endoscopy. We emphasize the fact that physicians should be attentive to the development of peripheral FNP following therapeutic endoscopy.

  17. Measuring Facial Movement

    Science.gov (United States)

    Ekman, Paul; Friesen, Wallace V.

    1976-01-01

    The Facial Action Code (FAC) was derived from an analysis of the anatomical basis of facial movement. The development of the method is explained, contrasting it to other methods of measuring facial behavior. An example of how facial behavior is measured is provided, and ideas about research applications are discussed. (Author)

  18. [Peripheral facial nerve palsy].

    Science.gov (United States)

    Pons, Y; Ukkola-Pons, E; Ballivet de Régloix, S; Champagne, C; Raynal, M; Lepage, P; Kossowski, M

    2013-06-01

    Facial palsy can be defined as a decrease in function of the facial nerve, the primary motor nerve of the facial muscles. When the facial palsy is peripheral, it affects both the superior and inferior areas of the face as opposed to central palsies, which affect only the inferior portion. The main cause of peripheral facial palsies is Bell's palsy, which remains a diagnosis of exclusion. The prognosis is good in most cases. In cases with significant cosmetic sequelae, a variety of surgical procedures are available (such as hypoglossal-facial anastomosis, temporalis myoplasty and Tenzel external canthopexy) to rehabilitate facial aesthetics and function.

  19. Trauma Fact Sheet

    Science.gov (United States)

    ... Home > Science Education > Physical Trauma Fact Sheet Physical Trauma Fact Sheet Tagline (Optional) Middle/Main Content Area ... of physical trauma. Credit: iStock. What is physical trauma? Physical trauma is a serious injury to the ...

  20. Does vitamin C prevent the occurrence of complex regional pain syndrome in patients with extremity trauma requiring surgery?

    Directory of Open Access Journals (Sweden)

    Jorge Cabrolier

    2015-07-01

    Full Text Available El síndrome de dolor regional complejo es una patología neuroinflamatoria que afecta tanto al sistema nervioso central como al periférico, y se caracteriza por dolor desproporcionado en relación al trauma experimentado por el paciente. Se ha planteado que el uso de vitamina C podría prevenir la aparición de este síndrome en pacientes con trauma y cirugía de extremidades. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos dos revisiones sistemáticas que en conjunto incluyen sólo un estudio controlado aleatorizado. Realizamos una tabla de resumen de los resultados utilizando el método GRADE. Concluimos que existe incertidumbre sobre si la vitamina C podría ser útil en la prevención del síndrome de dolor regional complejo en estos pacientes porque la certeza de la evidencia es muy baja.

  1. Traumatología máxilo facial: diagnóstico y tratamiento

    Directory of Open Access Journals (Sweden)

    M. Marcelo Mardones, Dr.

    2011-09-01

    En el presente artículo se revisan, a modo general, los principales diagnósticos de trauma máxilo facial incluyendo el traumatismo alveolo dentario, con sus respectivos manejos y tratamientos de urgencia.

  2. Lagophthalmos after facial palsy: current therapeutic options.

    Science.gov (United States)

    Vásquez, Luz María; Medel, Ramón

    2014-01-01

    As the facial nerve carries sensory, motor and parasympathetic fibres involved in facial muscle innervation, facial palsy results in functional and cosmetic impairment. It can result from a wide variety of causes like infectious processes, trauma, neoplasms, autoimmune diseases, and most commonly Bell's palsy, but it can also be of iatrogenic origin. The main ophthalmic sequel is lagophthalmos. The increased surface exposure increases the risk of keratitis, corneal ulceration, and potentially loss of vision. Treatment options are wide; some are temporary, some permanent. In addition to gold standard and traditional therapies and procedures, new options are being proposed aiming to improve not only lagophthalmos but also the quality of life of these patients. © 2014 S. Karger AG, Basel.

  3. Reasonable application of antibiotic prophylaxis in maxillofacial trauma: Literature review

    Directory of Open Access Journals (Sweden)

    Afshin Yadegari Naeeni

    2016-07-01

    Full Text Available Background and Aims: Despite advances in trauma management, treatment of the consequent infections has remained a major challenge. Antibiotic prophylaxis has been widely applied to reduce such infections. Although bacteria are present in most body parts, severe infections after treatment are less frequent in the head and neck of healthy individuals. The aim of the present study was to review the reasonable application of antibiotic prophylaxis in maxillofacial trauma. Materials and Methods: In this review article, PubMed and Google Scholar databases were searched for studies on antibiotic prophylaxis in maxillofacial trauma published during 2000-2014. Conclusion: Antibiotics were not prescribed for tears and small clean wounds in the face and mouth. However, prophylaxis was applied for extensive mouth injuries which involved the facial skin. In case of maxillofacial fractures, 24-hour administration of antibiotics sufficed for compound fractures of the mandible and other parts of the face. Antibiotics were not required in other types of fractures. Prophylaxis should be applied over short pre- or post-operative periods based on the severity and complexity of maxillofacial fractures and their relations with intra- and extraoral environments. Apparently, more detailed studies are warranted to further clarify the subject.

  4. Trauma Africa

    Directory of Open Access Journals (Sweden)

    Victor Y. Kong

    2013-11-01

    Full Text Available “Major Trauma. Dr. Kong, please come to the Trauma Unit immediately. Dr. Kong, please come to the Trauma Unit immediately.” Even though I have been working at Edendale Hospital as a trauma registrar for over a year, whenever I hear this announcement over the hospital intercom system, my heart beats just a little faster than normal. When I first arrived at Edendale my colleagues told me that the adrenaline rush I would experience after being called out to attend a new emergency would decrease over time, and indeed they were right. However, it is also true to say that on some occasions more than others, it is still felt more strongly than ever.

  5. TRAUMA SURGERY

    African Journals Online (AJOL)

    utilisation of multiple resources, including blood products, anaesthetic ... surgical management of AVC injuries in the trauma centre at ... Sciences Human Research Ethics Committee. ..... Karinos N, Hayes PM, Nicol AJ, Kahn D. Avoiding futile.

  6. Facial orientation and facial shape in extant great apes: a geometric morphometric analysis of covariation.

    Directory of Open Access Journals (Sweden)

    Dimitri Neaux

    Full Text Available The organization of the bony face is complex, its morphology being influenced in part by the rest of the cranium. Characterizing the facial morphological variation and craniofacial covariation patterns in extant hominids is fundamental to the understanding of their evolutionary history. Numerous studies on hominid facial shape have proposed hypotheses concerning the relationship between the anterior facial shape, facial block orientation and basicranial flexion. In this study we test these hypotheses in a sample of adult specimens belonging to three extant hominid genera (Homo, Pan and Gorilla. Intraspecific variation and covariation patterns are analyzed using geometric morphometric methods and multivariate statistics, such as partial least squared on three-dimensional landmarks coordinates. Our results indicate significant intraspecific covariation between facial shape, facial block orientation and basicranial flexion. Hominids share similar characteristics in the relationship between anterior facial shape and facial block orientation. Modern humans exhibit a specific pattern in the covariation between anterior facial shape and basicranial flexion. This peculiar feature underscores the role of modern humans' highly-flexed basicranium in the overall integration of the cranium. Furthermore, our results are consistent with the hypothesis of a relationship between the reduction of the value of the cranial base angle and a downward rotation of the facial block in modern humans, and to a lesser extent in chimpanzees.

  7. Peripheral facial nerve paralysis after upper third molar extraction.

    Science.gov (United States)

    Cakarer, Sirmahan; Can, Taylan; Cankaya, Burak; Erdem, Mehmet Ali; Yazici, Sinem; Ayintap, Emre; Özden, Ali Veysel; Keskin, Cengizhan

    2010-11-01

    Peripheral facial nerve paralysis (PFNP) after mandibular interventions has been reported in the literature. In most cases, paralysis begins immediately after the injection of the mandibular anesthesia, and duration of facial weakness is less than 12 hours. However, there are few documented cases of PFNP after maxillary dental or surgical procedures. A variety of mechanisms have been associated to PFNP, including viral reactivation, demyelination, edema, vasospasm, and trauma. The purpose of this presentation was to report a rare case of facial paralysis that occurred after an upper third molar extraction. The cause of the PFNP and the importance of the multidisciplinary approach in the management are emphasized.

  8. Application of Shape Memory Alloys in Facial Nerve Paralysis

    Directory of Open Access Journals (Sweden)

    M Vloeberghs

    2009-11-01

    Full Text Available The Facial Nerve can be damaged at a peripheral level by a stroke or, for example by trauma or infection within the faceor the ear. In these cases the facial muscles are paralysed with little or no chance of spontaneous recovery. This research focuses on the potential utilisation of a Shape Memory Alloy(SMA to replace the function of the Facial Nerve, which willallow in conjunction with passive reconstructive methods, a patient to regain limited but active movement of the mouthcorner. Paralysis of the mouth corner is a very disabling bothfunctionally and cosmetically, speech and swallowing are hampered and the patient loses saliva, with presents a social problem.

  9. A review of facial nerve anatomy.

    Science.gov (United States)

    Myckatyn, Terence M; Mackinnon, Susan E

    2004-02-01

    An intimate knowledge of facial nerve anatomy is critical to avoid its inadvertent injury during rhytidectomy, parotidectomy, maxillofacial fracture reduction, and almost any surgery of the head and neck. Injury to the frontal and marginal mandibular branches of the facial nerve in particular can lead to obvious clinical deficits, and areas where these nerves are particularly susceptible to injury have been designated danger zones by previous authors. Assessment of facial nerve function is not limited to its extratemporal anatomy, however, as many clinical deficits originate within its intratemporal and intracranial components. Similarly, the facial nerve cannot be considered an exclusively motor nerve given its contributions to taste, auricular sensation, sympathetic input to the middle meningeal artery, and parasympathetic innervation to the lacrimal, submandibular, and sublingual glands. The constellation of deficits resulting from facial nerve injury is correlated with its complex anatomy to help establish the level of injury, predict recovery, and guide surgical management.

  10. Facial Injuries and Disorders

    Science.gov (United States)

    Face injuries and disorders can cause pain and affect how you look. In severe cases, they can affect sight, ... your nose, cheekbone and jaw, are common facial injuries. Certain diseases also lead to facial disorders. For ...

  11. Fast Facial Detection by Depth Map Analysis

    Directory of Open Access Journals (Sweden)

    Ming-Yuan Shieh

    2013-01-01

    Full Text Available In order to obtain correct facial recognition results, one needs to adopt appropriate facial detection techniques. Moreover, the effects of facial detection are usually affected by the environmental conditions such as background, illumination, and complexity of objectives. In this paper, the proposed facial detection scheme, which is based on depth map analysis, aims to improve the effectiveness of facial detection and recognition under different environmental illumination conditions. The proposed procedures consist of scene depth determination, outline analysis, Haar-like classification, and related image processing operations. Since infrared light sources can be used to increase dark visibility, the active infrared visual images captured by a structured light sensory device such as Kinect will be less influenced by environmental lights. It benefits the accuracy of the facial detection. Therefore, the proposed system will detect the objective human and face firstly and obtain the relative position by structured light analysis. Next, the face can be determined by image processing operations. From the experimental results, it demonstrates that the proposed scheme not only improves facial detection under varying light conditions but also benefits facial recognition.

  12. Application of local flap in emergent reconstruction of the skin and soft tissue defects after facial trauma%局部皮瓣在面部创伤性皮肤软组织缺损急诊修复中的应用

    Institute of Scientific and Technical Information of China (English)

    何小川; 胡纯兵; 周滨; 刘震; 高志丹; 吴国平; 郭力

    2012-01-01

    Objective To explore the procedures of reconstruction emergency for skin and soft tisue defects due to trauma with local flap based on plastic surgical principles and techniques.Methods Thirty-two patients with facial defects caused by tramua were treated.After strict debridement of the wound of the skin and soft tissue,the flaps were designed according to the wound condition with plastic surgical principles.Subcutaneous SMAS pedicle flap,V-Y advancement flap,orbicularis flap,nasolabial groove flaps and others were chosen for wound repair,to suture and close the wound meticu lously.Results All of 32 treated cases,the wounds were primary healing.After 6-18 months follow-up,there was no obvious scar formation or functional problems.Second stage reconstruction was not needed since the cosmetic effect was perfect.Conclusions It is a satisfactory and effective method to emergently treat the skin and soft tissue defects after facial trauma with local flap based on the plastic surgical principles,which is well worth popularizing in clinic.%目的 探索依据整形外科原则应用局部皮瓣急诊修复面部创伤性软组织缺损的效果.方法 对32例面部皮肤软组织即时性创伤性缺损,于严格清创后,根据创面缺损情况,按整形外科原则分别设计皮下浅表肌腱膜系统(SMAS)蒂皮瓣、V-Y推进皮瓣、眼轮匝肌蒂岛状皮瓣、鼻唇沟皮瓣等修复创面,精细缝合关闭伤口.结果 32例伤口均Ⅰ期愈合,随访6~18个月,无明显瘢痕增生,无功能障碍,无需Ⅱ期修复,美容效果良好.结论 遵照整形外科基本原则采用局部皮瓣修复面部创伤性皮肤软组织缺损,可获得满意的效果,值得临床推广应用.

  13. A lethal syndrome resembling branchio-oculo-facial syndrome.

    Science.gov (United States)

    Hing, A V; Torack, R; Dowton, S B

    1992-02-01

    Branchio-oculo-facial syndrome, a recently delineated autosomal dominant condition, is characterized by branchial cleft sinuses, ocular anomalies, and unusual facial appearance. A patient with branchial cleft fistulae, microphthalmia, nasomaxillary dysplasia, in addition to cardiac and CNS malformation (holoprosencephaly and meningo-encephalocele), is described. Although many features of this lethal malformation complex resemble those seen in the branchio-oculo-facial syndrome, the complex may represent a new multiple malformation syndrome.

  14. Risk factors associated with facial fractures

    Directory of Open Access Journals (Sweden)

    Anne Margareth Batista

    2012-04-01

    Full Text Available The aim of the present study was to identify risk factors for facial fractures in patients treated in the emergency department of a hospital. The medical charts of 1121 patients treated in an emergency ward over a three-year period were analyzed. The independent variables were gender, age, place of residence (urban or rural area and type of accident. The dependent variables were fractured mandible, zygoma, maxilla, nasal bone and more than one fractured facial bone. Statistical analysis was performed using the chi-square test (a < 0.05, univariate and multivariate Poisson distributions and the logistic regression analysis (p < 0.20. Maxillofacial trauma was recorded in 790 charts (70.5%, with 393 (35.1% charts reporting facial fractures. Motorcycle accidents were found to be the main risk factor for mandibular fractures (PR = 1.576, CI = 1.402-1.772 and simultaneous fractures of more than one facial bone (OR = 4.625, CI = 1.888-11.329 as well as the only risk factor for maxillary bone fractures (OR = 11.032, CI = 5.294-22.989. Fractures of the zygomatic and nasal bones were mainly associated with accidents involving animals (PR = 1.206, CI = 1.104-1.317 and sports (OR = 8.710, CI = 4.006-18.936, respectively. The determinant for the majority of facial fractures was motorcycle accidents, followed by accidents involving animals and sports.

  15. Imaging of the midfacial and orbital trauma.

    Science.gov (United States)

    Wikner, Johannes; Riecke, Björn; Gröbe, Alexander; Heiland, Max; Hanken, Henning

    2014-10-01

    The severity of midfacial and orbital injuries depends on the one hand on cause, force vector, load point, or area and on the other hand on the bony and soft tissue resistance as well as individual anatomy. These variables result in a variety of possible injuries of the midfacial and orbital complex. The time critical choice of an adequate imaging modality of these injuries is influenced by the possible severity of concomitant injuries. Besides the confirmation of a clinical diagnosis, the need for high-resolution three-dimensional imaging for preoperative planning of facial reconstruction using intraoperative navigation has become more and more important in the past years. To achieve optimal functional and esthetic outcomes, the anatomical complexity of the midface has to be addressed and the adequate imaging modality has to be chosen keeping the upcoming surgical treatment in mind. The current imaging modalities for midfacial and orbital trauma are presented and critically evaluated depending on the indications. Furthermore, new strategies to support surgeons in achieving best possible midfacial reconstructions are discussed. An algorithm to choose the adequate imaging modality in midfacial and orbital traumatology is provided.

  16. Facial Expression Analysis

    NARCIS (Netherlands)

    Pantic, Maja; Li, S.; Jain, A.

    2009-01-01

    Facial expression recognition is a process performed by humans or computers, which consists of: 1. Locating faces in the scene (e.g., in an image; this step is also referred to as face detection), 2. Extracting facial features from the detected face region (e.g., detecting the shape of facial compon

  17. Facial Expression Recognition

    NARCIS (Netherlands)

    Pantic, Maja; Li, S.; Jain, A.

    2009-01-01

    Facial expression recognition is a process performed by humans or computers, which consists of: 1. Locating faces in the scene (e.g., in an image; this step is also referred to as face detection), 2. Extracting facial features from the detected face region (e.g., detecting the shape of facial

  18. Facial paralysis in children.

    Science.gov (United States)

    Reddy, Sashank; Redett, Richard

    2015-04-01

    Facial paralysis can have devastating physical and psychosocial consequences. These are particularly severe in children in whom loss of emotional expressiveness can impair social development and integration. The etiologies of facial paralysis, prospects for spontaneous recovery, and functions requiring restoration differ in children as compared with adults. Here we review contemporary management of facial paralysis with a focus on special considerations for pediatric patients.

  19. Maternal mortality due to trauma.

    Science.gov (United States)

    Romero, Vivian Carolina; Pearlman, Mark

    2012-02-01

    Maternal mortality is an important indicator of adequacy of health care in our society. Improvements in the obstetric care system as well as advances in technology have contributed to reduction in maternal mortality rates. Trauma complicates up to 7% of all pregnancies and has emerged as the leading cause of maternal mortality, becoming a significant concern for the public health system. Maternal mortality secondary to trauma can often be prevented by coordinated medical care, but it is essential that caregivers recognize the unique situation of providing simultaneous care to 2 patients who have a complex physiologic relationship. Optimal management of the pregnant trauma victim requires a multidisciplinary team, where the obstetrician plays a central role. This review focuses on the incidence of maternal mortality due to trauma, the mechanisms involved in traumatic injury, the important anatomic and physiologic changes that may predispose to mortality due to trauma, and finally, preventive strategies that may decrease the incidence of traumatic maternal death.

  20. A small-world network model of facial emotion recognition.

    Science.gov (United States)

    Takehara, Takuma; Ochiai, Fumio; Suzuki, Naoto

    2016-01-01

    Various models have been proposed to increase understanding of the cognitive basis of facial emotions. Despite those efforts, interactions between facial emotions have received minimal attention. If collective behaviours relating to each facial emotion in the comprehensive cognitive system could be assumed, specific facial emotion relationship patterns might emerge. In this study, we demonstrate that the frameworks of complex networks can effectively capture those patterns. We generate 81 facial emotion images (6 prototypes and 75 morphs) and then ask participants to rate degrees of similarity in 3240 facial emotion pairs in a paired comparison task. A facial emotion network constructed on the basis of similarity clearly forms a small-world network, which features an extremely short average network distance and close connectivity. Further, even if two facial emotions have opposing valences, they are connected within only two steps. In addition, we show that intermediary morphs are crucial for maintaining full network integration, whereas prototypes are not at all important. These results suggest the existence of collective behaviours in the cognitive systems of facial emotions and also describe why people can efficiently recognize facial emotions in terms of information transmission and propagation. For comparison, we construct three simulated networks--one based on the categorical model, one based on the dimensional model, and one random network. The results reveal that small-world connectivity in facial emotion networks is apparently different from those networks, suggesting that a small-world network is the most suitable model for capturing the cognitive basis of facial emotions.

  1. MAXILLOFACIAL TRAUMA MANAGEMENT IN POLYTRAUMATIZED PATIENTS – THE USE OF ADVANCED TRAUMA LIFE SUPPORT (ATLS PRINCIPLES.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-03-01

    Full Text Available Management of the multiply injured patient requires a co-ordinated multi-disciplinary approach in order to optimise patients’ outcome. A working knowledge of the sort of problems these patients encounter is therefore vital to ensure that life-threatening injuries are recognised and treated in a timely pattern and that more minor associated injuries are not omitted. This article outlines the management of polytraumatized patients using the Advanced Trauma Life Support (ATLS principles and highlights the areas of specific involvement of the engaged medical team. Advanced Trauma Life Support is generally regarded as the gold standard and is founded on a number of well known principles, but strict adherence to protocols may have its drawbacks when facial trauma co-exists. These can arise in the presence of either major or minor facial injuries, and oral and maxillofacial surgeons need to be aware of the potential problems.

  2. Update on the management of dentoalveolar trauma.

    Science.gov (United States)

    MacLeod, Stephen P R; Rudd, Travis C

    2012-08-01

    Dentoalveolar injuries are the most common type of facial injury and are often associated with concomitant facial fractures. These injuries may initially be seen by surgeons who do not have formal dental training. This article reviews the assessment and management of dentoalveolar fractures. Semi-flexible splinting of traumatized teeth for shorter periods of time than previously suggested is associated with better long-term outcomes. The use of dental implants to replace teeth lost to trauma is a predictable restorative option. Surgeons need to be aware that dentoalveolar injuries may be a marker for other injuries. Prompt relocation and splinting of displaced teeth is associated with better outcomes.

  3. Ballistic trauma

    Directory of Open Access Journals (Sweden)

    Parvathi Devi Munishwar

    2016-01-01

    Full Text Available Gunshot injuries are rather serious but uncommon type of trauma in India. Radiologists can contribute substantially in the evaluation and treatment of patients with gunshot wounds. Foreign bodies that enter a patient as a result of trauma are contaminated and produce a range of symptoms. Oral and maxillofacial gunshot injuries are usually fatal due to close proximity with vital structures. Here, we report a case in which radiographic evidence of foreign bodies in the right orofacial region exposed a history of a gunshot injury. The patient did not have any major complaints except for reduced mouth opening. These foreign bodies were clinically silent for approximately 12 years.

  4. Single-stage dynamic reanimation of the smile in irreversible facial paralysis by free functional muscle transfer.

    Science.gov (United States)

    Thiele, Jan; Bannasch, Holger; Stark, G Bjoern; Eisenhardt, Steffen U

    2015-03-01

    Unilateral facial paralysis is a common disease that is associated with significant functional, aesthetic and psychological issues. Though idiopathic facial paralysis (Bell's palsy) is the most common diagnosis, patients can also present with a history of physical trauma, infectious disease, tumor, or iatrogenic facial paralysis. Early repair within one year of injury can be achieved by direct nerve repair, cross-face nerve grafting or regional nerve transfer. It is due to muscle atrophy that in long lasting facial paralysis complex reconstructive methods have to be applied. Instead of one single procedure, different surgical approaches have to be considered to alleviate the various components of the paralysis. The reconstruction of a spontaneous dynamic smile with a symmetric resting tone is a crucial factor to overcome the functional deficits and the social handicap that are associated with facial paralysis. Although numerous surgical techniques have been described, a two-stage approach with an initial cross-facial nerve grafting followed by a free functional muscle transfer is most frequently applied. In selected patients however, a single-stage reconstruction using the motor nerve to the masseter as donor nerve is superior to a two-stage repair. The gracilis muscle is most commonly used for reconstruction, as it presents with a constant anatomy, a simple dissection and minimal donor site morbidity. Here we demonstrate the pre-operative work-up, the post-operative management, and precisely describe the surgical procedure of single-stage microsurgical reconstruction of the smile by free functional gracilis muscle transfer in a step by step protocol. We further illustrate common pitfalls and provide useful tips which should enable the reader to truly comprehend the procedure. We further discuss indications and limitations of the technique and demonstrate representative results.

  5. Trauma no idoso Trauma in the elderly

    Directory of Open Access Journals (Sweden)

    JOSÉ ANTONIO GOMES DE SOUZA

    2002-03-01

    Full Text Available O crescimento populacional de idosos, associado a uma forma de vida mais saudável e mais ativa, deixa este grupo de pessoas mais exposto ao risco de acidentes. Em alguns países, o trauma do idoso responde por uma elevada taxa de mortalidade, a qual se apresenta de forma desproporcionalmente maior do que a observada entre a população de adultos jovens. Tal fato acarreta um grande consumo de recursos financeiros destinados à assistência da saúde e um elevado custo social. As características fisiológicas próprias do idoso, assim como a presença freqüente de doenças associadas, faz com que estes pacientes se comportem diferentemente e de forma mais complexa do que os demais grupos etários. Estas particularidades fazem com que o atendimento ao idoso vítima de trauma se faça de forma diferenciada. A presente revisão aborda aspectos da epidemiologia, da prevenção, da fisiologia, do atendimento e da reabilitação do idoso vítima de trauma.The populational growth of the elderly, associated to a healthier and more active life, make this group of people more exposed to accidents. In some countries, trauma in the elderly is responsible for a high mortality rate, desproportionately higher than in the adults. This fact consumes a great portion of health care resources and implies in a high social cost. The distinct physiologic characteristics of the elderly and the frequent presence of associated diseases make that these patients behave diferently and in a more complex way than patients of other ages. These particularities make that health care to the elderly victims of trauma have to be different. The present revision is about aspects of epidemiology, prevention, physiology, health care and reabilitation of the elderly victims of trauma.

  6. CT and MR imaging of the normal and pathologic conditions of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Jaeger, Lorenz E-mail: jaeger@ikra.med.uni-muenchen.de; Reiser, Maximilian

    2001-11-01

    Computed tomography (CT) and magnetic resonance imaging (MRI) are well established imaging modalities to examine the facial nerve as well as the course of the facial nerve itself. High spatial resolution is guaranteed not only in the x- and y-axis, but also in the z-axis using multislice spiral CT. With this technique, reformatted multiplanar images in oblique planes, avoiding additional examinations in the coronal plane, facilitate the delineation of the facial nerve canal. This is beneficial in patients with temporal bone trauma, malformation or osseous changes. MR has a superior soft-tissue contrast to CT that enables imaging of the facial nerve itself. Therefore the normal facial nerve as well as pathologic changes of the facial nerve is readily visualized from the brain stem to the parotid gland. This review article presents anatomy, pathology and imaging strategies in the diagnostics of the facial nerve.

  7. Management of facial soft tissue injuries in children.

    Science.gov (United States)

    Vasconez, Henry C; Buseman, Jason L; Cunningham, Larry L

    2011-07-01

    Pediatric facial trauma can present a challenge to even the more experienced plastic surgeon. Injuries to the head and neck may involve bone and soft tissues with an assortment of specialized organs and tissue elements involved. Because of the active nature of children, facial soft tissue injuries can be diverse and extensive as well as some of the more common injuries a plastic surgeon is asked to treat. In 2007, approximately 800,000 patients younger than 15 years presented to emergency departments around the country with significant open wounds of the head that required treatment.In this review, we present the different types and regions of pediatric soft tissue facial trauma, as well as treatment options and goals of plastic surgery wound management. Special aspects, such as bite wounds, burns, pediatric analgesia, and antibiotic therapy, are also discussed.

  8. Trauma pattern in a level I east-European trauma center

    Directory of Open Access Journals (Sweden)

    Bogdan Stoica

    2015-10-01

    Conclusions: Our trauma pattern profile is similar to the one found in west-European countries, with a predominance of traffic-related injuries and falls. The severity and anatomical puzzle for trauma lesions were more complex secondary to motorcycle or bicycle-to-auto vehicles collisions. A trauma registry, with prospective enrollment of patients, is a very effective tool for constant improvements in trauma care.

  9. Trauma Theory

    DEFF Research Database (Denmark)

    Pedersen, Bodil Maria

    There are two main trends in psychological approaches to human suffering related to what we term trauma. Although they have their respective limitations both approaches may help us explore and alleviate human suffering. One trend, primarily using concepts like traumatic events and traumatisation...

  10. Trauma Ultrasound.

    Science.gov (United States)

    Wongwaisayawan, Sirote; Suwannanon, Ruedeekorn; Prachanukool, Thidathit; Sricharoen, Pungkava; Saksobhavivat, Nitima; Kaewlai, Rathachai

    2015-10-01

    Ultrasound plays a pivotal role in the evaluation of acute trauma patients through the use of multi-site scanning encompassing abdominal, cardiothoracic, vascular and skeletal scans. In a high-speed polytrauma setting, because exsanguinations are the primary cause of trauma morbidity and mortality, ultrasound is used for quick and accurate detection of hemorrhages in the pericardial, pleural, and peritoneal cavities during the primary Advanced Trauma Life Support (ATLS) survey. Volume status can be assessed non-invasively with ultrasound of the inferior vena cava (IVC), which is a useful tool in the initial phase and follow-up evaluations. Pneumothorax can also be quickly detected with ultrasound. During the secondary survey and in patients sustaining low-speed or localized trauma, ultrasound can be used to help detect abdominal organ injuries. This is particularly helpful in patients in whom hemoperitoneum is not identified on an initial scan because findings of organ injuries will expedite the next test, often computed tomography (CT). Moreover, ultrasound can assist in detection of fractures easily obscured on radiography, such as rib and sternal fractures.

  11. Delayed presentation of traumatic facial nerve (CN VII) paralysis.

    Science.gov (United States)

    Napoli, Anthony M; Panagos, Peter

    2005-11-01

    Facial nerve paralysis (Cranial Nerve VII, CN VII) can be a disfiguring disorder with profound impact upon the patient. The etiology of facial nerve paralysis may be congenital, iatrogenic, or result from neoplasm, infection, trauma, or toxic exposure. In the emergency department, the most common cause of unilateral facial paralysis is Bell's palsy, also known as idiopathic facial paralysis (IFP). We report a case of delayed presentation of unilateral facial nerve paralysis 3 days after sustaining a traumatic head injury. Re-evaluation and imaging of this patient revealed a full facial paralysis and temporal bone fracture extending into the facial canal. Because cranial nerve injuries occur in approximately 5-10% of head-injured patients, a good history and physical examination is important to differentiate IFP from another etiology. Newer generation high-resolution computed tomography (CT) scans are commonly demonstrating these fractures. An understanding of this complication, appropriate patient follow-up, and early involvement of the Otolaryngologist is important in management of these patients. The mechanism as well as the timing of facial nerve paralysis will determine the proper evaluation, consultation, and management for the patient. Patients with total or immediate paralysis as well as those with poorly prognostic audiogram results are good candidates for surgical repair.

  12. Analysis of Facial Injuries Caused by Power Tools.

    Science.gov (United States)

    Kim, Jiye; Choi, Jin-Hee; Hyun Kim, Oh; Won Kim, Sug

    2016-06-01

    The number of injuries caused by power tools is steadily increasing as more domestic woodwork is undertaken and more power tools are used recreationally. The injuries caused by the different power tools as a consequence of accidents are an issue, because they can lead to substantial costs for patients and the national insurance system. The increase in hand surgery as a consequence of the use of power tools and its economic impact, and the characteristics of the hand injuries caused by power saws have been described. In recent years, the authors have noticed that, in addition to hand injuries, facial injuries caused by power tools commonly present to the emergency room. This study aimed to review the data in relation to facial injuries caused by power saws that were gathered from patients who visited the trauma center at our hospital over the last 4 years, and to analyze the incidence and epidemiology of the facial injuries caused by power saws. The authors found that facial injuries caused by power tools have risen continually. Facial injuries caused by power tools are accidental, and they cause permanent facial disfigurements and functional disabilities. Accidents are almost inevitable in particular workplaces; however, most facial injuries could be avoided by providing sufficient operator training and by tool operators wearing suitable protective devices. The evaluation of the epidemiology and patterns of facial injuries caused by power tools in this study should provide the information required to reduce the number of accidental injuries.

  13. Are trauma patients better off in a trauma ICU?

    Directory of Open Access Journals (Sweden)

    Duane Therese

    2008-01-01

    Full Text Available There is very little data on the value of specialized intensive care unit (ICU care in the literature. To determine if specialize ICU care for the trauma patient improved outcomes in this patient population. Level I Trauma Center Compared outcomes of trauma patients treated in a surgical trauma ICU (STICU to those treated in non- trauma ICUs (non-STICU. Retrospective review of trauma registry data. Statistical Analysis: Wilcoxon Rank Test , Fischer′s Exact test, logistic regression. There were 1146 STICU patients compared to 1475 non-STICU. In all ISS groups there were more penetrating trauma patients in the STICU (32.54% STICU vs. 18.15% non-STICU, P < 0.0001 (ISS< 15, (21.03% STICU vs. 12.98% non-STICU, P =0.0074 (ISS between 15-25, and (19.42% STICU vs. 11.35% non-STICU, P =0.0026 (ISS> 25. All groups had similar lengths of stay. The blunt trauma patients were sicker in the STICU (20.8 ISS ± 12.2 STICU vs. 19.7 ISS ± 11.9 non-STICU, P =0.03 yet had similar outcomes to the non-STICU group. Logistic regression identified penetrating trauma and not ICU location as a predictor of mortality. Sicker STICU patients do as well as less injured non-STICU patients. Severely injured patients should be preferentially treated in a STICU where they are better equipped to care for the complex multi-trauma patient. All patients, regardless of location, do well when their management is guided by a surgical critical care team.

  14. Topical management of facial burns.

    Science.gov (United States)

    Leon-Villapalos, Jorge; Jeschke, Marc G; Herndon, David N

    2008-11-01

    The face is the central point of the physical features of the human being. It transmits expressions and emotions, communicates feelings and allows for individual identity. It contains complex musculature and a pliable and unique skin envelope that reacts to the environment through a vast network of nerve endings. The face hosts vital areas that make phonation, feeding, and vision possible. Facial burns disrupt these anatomical and functional structures creating pain, deformity, swelling, and contractures that may lead to lasting physical and psychological sequelae. The management of facial burns may include operative and non-operative treatment or both, depending on the depth and extent of the burn. This paper intends to provide a review of the available options for topical management of facial burns. Topical agents will be defined as any agent applied to the surface of the skin that alters the outcome of the facial burn. Therefore, the classic concept of topical therapy will be expanded and developed within two major stages: acute and rehabilitation. Comparison of the effectiveness of the different treatments and relevant literature will be discussed.

  15. A systematic comprehensive approach to management of irreversible facial paralysis.

    Science.gov (United States)

    Douglas, Raymond S; Gausas, Roberta E

    2003-02-01

    Irreversible facial palsy (IFP) presents a multitude of problems arising from a paretic periorbital and facial complex, the solutions to which cross the spectrum of multiple specialties. The process of facial rehabilitation can be simplified by subdividing the face into functional units. These units consist of the brow complex, the periorbital complex, the midface complex, and the lower face/oral complex. Although all of these units are interrelated and influence each other, careful study of the deformity and symptoms of each unit yields a coherent approach and customized surgical plan. The following provides a complete evaluation method for the surgeon to review and customize an approach to the individual patient's needs and desires. Facial rehabilitation must be tailored to each individual, addressing both functional as well as aesthetic concerns for each facial unit.

  16. Soft tissue trauma and scar revision.

    Science.gov (United States)

    Mobley, Steven R; Sjogren, Phayvanh P

    2014-11-01

    Numerous techniques and treatments have been described for scar revision, with most studies focusing on the adult population. A comprehensive review of the literature reveals a paucity of references related specifically to scar revision in children. This review describes the available modalities in pediatric facial scar revision. The authors have integrated current practices in soft tissue trauma and scar revision, including closure techniques and materials, topical therapy, steroid injection, cutaneous laser therapy, and tissue expanders.

  17. Cerebrovascular trauma

    Energy Technology Data Exchange (ETDEWEB)

    Krings, Timo [Hopital de Bicetre, Service de Neuroradiologie Diagnostique et Therapeutique, Paris (France); University Hospital Aachen, Department of Neuroradiology, Aachen (Germany); University Hospital, University of Technology, Aachen (DE), Departments of Neuroradiology and Neurosurgery, Aachen (Germany); Univ. of Technology, Aachen (Germany) Dept. of Neurosurgery; Geibprasert, Sasikhan [Hopital de Bicetre, Service de Neuroradiologie Diagnostique et Therapeutique, Paris (France); Ramathibodi Hospital Bangkok, Department of Radiology, Bangkok (Thailand); Lasjaunias, Pierre L. [Hopital de Bicetre, Service de Neuroradiologie Diagnostique et Therapeutique, Paris (France)

    2008-08-15

    Vascular injury of the head and neck region is a rare and often life-threatening complication of head or neck trauma and is due to two major pathomechanisms: penetrating or blunt trauma. Both the arterial and the venous site of the CNS vasculature can be involved, the latter one being often overlooked. Concerning arterial lesions, depending on how many layers of the arterial vessel are affected and on the spatial relationship to adjacent structures, dissections, false aneurysms or arteriovenous fistulae may develop. On the venous side, dural tears, compressive effects on pial veins and a deranged clotting system may lead to delayed venous thrombosis. In this review we describe clinical and imaging findings, as well as diagnostic and treatment strategies in these lesions. (orig.)

  18. Contemporary facial reanimation.

    Science.gov (United States)

    Bhama, Prabhat K; Hadlock, Tessa A

    2014-04-01

    The facial nerve is the most commonly paralyzed nerve in the human body. Facial paralysis affects aesthetic appearance, and it has a profound effect on function and quality of life. Management of patients with facial paralysis requires a multidisciplinary approach, including otolaryngologists, plastic surgeons, ophthalmologists, and physical therapists. Regardless of etiology, patients with facial paralysis should be evaluated systematically, with initial efforts focused upon establishing proper diagnosis. Management should proceed with attention to facial zones, including the brow and periocular region, the midface and oral commissure, the lower lip and chin, and the neck. To effectively compare contemporary facial reanimation strategies, it is essential to employ objective intake assessment methods, and standard reassessment schemas during the entire management period.

  19. Facial Reconstruction and Rehabilitation.

    Science.gov (United States)

    Guntinas-Lichius, Orlando; Genther, Dane J; Byrne, Patrick J

    2016-01-01

    Extracranial infiltration of the facial nerve by salivary gland tumors is the most frequent cause of facial palsy secondary to malignancy. Nevertheless, facial palsy related to salivary gland cancer is uncommon. Therefore, reconstructive facial reanimation surgery is not a routine undertaking for most head and neck surgeons. The primary aims of facial reanimation are to restore tone, symmetry, and movement to the paralyzed face. Such restoration should improve the patient's objective motor function and subjective quality of life. The surgical procedures for facial reanimation rely heavily on long-established techniques, but many advances and improvements have been made in recent years. In the past, published experiences on strategies for optimizing functional outcomes in facial paralysis patients were primarily based on small case series and described a wide variety of surgical techniques. However, in the recent years, larger series have been published from high-volume centers with significant and specialized experience in surgical and nonsurgical reanimation of the paralyzed face that have informed modern treatment. This chapter reviews the most important diagnostic methods used for the evaluation of facial paralysis to optimize the planning of each individual's treatment and discusses surgical and nonsurgical techniques for facial rehabilitation based on the contemporary literature.

  20. [Facial tics and spasms].

    Science.gov (United States)

    Potgieser, Adriaan R E; van Dijk, J Marc C; Elting, Jan Willem J; de Koning-Tijssen, Marina A J

    2014-01-01

    Facial tics and spasms are socially incapacitating, but effective treatment is often available. The clinical picture is sufficient for distinguishing between the different diseases that cause this affliction.We describe three cases of patients with facial tics or spasms: one case of tics, which are familiar to many physicians; one case of blepharospasms; and one case of hemifacial spasms. We discuss the differential diagnosis and the treatment possibilities for facial tics and spasms. Early diagnosis and treatment is important, because of the associated social incapacitation. Botulin toxin should be considered as a treatment option for facial tics and a curative neurosurgical intervention should be considered for hemifacial spasms.

  1. Recurring Facial Erythema in an Infant

    Directory of Open Access Journals (Sweden)

    Sam Hassan

    2016-01-01

    Full Text Available Causes of facial rashes and erythema in infants are many but rarely only happen during feeding times which are commonly and sometimes wrongly attributed to food allergy. There is a rare condition called Auriculotemporal nerve syndrome that is characterized by recurrent episodes of gustatory facial flushing and sweating along the cutaneous distribution of Auriculotemporal nerve: the so-called Frey syndrome. This condition is most frequently observed in adults usually after parotid surgery. It is rare in children and is mostly attributed to forceps assisted delivery. It can also be misinterpreted as food allergy. Here we report a case of an infant with Frey syndrome without any history of perinatal trauma, which was considered initially as food allergy and highlights the importance of distinguishing it from food allergy.

  2. History of facial pain diagnosis

    DEFF Research Database (Denmark)

    Zakrzewska, Joanna M; Jensen, Troels S

    2017-01-01

    Premise Facial pain refers to a heterogeneous group of clinically and etiologically different conditions with the common clinical feature of pain in the facial area. Among these conditions, trigeminal neuralgia (TN), persistent idiopathic facial pain, temporomandibular joint pain, and trigeminal...

  3. Impact of Sexual Trauma on HIV Care Engagement: Perspectives of Female Patients with Trauma Histories in Cape Town, South Africa.

    Science.gov (United States)

    Watt, Melissa H; Dennis, Alexis C; Choi, Karmel W; Ciya, Nonceba; Joska, John A; Robertson, Corne; Sikkema, Kathleen J

    2016-11-19

    South African women have disproportionately high rates of both sexual trauma and HIV. To understand how sexual trauma impacts HIV care engagement, we conducted in-depth qualitative interviews with 15 HIV-infected women with sexual trauma histories, recruited from a public clinic in Cape Town. Interviews explored trauma narratives, coping behaviors and care engagement, and transcripts were analyzed using a constant comparison method. Participants reported multiple and complex traumas across their lifetimes. Sexual trauma hindered HIV care engagement, especially immediately following HIV diagnosis, and there were indications that sexual trauma may interfere with future care engagement, via traumatic stress symptoms including avoidance. Disclosure of sexual trauma was limited; no women had disclosed to an HIV provider. Routine screening for sexual trauma in HIV care settings may help to identify individuals at risk of poor care engagement. Efficacious treatments are needed to address the psychological and behavioral sequelae of trauma.

  4. The MPI facial expression database--a validated database of emotional and conversational facial expressions.

    Directory of Open Access Journals (Sweden)

    Kathrin Kaulard

    Full Text Available The ability to communicate is one of the core aspects of human life. For this, we use not only verbal but also nonverbal signals of remarkable complexity. Among the latter, facial expressions belong to the most important information channels. Despite the large variety of facial expressions we use in daily life, research on facial expressions has so far mostly focused on the emotional aspect. Consequently, most databases of facial expressions available to the research community also include only emotional expressions, neglecting the largely unexplored aspect of conversational expressions. To fill this gap, we present the MPI facial expression database, which contains a large variety of natural emotional and conversational expressions. The database contains 55 different facial expressions performed by 19 German participants. Expressions were elicited with the help of a method-acting protocol, which guarantees both well-defined and natural facial expressions. The method-acting protocol was based on every-day scenarios, which are used to define the necessary context information for each expression. All facial expressions are available in three repetitions, in two intensities, as well as from three different camera angles. A detailed frame annotation is provided, from which a dynamic and a static version of the database have been created. In addition to describing the database in detail, we also present the results of an experiment with two conditions that serve to validate the context scenarios as well as the naturalness and recognizability of the video sequences. Our results provide clear evidence that conversational expressions can be recognized surprisingly well from visual information alone. The MPI facial expression database will enable researchers from different research fields (including the perceptual and cognitive sciences, but also affective computing, as well as computer vision to investigate the processing of a wider range of natural

  5. Trauma Theory

    DEFF Research Database (Denmark)

    Pedersen, Bodil Maria

    There are two main trends in psychological approaches to human suffering related to what we term trauma. Although they have their respective limitations both approaches may help us explore and alleviate human suffering. One trend, primarily using concepts like traumatic events and traumatisation...... and situated meanings and practices related to suffering and resilience connected to ‘traumatic’ events. This presentation is based on a large qualitative research project. Inspired by this study it will explore the possibilities of developing the theoretical understanding of personal meanings of violent and...

  6. A family with a complex clinical presentation characterized by arrhythmogenic right ventricular dysplasia/cardiomyopathy and features of branchio-oculo-facial syndrome.

    Science.gov (United States)

    Murray, Brittney; Wagle, Rohan; Amat-Alarcon, Nuria; Wilkens, Alisha; Stephens, Paul; Zackai, Elaine H; Goldmuntz, Elizabeth; Calkins, Hugh; Deardorff, Matthew A; Judge, Daniel P

    2013-02-01

    Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a familial form of cardiomyopathy typically caused by mutations in genes that encode an element of the cardiac desmosome. Branchio-oculo-facial syndrome (BOFS) is a craniofacial disorder caused by TFAP2A mutations. In a family segregating ARVD/C, some members also had features of BOFS. Genetic testing for ARVD/C identified a mutation in PKP2, encoding plakophilin-2, a component of the cardiac desmosome. Evaluation of dysmorphology by chromosome microarray (CMA) identified a 4.4 Mb deletion at chromosome 6p24 that included both TFAP2A and DSP, encoding desmoplakin, an additional component of the cardiac desmosome implicated in ARVD/C. A family member with both the 6p24 deletion and PKP2 mutation had more severe cardiac dysfunction. These findings suggest that this contiguous gene deletion contributes to both ARVD/C and BOFS, and that DSP haploinsufficiency may contribute to cardiomyopathy. This family provides a clinical example that underscores the need for careful evaluation in clinical scenarios where genetic heterogeneity is known to exist. Finally, it suggests that individuals with unexplained cardiomyopathy and dysmorphic facial features may benefit from CMA analysis.

  7. Facial expression and sarcasm.

    Science.gov (United States)

    Rockwell, P

    2001-08-01

    This study examined facial expression in the presentation of sarcasm. 60 responses (sarcastic responses = 30, nonsarcastic responses = 30) from 40 different speakers were coded by two trained coders. Expressions in three facial areas--eyebrow, eyes, and mouth--were evaluated. Only movement in the mouth area significantly differentiated ratings of sarcasm from nonsarcasm.

  8. Holistic facial expression classification

    Science.gov (United States)

    Ghent, John; McDonald, J.

    2005-06-01

    This paper details a procedure for classifying facial expressions. This is a growing and relatively new type of problem within computer vision. One of the fundamental problems when classifying facial expressions in previous approaches is the lack of a consistent method of measuring expression. This paper solves this problem by the computation of the Facial Expression Shape Model (FESM). This statistical model of facial expression is based on an anatomical analysis of facial expression called the Facial Action Coding System (FACS). We use the term Action Unit (AU) to describe a movement of one or more muscles of the face and all expressions can be described using the AU's described by FACS. The shape model is calculated by marking the face with 122 landmark points. We use Principal Component Analysis (PCA) to analyse how the landmark points move with respect to each other and to lower the dimensionality of the problem. Using the FESM in conjunction with Support Vector Machines (SVM) we classify facial expressions. SVMs are a powerful machine learning technique based on optimisation theory. This project is largely concerned with statistical models, machine learning techniques and psychological tools used in the classification of facial expression. This holistic approach to expression classification provides a means for a level of interaction with a computer that is a significant step forward in human-computer interaction.

  9. Facial talon cusps.

    LENUS (Irish Health Repository)

    McNamara, T

    1997-12-01

    This is a report of two patients with isolated facial talon cusps. One occurred on a permanent mandibular central incisor; the other on a permanent maxillary canine. The locations of these talon cusps suggests that the definition of a talon cusp include teeth in addition to the incisor group and be extended to include the facial aspect of teeth.

  10. Similarities in Aegyptopithecus and Afropithecus facial morphology.

    Science.gov (United States)

    Leakey, M G; Leakey, R E; Richtsmeier, J T; Simons, E L; Walker, A C

    1991-01-01

    Recently discovered cranial fossils from the Oligocene deposits of the Fayum depression in Egypt provide many details of the facial morphology of Aegyptopithecus zeuxis. Similar features are found in the Miocene hominoid Afropithecus turkanensis. Their presence is the first good evidence of a strong phenetic link between the Oligocene and Miocene hominoids of Africa. A comparison of trait lists emphasizes the similarities of the two fossil species, and leads us to conclude that the two fossil genera share many primitive facial features. In addition, we studied facial morphology using finite-element scaling analysis and found that the two genera show similarities in morphological integration, or the way in which biological landmarks relate to one another in three dimensions to define the form of the organism. Size differences between the two genera are much greater than the relatively minor shape differences. Analysis of variability in landmark location among the four Aegyptopithecus specimens indicates that variability within the sample is not different from that found within two samples of modern macaques. We propose that the shape differences found among the four Aegyptopithecus specimens simply reflect individual variation in facial characteristics, and that the similarities in facial morphology between Aegyptopithecus and Afropithecus probably represent a complex of primitive facial features retained over millions of years.

  11. Spontaneous Facial Mimicry in Response to Dynamic Facial Expressions

    Science.gov (United States)

    Sato, Wataru; Yoshikawa, Sakiko

    2007-01-01

    Based on previous neuroscientific evidence indicating activation of the mirror neuron system in response to dynamic facial actions, we hypothesized that facial mimicry would occur while subjects viewed dynamic facial expressions. To test this hypothesis, dynamic/static facial expressions of anger/happiness were presented using computer-morphing…

  12. Sound-induced facial synkinesis following facial nerve paralysis

    NARCIS (Netherlands)

    Ma, Ming-San; van der Hoeven, Johannes H.; Nicolai, Jean-Philippe A.; Meek, Marcel F.

    2009-01-01

    Facial synkinesis (or synkinesia) (FS) occurs frequently after paresis or paralysis of the facial nerve and is in most cases due to aberrant regeneration of (branches of) the facial nerve. Patients suffer from inappropriate and involuntary synchronous facial muscle contractions. Here we describe two

  13. Shape-constrained Gaussian Process Regression for Facial-point-based Head-pose Normalization

    NARCIS (Netherlands)

    Rudovic, Ognjen; Pantic, Maja

    2011-01-01

    Given the facial points extracted from an image of a face in an arbitrary pose, the goal of facial-point-based headpose normalization is to obtain the corresponding facial points in a predefined pose (e.g., frontal). This involves inference of complex and high-dimensional mappings due to the large n

  14. Live facial feature extraction

    Institute of Scientific and Technical Information of China (English)

    ZHAO JieYu

    2008-01-01

    Precise facial feature extraction is essential to the high-level face recognition and expression analysis. This paper presents a novel method for the real-time geomet-ric facial feature extraction from live video. In this paper, the input image is viewed as a weighted graph. The segmentation of the pixels corresponding to the edges of facial components of the mouth, eyes, brows, and nose is implemented by means of random walks on the weighted graph. The graph has an 8-connected lattice structure and the weight value associated with each edge reflects the likelihood that a random walker will cross that edge. The random walks simulate an anisot-ropic diffusion process that filters out the noise while preserving the facial expres-sion pixels. The seeds for the segmentation are obtained from a color and motion detector. The segmented facial pixels are represented with linked lists in the origi-nal geometric form and grouped into different parts corresponding to facial com-ponents. For the convenience of implementing high-level vision, the geometric description of facial component pixels is further decomposed into shape and reg-istration information. Shape is defined as the geometric information that is invari-ant under the registration transformation, such as translation, rotation, and iso-tropic scale. Statistical shape analysis is carried out to capture global facial fea-tures where the Procrustes shape distance measure is adopted. A Bayesian ap-proach is used to incorporate high-level prior knowledge of face structure. Ex-perimental results show that the proposed method is capable of real-time extraction of precise geometric facial features from live video. The feature extraction is robust against the illumination changes, scale variation, head rotations, and hand inter-ference.

  15. Surgeons’ and Emergency Physicians’ Perceptions of Trauma Management and Training

    Directory of Open Access Journals (Sweden)

    Hemphill, Robin R

    2009-08-01

    Full Text Available Objective: The study objective was to determine whether surgeons and emergency medicine physicians (EMPs have differing opinions on trauma residency training and trauma management in clinical practice.Methods: A survey was mailed to 250 EMPs and 250 surgeons randomly selected.Results: Fifty percent of surgeons perceived that surgery exclusively managed trauma compared to 27% of EMPs. Surgeons were more likely to feel that only surgeons should manage trauma on presentation to the ED. However, only 60% of surgeons currently felt comfortable with caring for the trauma patient, compared to 84% of EMPs. Compared to EMPs, surgeons are less likely to feel that EMPs can initially manage the trauma patient (71% of surgeons vs. 92% of EMPs.Conclusion: EMPs are comfortable managing trauma while many surgeons do not feel comfortable with the complex trauma patient although the majority of surgeons responded that surgeons should manage the trauma.[WestJEM. 2009;10:144-149.

  16. PCA facial expression recognition

    Science.gov (United States)

    El-Hori, Inas H.; El-Momen, Zahraa K.; Ganoun, Ali

    2013-12-01

    This paper explores and compares techniques for automatically recognizing facial actions in sequences of images. The comparative study of Facial Expression Recognition (FER) techniques namely Principal Component's analysis (PCA) and PCA with Gabor filters (GF) is done. The objective of this research is to show that PCA with Gabor filters is superior to the first technique in terms of recognition rate. To test and evaluates their performance, experiments are performed using real database by both techniques. The universally accepted five principal emotions to be recognized are: Happy, Sad, Disgust and Angry along with Neutral. The recognition rates are obtained on all the facial expressions.

  17. Oral and Maxillofacial Trauma and the Use of Telemedicine in the Grampian Region of Scotland: a Retrospective Study

    Directory of Open Access Journals (Sweden)

    Colin Hutchison

    2012-09-01

    Full Text Available Objectives: To evaluate the amount and nature of adult facial trauma in Aberdeen, Scotland’s third largest city, that requires referral to Aberdeen Royal Infirmary oral and maxillofacial surgery department by the Emergency Department and Grampian’s telemedicine service over a six month period.Material and Methods: A retrospective audit using oral and maxillofacial surgery trauma clinic and theatre records to identify Emergency Department (ED notes for those patients presenting with facial trauma. ED notes were examined to extract demographic data on each patient as well as information on the nature and outcomes of the facial trauma. This data was compared with previously published national and international statistics.Results: 137 patients were identified with a mean age of 33.7 years with a standard deviation of 16.7. 83.2% of facial trauma victims were male and 62% of facial injuries were caused by alleged assault. Only 1 patient was referred to Aberdeen Royal Infirmary by telemedicine. Conclusions: Aberdeen has a high number of injuries caused by interpersonal violence. Telemedicine is an underused resource in the referral and review of facial trauma at Aberdeen Royal Infirmary.

  18. Ocular and periocular injuries associated with an isolated orbital fracture depending on a blunt cranial trauma: anatomical and surgical aspects.

    Science.gov (United States)

    Karabekir, H Selim; Gocmen-Mas, Nuket; Emel, Erhan; Karacayli, Umit; Koymen, Ramazan; Atar, Elmas Kagnici; Ozkan, Nezih

    2012-10-01

    The anatomical location of fractures following blunt cranio-orbital trauma is important for neurosurgeons and maxillofacial surgeons. In this study, 588 cranio-orbital fractures following blunt trauma were evaluated retrospectively with regard to the anatomical site and surgical treatment. Orbital cranial nerve injuries and the outcomes of the medical and/or surgical treatment are described. Distribution of the zygomatic complex and orbital fractures were as follows: zygomatic complex fractures (n:304), isolated orbital fractures (n:58), complex comminuted fractures (n:226). In 58 cases, 69 orbit fractures were found (11 bilateral and 47 unilateral fractures). The lateral wall was the most frequent fracture (n:63). The least frequent fracture was the roof of the orbit (n:11). The accompanying lesions were as follows: 89.65% of cases were associated with periorbital haematoma (n:52), 13.79% of cases with retrobulbar haemorrhage (n:8), 96.55% cases with periorbital soft tissue oedema (n:56), 53.45% cases with pneumocephalus (n:31), 8.62% cases with intra-parenchymal contusion (n:5), 6.89% cases with enophthalmia (n:4), 5.17% of cases with rhinorrhoea (n: 3), 5.17% cases with optic bulb injury and adnexial trauma (n:3), 32.76% cases with intra-orbital emphysema (n:19), and 20.69% with vision dysfunctions (n:12), of whom 2 had no optic nerve injury. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  19. Total Facial Nerve Decompression for Severe Traumatic Facial Nerve Paralysis: A Review of 10 Cases

    Directory of Open Access Journals (Sweden)

    Sertac Yetiser

    2012-01-01

    Full Text Available Management of traumatic facial nerve disorders is challenging. Facial nerve decompression is indicated if 90–95% loss of function is seen at the very early period on ENoG or if there is axonal degeneration on EMG lately with no sign of recovery. Middle cranial or translabyrinthine approach is selected depending on hearing. The aim of this study is to present retrospective review of 10 patients with sudden onset complete facial paralysis after trauma who underwent total facial nerve decompression. Operation time after injury is ranging between 16 and105 days. Excitation threshold, supramaximal stimulation, and amplitude on the paralytic side were worse than at least %85 of the healthy side. Six of 11 patients had HBG-II, one patient had HBG-I, 3 patients had HBG-III, and one patient had HBG-IV recovery. Stretch, compression injuries with disruption of the endoneurial tubules undetectable at the time of surgery and lack of timely decompression may be associated with suboptimal results in our series.

  20. Facial nerve palsy: Evaluation by contrast-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, T.; Ishii, K.; Okitsu, T.; Okudera, T.; Ogawa, T

    2001-11-01

    AIM: The purpose of this study was to investigate the value of contrast-enhanced magnetic resonance (MR) imaging in patients with peripheral facial nerve palsy. MATERIALS AND METHODS: MR imaging was performed in 147 patients with facial nerve palsy, using a 1.0 T unit. All of 147 patients were evaluated by contrast-enhanced MR imaging and the pattern of enhancement was compared with that in 300 control subjects evaluated for suspected acoustic neurinoma. RESULTS: The intrameatal and labyrinthine segments of the normal facial nerve did not show enhancement, whereas enhancement of the distal intrameatal segment and the labyrinthine segment was respectively found in 67% and 43% of patients with Bell's palsy. The geniculate ganglion or the tympanic-mastoid segment was enhanced in 21% of normal controls versus 91% of patients with Bell's palsy. Abnormal enhancement of the non-paralyzed facial nerve was found in a patient with bilateral temporal bone fracture. CONCLUSION: Enhancement of the distal intrameatal and labyrinthine segments is specific for facial nerve palsy. Contrast-enhanced MR imaging can reveal inflammatory facial nerve lesions and traumatic nerve injury, including clinically silent damage in trauma. Kinoshita T. et al. (2001)

  1. Trauma during pregnancy.

    Science.gov (United States)

    Tweddale, Carla J

    2006-01-01

    Trauma is the leading nonobstetrical cause of maternal death. The effect of trauma on the pregnant woman and unborn fetus can be devastating. The major causes of maternal injury are blunt trauma, penetrating trauma, burns, falls, and assaults. There are specific changes associated with pregnancy that are important for the clinician to consider when providing care to these patients. Initial management of traumatic injuries during pregnancy is essential for maternal and fetal well-being. This review outlines common causes of maternal trauma, the initial assessment of the pregnant trauma patient, and ongoing care for the pregnant trauma patient and unborn fetus.

  2. Radiologic evaluation of facial injury; Avaliacao radiologica dos traumatismos faciais

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Ricardo Pires de; Volpato, Richard [Complexo Hospitalar Heliopolis, Sao Paulo, SP (Brazil). Servico de Diagnostico por Imagem]. E-mail: richard_volpato@uol.com.br; Nascimento, Lia Paula [Complexo Hospitalar Heliopolis, Sao Paulo, SP (Brazil)

    2003-03-01

    A detailed radiological investigation of the maxillofacial injuries is essential to achieve good treatment results. The images should identify every lesion and guide the treatment, thus improving esthetic and functional results. With the aim of simplifying the diagnostic task, the face may be seen as a five regions structure that may suffer a regional fracture or combined fractures involving the adjacent regions. These regions represent areas of focus for pre surgical planning and are as follows: nasal, orbital, zygomatic, maxillary, and mandibular. In order to understand the injury mechanisms and their consequences it is useful to know the supporting buttresses, which are divided in five sagittal planes, three horizontal planes and two coronal planes. We reviewed the cases of patients with facial trauma treated at Complexo Hospitalar Heliopolis, Sao Paulo, Brazil. A review of the relevant issues concerning radiological investigation of these injuries is presented. This study allowed standardization and ordering of the radiological investigation in patients with facial trauma. (author)

  3. Persistent facial pain conditions

    DEFF Research Database (Denmark)

    Forssell, Heli; Alstergren, Per; Bakke, Merete

    2016-01-01

    , clinical features, consequences, central and peripheral mechanisms, diagnostic criteria (DC/TMD), and principles of management. For each of the neuropathic facial pain entities, the definitions, prevalence, clinical features, and diagnostics are described. The current understanding of the pathophysiology......Persistent facial pains, especially temporomandibular disorders (TMD), are common conditions. As dentists are responsible for the treatment of most of these disorders, up-to date knowledge on the latest advances in the field is essential for successful diagnosis and management. The review covers...... TMD, and different neuropathic or putative neuropathic facial pains such as persistent idiopathic facial pain and atypical odontalgia, trigeminal neuralgia and painful posttraumatic trigeminal neuropathy. The article presents an overview of TMD pain as a biopsychosocial condition, its prevalence...

  4. Persistent facial pain conditions

    DEFF Research Database (Denmark)

    Forssell, Heli; Alstergren, Per; Bakke, Merete

    2016-01-01

    TMD, and different neuropathic or putative neuropathic facial pains such as persistent idiopathic facial pain and atypical odontalgia, trigeminal neuralgia and painful posttraumatic trigeminal neuropathy. The article presents an overview of TMD pain as a biopsychosocial condition, its prevalence......Persistent facial pains, especially temporomandibular disorders (TMD), are common conditions. As dentists are responsible for the treatment of most of these disorders, up-to date knowledge on the latest advances in the field is essential for successful diagnosis and management. The review covers......, clinical features, consequences, central and peripheral mechanisms, diagnostic criteria (DC/TMD), and principles of management. For each of the neuropathic facial pain entities, the definitions, prevalence, clinical features, and diagnostics are described. The current understanding of the pathophysiology...

  5. Persistent facial pain conditions

    DEFF Research Database (Denmark)

    Forssell, Heli; Alstergren, Per; Bakke, Merete;

    2016-01-01

    , clinical features, consequences, central and peripheral mechanisms, diagnostic criteria (DC/TMD), and principles of management. For each of the neuropathic facial pain entities, the definitions, prevalence, clinical features, and diagnostics are described. The current understanding of the pathophysiology...

  6. Management of facial blushing

    DEFF Research Database (Denmark)

    Licht, Peter B; Pilegaard, Hans K

    2008-01-01

    people. Side effects are frequent, but most patients are satisfied with the operation. In the short term, the key to success in sympathetic surgery for facial blushing lies in a meticulous and critical patient selection and in ensuring that the patient is thoroughly informed about the high risk of side...... effects. In the long term, the key to success in sympathetic surgery for facial blushing lies in more quality research comparing surgical, pharmacologic, and psychotherapeutic treatments....

  7. Simultaneous facial feature tracking and facial expression recognition.

    Science.gov (United States)

    Li, Yongqiang; Wang, Shangfei; Zhao, Yongping; Ji, Qiang

    2013-07-01

    The tracking and recognition of facial activities from images or videos have attracted great attention in computer vision field. Facial activities are characterized by three levels. First, in the bottom level, facial feature points around each facial component, i.e., eyebrow, mouth, etc., capture the detailed face shape information. Second, in the middle level, facial action units, defined in the facial action coding system, represent the contraction of a specific set of facial muscles, i.e., lid tightener, eyebrow raiser, etc. Finally, in the top level, six prototypical facial expressions represent the global facial muscle movement and are commonly used to describe the human emotion states. In contrast to the mainstream approaches, which usually only focus on one or two levels of facial activities, and track (or recognize) them separately, this paper introduces a unified probabilistic framework based on the dynamic Bayesian network to simultaneously and coherently represent the facial evolvement in different levels, their interactions and their observations. Advanced machine learning methods are introduced to learn the model based on both training data and subjective prior knowledge. Given the model and the measurements of facial motions, all three levels of facial activities are simultaneously recognized through a probabilistic inference. Extensive experiments are performed to illustrate the feasibility and effectiveness of the proposed model on all three level facial activities.

  8. Muscular subunits transplantation for facial reanimation Transplantes de sub-unidades musculares na reanimação facial

    Directory of Open Access Journals (Sweden)

    André Salo Buslik Hazan

    2006-04-01

    Full Text Available PURPOSE: To present an alternative technique for reconstruction of musculocutaneous damages in the face transferring innervated subsegments(subunits of the latissimus dorsi flap for replacement of various facial mimetic muscles. METHODS: One clinical case of trauma with skin and mimetic muscles damage is described as an example of the technique. The treatment was performed with microsurgical transfer of latissimus dorsi muscle subunits. Each subunit present shape and dimensions of the respective mimetic muscles replaced. The origin, insertions and force vectors for the mimicmuscle lost were considered. Each subsegment has its own arterial and venous supply with a motor nerve component for the muscular unit. RESULTS: Pre and one year postoperative photos registration of static and dynamic mimic aspects, as well as digital electromyography digital data of the patients were compared. The transplanted muscular units presented myoeletric activity, fulfilling both the functional and cosmetic aspect. CONCLUSION: This technique seems to be a promising way to deal with the complex musculocutaneous losses of the face as well as facial palsy.OBJETIVO: Apresentar uma alternativa técnica para reconstrução de perdas músculo-cutâneas na face com a transferência de sub-segmentos(sub-unidades inervados do músculo grande dorsal para a substituição dos diversos músculos da mímica facial. MÉTODOS: É descrito um caso de trauma com perda de pele e músculo da mímica. Foi corrigido com a transferência microcirúrgica de uma sub-unidade de músculo grande dorsal que apresenta, forma, tamanho e peso similares aos dos músculos da mímica. Respeitou-se as origens e inserções e vetores de ação para a mímica desejada. Cada um dos sub-segmentos têm artéria e veia que irrigam a unidade muscular e também um nervo com componente motor. RESULTADOS: O paciente foi avaliado comparando-se o pré e pós-operatório de um ano com foto e vídeo com mímica em

  9. Classifying Facial Actions

    Science.gov (United States)

    Donato, Gianluca; Bartlett, Marian Stewart; Hager, Joseph C.; Ekman, Paul; Sejnowski, Terrence J.

    2010-01-01

    The Facial Action Coding System (FACS) [23] is an objective method for quantifying facial movement in terms of component actions. This system is widely used in behavioral investigations of emotion, cognitive processes, and social interaction. The coding is presently performed by highly trained human experts. This paper explores and compares techniques for automatically recognizing facial actions in sequences of images. These techniques include analysis of facial motion through estimation of optical flow; holistic spatial analysis, such as principal component analysis, independent component analysis, local feature analysis, and linear discriminant analysis; and methods based on the outputs of local filters, such as Gabor wavelet representations and local principal components. Performance of these systems is compared to naive and expert human subjects. Best performances were obtained using the Gabor wavelet representation and the independent component representation, both of which achieved 96 percent accuracy for classifying 12 facial actions of the upper and lower face. The results provide converging evidence for the importance of using local filters, high spatial frequencies, and statistical independence for classifying facial actions. PMID:21188284

  10. Alcohol consumption and interpersonal injury in a pediatric oral and maxillofacial trauma population: a retrospective review of 1,192 trauma patients.

    Science.gov (United States)

    McAllister, Peter; Laverick, Sean; Makubate, Boikanyo; Jones, David Carl

    2015-06-01

    The social, financial, and health implications of adult alcohol-related oral and maxillofacial trauma have been recognized for several years. Affordability and widespread accessibility of alcohol and issues of misuse in the pediatric trauma population have fostered concerns alcohol may be similarly implicated in young patients with orofacial trauma. The aim of this study was to review data of pediatric facial injuries at a regional maxillofacial unit, assess the prevalence of alcohol use, and review data of patients sustaining injury secondary to interpersonal violence. This study is a retrospective, 3-year review of a Regional Maxillofacial Unit (RMU) trauma database. Inclusion criterion was consecutive facial trauma patients under 16 years of age, referred to RMU for further assessment and/or management. Alcohol use and injuries sustained were reviewed. Of 1,192 pediatric facial trauma patients, 35 (2.9%) were associated with alcohol intake. A total of 145 (12.2%) alleged assault as the mechanism of injury, with older (12-15 years) (n = 129; 88.9%), male (n = 124; 85.5%) (p role of alcohol in the pediatric trauma population is essential.

  11. The role of facial proportion in hair restoration surgery.

    Science.gov (United States)

    Stough, D B; Schell, B J; Weyrich, R P

    1997-02-01

    Facial aesthetics involve basic artistic principles that relate individual features to the face as a whole. These principles, such as balance and proportion, are key elements in the development of hair restoration surgery and can be applied to reconstructive procedures for the trauma or burn patient. This paper describes the application of anthropometric and artistic principles used in hair reconstruction. Attention has been directed to the procedures used to determine hairline contour and placement, and certain aspects of frontotemporal recession management. The frontal hair has a profound effect on facial balance because of the major role hair plays in framing and visually enhancing the face. The presence of frontal hair and facial framing also serves to retain a vital element of autonomy in appearance for the individual.

  12. Management of liver trauma.

    LENUS (Irish Health Repository)

    Badger, S A

    2012-02-01

    BACKGROUND: Blunt and penetrating liver trauma is common and often presents major diagnostic and management problems. METHODS: A literature review was undertaken to determine the current consensus on investigation and management strategies. RESULTS: The liver is the most frequently injured organ following abdominal trauma. Immediate assessment with ultrasound has replaced diagnostic peritoneal lavage in the resuscitation room, but computerised tomography remains the gold standard investigation. Nonoperative management is preferred in stable patients but laparotomy is indicated in unstable patients. Damage control techniques such as perihepatic packing, hepatotomy plus direct suture, and resectional debridement are recommended. Major complex surgical procedures such as anatomical resection or atriocaval shunting are now thought to be redundant in the emergency setting. Packing is also recommended for the inexperienced surgeon to allow control and stabilisation prior to transfer to a tertiary centre. Interventional radiological techniques are becoming more widely used, particularly in patients who are being managed nonoperatively or have been stabilised by perihepatic packing. CONCLUSIONS: Management of liver injuries has evolved significantly throughout the last two decades. In the absence of other abdominal injuries, operative management can usually be avoided. Patients with more complex injuries or subsequent complications should be transferred to a specialist centre to optimise final outcome.

  13. Management of liver trauma.

    LENUS (Irish Health Repository)

    Badger, S A

    2012-02-01

    BACKGROUND: Blunt and penetrating liver trauma is common and often presents major diagnostic and management problems. METHODS: A literature review was undertaken to determine the current consensus on investigation and management strategies. RESULTS: The liver is the most frequently injured organ following abdominal trauma. Immediate assessment with ultrasound has replaced diagnostic peritoneal lavage in the resuscitation room, but computerised tomography remains the gold standard investigation. Nonoperative management is preferred in stable patients but laparotomy is indicated in unstable patients. Damage control techniques such as perihepatic packing, hepatotomy plus direct suture, and resectional debridement are recommended. Major complex surgical procedures such as anatomical resection or atriocaval shunting are now thought to be redundant in the emergency setting. Packing is also recommended for the inexperienced surgeon to allow control and stabilisation prior to transfer to a tertiary centre. Interventional radiological techniques are becoming more widely used, particularly in patients who are being managed nonoperatively or have been stabilised by perihepatic packing. CONCLUSIONS: Management of liver injuries has evolved significantly throughout the last two decades. In the absence of other abdominal injuries, operative management can usually be avoided. Patients with more complex injuries or subsequent complications should be transferred to a specialist centre to optimise final outcome.

  14. Recovery of Facial Nerve Paralysis After Temporal Nerve Reconstruction: A Case Report

    OpenAIRE

    Emamhadi; Mahmoudi

    2015-01-01

    Introduction Facial paralysis is common following accidents, trauma, viral infection or tumors. Case Presentation A 24-year-old male patient was referred to us with a history of sharp penetrating trauma to the right temporal region causing unilateral paralysis of the muscles of the right forehead. He was unable to scowl or elevate his right eyebrow and there were no folds on his right forehead. Anastomosis of branches of the tempo...

  15. Etiopathogenesis of lower motor neuron facial palsy: Our experience

    Directory of Open Access Journals (Sweden)

    M Venugopal

    2011-01-01

    Full Text Available Introduction : Facial nerve is the seventh cranial nerve having important functions, and hence its paralysis can lead to a great deal of mechanical impairment and emotional embarrassment. Etiopathogenisis of lower motor neuron facial palsy is still a diagnostic challenge and the literature has shown varying results pertaining to the same. This study was designed to sketch out the prevalence of disease causation and the profile of peripheral facial palsy patients presenting to the ENT department at Government Medical College, Kozhikode. Materials and Methods : A prospective study involving 60 patients with facial nerve palsy, presented during the period November 2006 to October 2008, was undertaken. Detailed analysis of etiopathogenesis, age and sex distribution, severity of palsy, anatomical levels and follow up for 1 year was done. Results : Trauma, both iatrogenic and non-iatrogenic, was the most widespread etiology in our study, followed by Bell′s palsy which is described as the commonest cause in world literature. Majority of the patients belonged to the age group of 31-40 years and there was slight male preponderance Non-iatrogenic facial palsy following road traffic accident was common in young males, while females dominated in infectious palsies. Majority of cases reported with grade III palsy, followed by grade IV. High-resolution computed tomography of temporal bone is exceedingly sensitive in delineating facial canal. Conclusions : Data analysis shows similarity with the existing literature except a novel trend towards amplified incidence of trauma surpassing Bell′s palsy. The need for comprehensive history taking, meticulous clinical examination, judicious investigations and appropriate intervention is substantiated by the study.

  16. Burden of maxillofacial trauma at level 1 trauma center.

    Science.gov (United States)

    Kaul, Ruchi Pathak; Sagar, Sushma; Singhal, Maneesh; Kumar, Abhishek; Jaipuria, Jiten; Misra, Mahesh

    2014-06-01

    There is an upward trend in facial injuries following changes in population pattern, increasing industrialization and urbanization, hence maxillofacial trauma is becoming a burden and a leading medical problem in emergency rooms worldwide. This study was performed to evaluate the pattern of maxillofacial fractures, associated injuries, and treatment used at Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi, India, between January 2007 and June 2010. The study provides basis for establishment of trauma as major etiology of maxillofacial injuries and planning for preventive strategies. A retrospective study of patients seen and treated at JPNATC, AIIMS, New Delhi, between January 2007 and June 2010 was performed. Data extracted from patient records included etiology, age, sex, types and sites of fractures, treatment modality, and concomitant injuries. There were 795 fractures of the maxillofacial skeleton and 86 concomitant injuries from 542 patients. Road traffic accident (RTA) (56.8%) was the most common etiologic factor, followed by falls (22.3%) and fights (18.5%). The age range was from 3 to 75 years (mean, 34.7 years) with a peak incidence in the third decade with a male-to-female ratio of 3.7:1. The most common location of maxillofacial fractures was the mandible 615 (77%) and middle third 180 (23%). With regard to mandibular fractures, the body (29.6%) was the most common site, followed by the angle (24.4%), ramus (19.5%), dentoalveolar (14.6%), symphysis (11.0%), condyle (0.8%) while in the middle third, the nasal bone (36.7%) was the most common, followed by zygomatic bone (27.8), Lefort II (14.4), Lefort I (7.8%), dentoalveolar (10.0%), and Lefort III (3.3%). Majority of the patients were treated by open reduction and internal fixation (70.6). Concomitant injuries were 84 (10.8%) with orthopedic injuries accounting for the majority (63.9%). Head injury was associated in 16.3% of cases. RTA was the

  17. The Aftermath of Road Trauma: Survivors' Perceptions of Trauma and Growth

    Science.gov (United States)

    Harms, Louise; Talbot, Michelle

    2007-01-01

    For many survivors of serious road trauma, the physical and psychological consequences are complex and lifelong. The longer-term psychosocial recovery experience for survivors, however, is rarely documented in the social work literature. This article reports on findings from a study of road trauma recovery experiences. The findings are presented…

  18. Electronic documentation of trauma resuscitations at a level 1 pediatric trauma center.

    Science.gov (United States)

    Wurster, Lee Ann; Groner, Jonathan I; Hoffman, Jeffrey

    2012-01-01

    Although many hospitals across the country have implemented an electronic medical record (EMR) for inpatient care, very few have successfully implemented an EMR for trauma resuscitations. Although there is evidence that the EMR improves patient safety, increases access to all care providers, increases workflow efficiency, and minimizes time spent on documenting thereby improving nursing care, the fast paced, complex nature of trauma resuscitations makes it difficult to implement such a system for trauma documentation. With the support of multiple disciplines with a variety of clinical knowledge, this article describes the design process that has led us to successful development and implementation of an EMR for documentation of trauma resuscitations.

  19. Utility of Vital Signs, Heart-rate Variability and Complexity, and Machine Learning for Identifying the Need for Life-saving Interventions in Trauma Patients

    Science.gov (United States)

    2014-08-01

    nurses nor an electronic monitor provides accurate measurements of respiratory rate in triage . Ann Emerg Med 45:68Y76, 2005. 13. Batchinsky AI, Cooke...WVSMVWireless Vital Signs Monitor INTRODUCTION Capture of high-frequency (HF) data for real-time triage and assessment of trauma patients is now a viable...to assess battlefield injuries (automated triage ) (2, 6). Although the last few decades have witnessed an emergence of various CDS systems and studies

  20. Adolescents with HIV and facial lipoatrophy: response to facial stimulation

    OpenAIRE

    Jesus Claudio Gabana-Silveira; Laura Davison Mangilli; Sassi, Fernanda C.; Arnaldo Feitosa Braga; Claudia Regina Furquim de Andrade

    2014-01-01

    OBJECTIVES: This study evaluated the effects of facial stimulation over the superficial muscles of the face in individuals with facial lipoatrophy associated with human immunodeficiency virus (HIV) and with no indication for treatment with polymethyl methacrylate. METHOD: The study sample comprised four adolescents of both genders ranging from 13 to 17 years in age. To participate in the study, the participants had to score six or less points on the Facial Lipoatrophy Index. The facial stim...

  1. Assessing Pain by Facial Expression: Facial Expression as Nexus

    OpenAIRE

    Prkachin, Kenneth M.

    2009-01-01

    The experience of pain is often represented by changes in facial expression. Evidence of pain that is available from facial expression has been the subject of considerable scientific investigation. The present paper reviews the history of pain assessment via facial expression in the context of a model of pain expression as a nexus connecting internal experience with social influence. Evidence about the structure of facial expressions of pain across the lifespan is reviewed. Applications of fa...

  2. The complexity of trauma types in the lives of women in families referred for family violence: Multiple mediators of mental health.

    Science.gov (United States)

    Banyard, Victoria L; Williams, Linda M; Saunders, Benjamin E; Fitzgerald, Monica M

    2008-10-01

    Responding to calls for further research about the impact of multiple types of trauma across the life span, this study examines the interconnections among types of trauma in childhood and adulthood in a convenience clinical sample of 283 women obtaining social services for family violence. In particular, variables including family of-origin dysfunction and other childhood risk factors, relationship victimization in adulthood, and the presence of adult resources were examined as mediators of links between child maltreatment and adult mental health symptoms. Variables were assessed at different time points, 3 years apart. Path analysis revealed that the conceptual model of multiple pathways between childhood family violence exposure and adult outcomes fit the data well. In particular, the link between child maltreatment and adult trauma symptoms was mediated by more proximal adult sexual and intimate partner violence and its association with childhood risk markers (e.g., negative family environment) and decreased markers of resources. This link was not significant for a more general index of mental health symptoms in adulthood.

  3. The use of prosthetic grafts in complex military vascular trauma: a limb salvage strategy for patients with severely limited autologous conduit.

    Science.gov (United States)

    Vertrees, Amy; Fox, Charles J; Quan, Reagan W; Cox, Mitchell W; Adams, Eric D; Gillespie, David L

    2009-04-01

    The use of prosthetic grafts for reconstruction of military vascular trauma has been consistently discouraged. In the current conflict, however, the signature wound involves multiple extremities with significant loss of soft tissue and potential autogenous venous conduits. We reviewed the experience with the use of prosthetic grafts for the treatment of vascular injuries sustained during recent conflicts in Iraq and Afghanistan. Trauma registry records with combat-related vascular injuries repaired using prosthetic grafts were retrospectively reviewed from March 2003 to April 2006. Data collected included age, gender, mechanism of injury, vessel injured, conduit, graft patency, complications, including amputation and eventual outcome of repair. Prosthetic grafts were placed in 14 of 95 (15%) patients undergoing extremity bypass for vascular injuries. Patients were men with an average age of 25 years (range, 19-39 years). All prosthetic grafts in this series were made of polytetrafluoroethylene. Mechanism of injury included blast (n = 6), gunshot wounds (n = 6), and blunt trauma (n = 2), resulting in prosthetic repair of injuries to the superficial femoral (n = 8), brachial (n = 3), common carotid (n = 1), subclavian (n = 1), and axillary (n = 1) arteries. Mean evacuation time from injury to stateside arrival was 7 days (range, 3-9 days). Twelve grafts were placed initially at the time of injury, and two after vein graft blow out with secondary hemorrhage. The mean follow-up period was 427 days (range, 49-1,285 days). Seventy-nine percent of prosthetic grafts stayed patent in the short term, allowing patient stabilization, transport to a stateside facility, and elective revascularization with the remaining autologous vein graft. Three prosthetic grafts were replaced urgently for thrombosis. The remaining seven grafts were replaced electively for severe stenosis (3) or exposure (4) with presumed infection. There were no prosthetic graft blow outs or deaths in this

  4. Odontogenic maxillary sinusitis obscured by midfacial trauma.

    Science.gov (United States)

    Simuntis, Regimantas; Kubilius, Ričardas; Ryškienė, Silvija; Vaitkus, Saulius

    2015-01-01

    We present a case of odontogenic maxillary sinusitis whose sinonasal symptomatology was thought to be the consequence of a previous midfacial trauma. The patient was admitted to the Clinic of Oral and Maxillofacial Surgery after more than 10 years of exacerbations of sinonasal symptoms, which began to plague soon after a facial contusion. We decided to perform CT of paranasal sinuses, and despite the absence dental symptomatology, the dental origin of sinusitis was discovered. The majority of sinonasal symptoms resolved after appropriate dental treatment, and there was no need for nasal or sinus surgery.

  5. [Contusive ocular trauma--case report].

    Science.gov (United States)

    Muşat, O; Coman, Corina; Cristescu, R; Asandi, R

    2012-01-01

    We present the case of a 48 year old man who was admitted for the decreased visual acuity of the left eye for about 20 years, when a left sided facial trauma had occured. Clinical examination and lab exams revealed the cause of this change: ocular contusive posttraumatic status for about 20 years (anamnestic), iridodialysis, corectopie, traumatic cataract, PVR, tractional retinal detachment. Surgical treatment was warranted. We performed cataract extraction, posterior vitrectomy with laser fotocoagulation and injection of silicon oil 1000. We followed the pacient's post-operative evolution and we extracted of the silicone oil six months later. The evolution was favorable.

  6. [Maxillo-facial aspects of dento-alveolar trauma].

    Science.gov (United States)

    Mahy, P; Piette, E; Reychler, H

    1998-01-01

    The management of oral injuries requires expertise in dental and medical cares. The need for a multidisciplinary assessment, including medical, has to be ascertained early. Diagnostic and management procedures are described as well as concomitant lesions such as maxillofacial bony fractures.

  7. Suspension Trauma / Orthostatic Intolerance

    Science.gov (United States)

    ... of Science and Technology Assessment Printer Friendly Version Suspension Trauma/Orthostatic Intolerance Safety and Health Information Bulletin ... information about the hazards of orthostatic intolerance and suspension trauma when using fall arrest systems. This bulletin: ...

  8. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... total__ Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans Health ... 10 VA HSR&D Investigator Insights: Military Sexual Trauma - Duration: 3:27. Veterans Health Administration 898 views ...

  9. Ancillary procedures in facial animation surgery.

    Science.gov (United States)

    Bianchi, Bernardo; Ferri, Andrea; Ferrari, Silvano; Leporati, Massimiliano; Ferri, Teore; Sesenna, Enrico

    2014-12-01

    Facial animation surgery with neuromuscular transplants has become a standard procedure for the treatment of facial palsies. However, the forehead, periocular complex, nasal base area, and inferior lip are secondary sites that also need to be considered in the complete rehabilitation of a flaccid facial palsy. A total of 136 ancillary procedures were performed in 49 patients between 2003 and 2013 and consisted of eyebrow suspensions (11), upper eyelid loading with a platinum chain (39), inferior palpebral suspension with fascia lata (22), nasal base suspension with fascia lata (26), and botulinum toxin injection (38). Cosmetic results were good and excellent in 30.7% and 63.2% of the procedures, respectively. Functionally, periocular complex rehabilitation and nasal base suspension led to excellent improvements in function in 87.2% and 73.1% of the patients, respectively. The use of ancillary procedures can improve the functional and esthetic results of facial animation surgery. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Submental Intubation in Maxillofacial Trauma Patients

    Directory of Open Access Journals (Sweden)

    Amin Rahpeyma

    2012-12-01

    Full Text Available Introduction: To describe a modified technique for submental intubation in severely traumatized maxillofacial patients and to evaluate complications arising from the procedure.  Materials and Methods: Submental intubation was performed in twelve patients with maxillofacial trauma ,from 2007 – 2012, which were operated under general anesthesia for treatment of facial fractures. Results: The patients ranged in age from 14 to 39 years.  No complications due to submental intubation, such as infection, hypertrophic scarring, lingual nerve injury, hematoma, bleeding, ranula formation, or orocutaneous fistula, were observed following submental intubation.  Conclusion:  Submental intubation is a very useful technique in the management of maxillofacial trauma patients, with a low complication rate.

  11. Neuromuscular retraining for facial paralysis.

    Science.gov (United States)

    Diels, H J; Combs, D

    1997-10-01

    Neuromuscular retraining is an effective method for rehabilitating facial musculature in patients with facial paralysis. This nonsurgical therapy has demonstrated improved functional outcomes and is an important adjunct to surgical treatment for restoring facial movement. Treatment begins with an intensive clinical evaluation and incorporates appropriate sensory feedback techniques into a patient-specific, comprehensive, home therapy program. This article discusses appropriate patients, timelines for referral, and basic treatment practices of facial neuromuscular retraining for restoring function and expression to the highest level possible.

  12. Computer facial animation

    CERN Document Server

    Parke, Frederic I

    2008-01-01

    This comprehensive work provides the fundamentals of computer facial animation and brings into sharper focus techniques that are becoming mainstream in the industry. Over the past decade, since the publication of the first edition, there have been significant developments by academic research groups and in the film and games industries leading to the development of morphable face models, performance driven animation, as well as increasingly detailed lip-synchronization and hair modeling techniques. These topics are described in the context of existing facial animation principles. The second ed

  13. Recognition of facial affect in girls with conduct disorder.

    Science.gov (United States)

    Pajer, Kathleen; Leininger, Lisa; Gardner, William

    2010-02-28

    Impaired recognition of facial affect has been reported in youths and adults with antisocial behavior. However, few of these studies have examined subjects with the psychiatric disorders associated with antisocial behavior, and there are virtually no data on females. Our goal was to determine if facial affect recognition was impaired in adolescent girls with conduct disorder (CD). Performance on the Ekman Pictures of Facial Affect (POFA) task was compared in 35 girls with CD (mean age of 17.9 years+/-0.95; 38.9% African-American) and 30 girls who had no lifetime history of psychiatric disorder (mean age of 17.6 years+/-0.77; 30% African-American). Forty-five slides representing the six emotions in the POFA were presented one at a time; stimulus duration was 5s. Multivariate analyses indicated that CD vs. control status was not significantly associated with the total number of correct answers nor the number of correct answers for any specific emotion. Effect sizes were all considered small. Within-CD analyses did not demonstrate a significant effect for aggressive antisocial behavior on facial affect recognition. Our findings suggest that girls with CD are not impaired in facial affect recognition. However, we did find that girls with a history of trauma/neglect made a greater number of errors in recognizing fearful faces. Explanations for these findings are discussed and implications for future research presented. 2009 Elsevier B.V. All rights reserved.

  14. Trigemino-solitarii-facial pathway in rats.

    Science.gov (United States)

    Zerari-Mailly, Fawzia; Buisseret, Pierre; Buisseret-Delmas, Catherine; Nosjean, Anne

    2005-06-27

    This study was undertaken to identify premotor neurons in the nucleus tractus solitarii (NTS) serving as relay neurons between the sensory trigeminal complex (STC) and the facial motor nucleus in rats. Trigemino-solitarii connections were first investigated following injections of anterograde and/or retrograde (biotinylated dextran amine, biocytin, or gold-HRP) tracers in STC or NTS. Trigemino-solitarii neurons were abundant in the ventral and dorsal parts of the STC and of moderate density in its intermediate part. They project throughout the entire rostrocaudal extent of the NTS with a strong lateral preponderance. Solitarii-trigeminal neurons were observed mostly in the rostral and rostrolateral NTS. They mainly project to the ventral and dorsal parts of the spinal trigeminal nucleus but not to the principal nucleus. Additional neurons located in the middle NTS were found to project exclusively to the spinal trigeminal nucleus pars caudalis. No solitarii-trigeminal cells were observed in the caudal NTS. In addition, evidence was obtained of NTS retrogradely labeled neurons contacted by anterogradely labeled trigeminal terminals. Second, solitarii-facial projections were analyzed following injections of anterograde and retrograde tracers into the NTS and the facial nucleus, respectively. NTS neurons, except those of the rostrolateral part, reached the dorsal aspect of the facial nucleus. Finally, simultaneous injections of anterograde tracer in the STC and retrograde tracer in the facial nucleus gave retrogradely labeled neurons in the NTS receiving contacts from anterogradely labeled trigeminal boutons. Thus, the present data demonstrate for the first time the existence of a trigemino-solitarii-facial pathway. This could account for the involvement of the NTS in the control of orofacial motor behaviors.

  15. Trauma resuscitation time.

    NARCIS (Netherlands)

    Olden, G.D.J. van; Vugt, A.B. van; Biert, J.; Goris, R.J.A.

    2003-01-01

    Documenting the timing and organisation of trauma resuscitation can be utilised to assess performance standards, and to ensure a high quality of trauma resuscitation procedures. Since there is no European literature available on trauma resuscitation time (TRT) in the emergency room, the aim of this

  16. Trauma Facts for Educators

    Science.gov (United States)

    National Child Traumatic Stress Network, 2008

    2008-01-01

    This paper offers facts which can help educators deal with children undergoing trauma. These include: (1) One out of every 4 children attending school has been exposed to a traumatic event that can affect learning and/or behavior; (2) Trauma can impact school performance; (3) Trauma can impair learning; (4) Traumatized children may experience…

  17. Trauma resuscitation time.

    NARCIS (Netherlands)

    Olden, G.D.J. van; Vugt, A.B. van; Biert, J.; Goris, R.J.A.

    2003-01-01

    Documenting the timing and organisation of trauma resuscitation can be utilised to assess performance standards, and to ensure a high quality of trauma resuscitation procedures. Since there is no European literature available on trauma resuscitation time (TRT) in the emergency room, the aim of this

  18. Characteristics of associated craniofacial trauma in patients with head injuries: An experience with 100 cases

    Directory of Open Access Journals (Sweden)

    Rajendra Prasad

    2009-01-01

    Full Text Available Background: Facial fractures and concomitant cranial injuries carry the significant potential for mortality and neurological morbidity mainly in young adults. Aims and Objectives: To analyze the characteristics of head injuries and associated facial injuries, the management options and outcome following cranio-facial trauma. Methods: This retrospective review was performed at Justice K. S. Hegde Charitable Hospital, and associated A. B. Shetty Memorial Institute of Dental sciences, Deralakatte, Mangalore. Following Ethical Committee approval, hospital charts and radiographs of 100 consecutive patients of cranio-facial trauma managed at the Department of Oral and Maxillofacial Surgery and Neurosurgery between January 2004 and December 2004 were reviewed. Results: Majority of the patients were in the 2nd to 4th decade (79% with a male to female ratio of -8.09:1. Road traffic accidents were the common cause of craniofacial trauma in present study (54% followed by fall from height (30%. Loss of consciousness was the most common clinical symptom (62% followed by headache (33%. Zygoma was the most commonly fractured facial bone 48.2% (alone 21.2%, in combination 27.2%. Majority of patients had mild head injury and managed conservatively in present series. Causes of surgical intervention for intracranial lesions were compound depressed fracture, contusion and intracranial hematoma. Operative indications for facial fractures were displaced facial bone fractures. Major causes of mortality were associated systemic injuries. Conclusion: Adult males are the most common victims in craniofacial trauma, and road traffic accidents were responsible for the majority. Most of the patients sustained mild head injuries and were managed conservatively. Open reduction and internal fixation with miniplates was used for displaced facial bone fractures.

  19. Modeling the 2-His-1-Carboxylate Facial Triad: Iron-Catecholato Complexes as Structural and Functional Models of the Extradiol Cleaving Dioxygenases

    NARCIS (Netherlands)

    Bruijnincx, P.C.A.; Lutz, M.; Spek, A.L.; Hagen, W.R.; Weckhuysen, B.M.; van Koten, G.; Klein Gebbink, R.J.M.

    2007-01-01

    Mononuclear iron(II)- and iron(III)-catecholato complexes with three members of a new 3,3-bis(1-alkylimidazol-2-yl)propionate ligand family have been synthesized as models of the active sites of the extradiol cleaving catechol dioxygenases. These enzymes are part of the superfamily of dioxygen-activ

  20. Multiracial Facial Golden Ratio and Evaluation of Facial Appearance.

    Science.gov (United States)

    Alam, Mohammad Khursheed; Mohd Noor, Nor Farid; Basri, Rehana; Yew, Tan Fo; Wen, Tay Hui

    2015-01-01

    This study aimed to investigate the association of facial proportion and its relation to the golden ratio with the evaluation of facial appearance among Malaysian population. This was a cross-sectional study with 286 randomly selected from Universiti Sains Malaysia (USM) Health Campus students (150 females and 136 males; 100 Malaysian Chinese, 100 Malaysian Malay and 86 Malaysian Indian), with the mean age of 21.54 ± 1.56 (Age range, 18-25). Facial indices obtained from direct facial measurements were used for the classification of facial shape into short, ideal and long. A validated structured questionnaire was used to assess subjects' evaluation of their own facial appearance. The mean facial indices of Malaysian Indian (MI), Malaysian Chinese (MC) and Malaysian Malay (MM) were 1.59 ± 0.19, 1.57 ± 0.25 and 1.54 ± 0.23 respectively. Only MC showed significant sexual dimorphism in facial index (P = 0.047; Pmean score of 2.18 ± 0.97 for overall impression and 2.15 ± 1.04 for facial parts, compared to MM and MI, with mean score of 1.80 ± 0.97 and 1.64 ± 0.74 respectively for overall impression; 1.75 ± 0.95 and 1.70 ± 0.83 respectively for facial parts. 1) Only 17.1% of Malaysian facial proportion conformed to the golden ratio, with majority of the population having short face (54.5%); 2) Facial index did not depend significantly on races; 3) Significant sexual dimorphism was shown among Malaysian Chinese; 4) All three races are generally satisfied with their own facial appearance; 5) No significant association was found between golden ratio and facial evaluation score among Malaysian population.

  1. Diplegia facial traumatica

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1975-12-01

    Full Text Available É relatado um caso de paralisia facial bilateral, incompleta, associada a hipoacusia esquerda, após traumatismo cranioencefálico, com fraturas evidenciadas radiológicamente. Algumas considerações são formuladas tentando relacionar ditas manifestações com fraturas do osso temporal.

  2. Management of facial blushing

    DEFF Research Database (Denmark)

    Licht, Peter B; Pilegaard, Hans K

    2008-01-01

    an indication for treatment, facial blushing may be treated effectively by thoracoscopic sympathectomy. The type of blushing likely to benefit from sympathectomy is mediated by the sympathetic nerves and is the uncontrollable, rapidly developing blush typically elicited when one receives attention from other...

  3. Paralisia facial bilateral

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1976-03-01

    Full Text Available É apresentado um caso de diplegia facial surgida após meningite meningocócica e infecção por herpes simples. Depois de discutir as diversas condições que o fenômeno pode apresentar-se, o autor inclina-se por uma etiologia herpética.

  4. Cerebral infarction after mild head trauma in children.

    Science.gov (United States)

    Yang, Feng-Hua; Wang, Hua; Zhang, Jun-Mei; Liang, Hong-Yuan

    2013-09-01

    We conducted this retrospective, case record review to determine the risk factors and clinical features associated with cerebral infarction after mild head trauma in children. The median age of the cohort was 2.18 years (range, 6 mo-8 y). Most (26/29) of the patients developed the neurological symptoms and signs within 72 hours after trauma, 51.7% within 30 minutes. The first symptoms included hemiparesis (20), facial paresis (7), and convulsion (7). 86.21% of the lesions lay in basal ganglia region. Pre-existing basal ganglia calcification was identified in 13 as a risk factor.

  5. Hemorragia incoercible por trauma maxilofacial: experiencia del Hospital del Trabajador

    OpenAIRE

    Andrades C,Patricio; Román F,José Luis; Bartel A,Ricardo; Borel B,Claudio; Hernández N,Rodrigo; Rojas S,René; Lankin B,Jorge; Villalobos A,Rodrigo

    2012-01-01

    Introducción: El objetivo del presente trabajo es mostrar nuestra experiencia en el manejo de la hemorragia incoercible por trauma facial durante los últimos 10 años, para determinar su incidencia y delinear los principios básicos del tratamiento. Material y Método: Estudio retrospectivo de todos los pacientes con hemorragia incoercible por trauma maxilofacial entre 1999 y 2009. Criterios de inclusión fueron hemorragia oro-nasal secundaria a traumatismo maxilofacial, sin otras lesiones asocia...

  6. Tooth embedded in tongue following firearm trauma: report of two cases.

    Science.gov (United States)

    de Santana Santos, Thiago; Melo, Auremir Rocha; Pinheiro, Roberto Tiago Alves; Antunes, Antonio Azoubel; de Carvalho, Ricardo Wathson Feitosa; Dourado, Edwaldo

    2011-08-01

    Injuries caused by projectiles from firearms involve diverse patterns of dentoalveolar trauma due to the different types of wound and extent of tissue damage. This article reports two cases in which tooth fragments were embedded in the tongue following aggression from a firearm projectile in the facial region. Radiographs confirmed the presence of foreign bodies, which were surgically removed under local anesthesia. When dentoalveolar trauma occurs in facial injuries, both hard and soft tissues must be carefully examined to avoid overlooking embedded tooth fragments not located immediately in the soft tissue.

  7. Novel Facial Features Segmentation Algorithm

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    An efficient algorithm for facial features extractions is proposed. The facial features we segment are the two eyes, nose and mouth. The algorithm is based on an improved Gabor wavelets edge detector, morphological approach to detect the face region and facial features regions, and an improved T-shape face mask to locate the extract location of facial features. The experimental results show that the proposed method is robust against facial expression, illumination, and can be also effective if the person wearing glasses, and so on.

  8. Trauma-Sensitive Schools: An Evidence-Based Approach

    Science.gov (United States)

    Plumb, Jacqui L.; Bush, Kelly A.; Kersevich, Sonia E.

    2016-01-01

    Adverse childhood experiences (ACEs) are a common and pervasive problem. There is a positive correlation between ACEs and difficulties across the lifespan. Unlike healthy forms of stress, ACEs have a detrimental impact on the developing brain. There are three types of trauma: acute, chronic, and complex. Most ACEs are considered complex trauma,…

  9. Trauma-Sensitive Schools: An Evidence-Based Approach

    Science.gov (United States)

    Plumb, Jacqui L.; Bush, Kelly A.; Kersevich, Sonia E.

    2016-01-01

    Adverse childhood experiences (ACEs) are a common and pervasive problem. There is a positive correlation between ACEs and difficulties across the lifespan. Unlike healthy forms of stress, ACEs have a detrimental impact on the developing brain. There are three types of trauma: acute, chronic, and complex. Most ACEs are considered complex trauma,…

  10. Facial reconstruction by biosurgery: cell transplantation versus cell homing.

    Science.gov (United States)

    Mao, Jeremy J; Stosich, Michael S; Moioli, Eduardo K; Lee, Chang Hun; Fu, Susan Y; Bastian, Barbara; Eisig, Sidney B; Zemnick, Candice; Ascherman, Jeffrey; Wu, June; Rohde, Christine; Ahn, Jeffrey

    2010-04-01

    The face distinguishes one human being from another. When the face is disfigured because of trauma, tumor removal, congenital anomalies, or chronic diseases, the patient has a strong desire for functional and esthetic restoration. Current practice of facial reconstruction using autologous grafts, synthetic fillers, and prostheses is frequently below the surgeon's and patient's expectations. Facial reconstruction is yet to take advantage of recent advances in seemingly unrelated fields of stem cell biology, chemical engineering, biomaterials, and tissue engineering. "Biosurgery," a new concept that we propose, will incorporate novel principles and strategies of bioactive cues, biopolymers, and/or cells to restore facial defects. Small facial defects can likely be reconstructed by cell homing and without cell transplantation. A critical advantage of cell homing is that agilely recruited endogenous cells have the potential to harness the host's innate capacity for regeneration, thus accelerating the rate of regulatory and commercialization processes for product development. Large facial defects, however, may not be restorable without cell delivery per our understanding at this time. New breakthrough in biosurgery will likely originate from integrated strategies of cell biology, cytokine biology, chemical engineering, biomaterials, and tissue engineering. Regardless of cell homing or cell delivery approaches, biosurgery not only will minimize surgical trauma and repetitive procedures, but also produce long-lasting results. At the same time, caution must be exercised against the development of products that lack scientific basis or dogmatic combination of cells, biomaterials, and biomolecules. Together, scientifically derived biosurgery will undoubtedly develop into new technologies that offer increasingly natural reconstruction and/or augmentation of the face.

  11. 3D-FT MRI of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Girard, N. (Neuroradiology, Hopital Nord, 13 Marseille (France)); Raybaud, C. (Neuroradiology, Hopital Nord, 13 Marseille (France)); Poncet, M. (Neuroradiology, Hopital Nord, 13 Marseille (France))

    1994-08-01

    Contrast-enhanced 3D-FT MRI of the intrapetrous facial nerve was obtained in 38 patients with facial nerve disease, using a 1.0 T magnet and fast gradient-echo acquisition sequences. Contiguous millimetric sections were obtained, which could be reformatted in any desired plane. Acutely ill patients, were examined within the first 2 months, included: 24 with Bell's palsy and 6 with other acute disorders (Herpes zoster, trauma, neuroma, meningeal metastasis, middle ear granuloma). Six patients investigated more than a year after the onset of symptoms included 3 with congenital cholesteatoma, 2 with neuromas and one with a chronic Bell's palsy. The lesion was found incidentally in two cases (a suspected neurofibroma and a presumed drop metastasis from an astrocytoma). Patients with tumours had nodular, focally-enhancing lesions, except for the leptomeningeal metastasis in which the enhancement was linear. Linear, diffuse contrast enhancement of the facial nerve was found in trauma, and in the patient with a middle ear granuloma. Of the 24 patients with an acute Bell's palsy 15 exhibited linear contrast enhancement of the facial nerve. Three of these were lost to follow-up, but correlation of clinical outcome and contrast enhancement showed that only 4 of the 11 patients who made a complete recovery and all 10 patients with incomplete recovery demonstrated enhancement. Possible explanations for these findings are suggested by pathological data from the literature. 3D-FT imaging of the facial nerve thus yields direct information about the of the nerve condition and defines the morphological abnormalities. It can also demonstrate contrast enhancement which seems to have some prognostic value in acute idiopathic Bell's palsy. (orig.)

  12. Citation classics in trauma.

    Science.gov (United States)

    Ollerton, Joanne Emma; Sugrue, Michael

    2005-02-01

    The evolution of trauma may be analyzed by review of articles most frequently cited by scientific articles worldwide. This study identified the "trauma classics" by reviewing the most-cited articles ever published in The Journal of Trauma. The Science Citation Index of the Institute for Scientific Information was searched for the 50 most-cited articles in The Journal of Trauma. Of the 12,672 articles published since 1961, 80 were cited over 100 times and 17 over 200 times. The most-cited article was by Baker, a hallmark publication on injury scoring published in 1974. Feeding postinjury, bacterial translocation, and multiple organ failure were common themes. Overall, 32% involved gastrointestinal topics and 18% involved injury scoring, with institutions in the United States publishing 80% of the articles. This study identified the trauma classics from the last 42 years of The Journal of Trauma. Citation analysis has recognized limitations but gives a fascinating insight into the evolution of trauma care.

  13. Ultrasonography in trauma

    DEFF Research Database (Denmark)

    Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C

    2017-01-01

    BACKGROUND: The Focused Assessment with Sonography in Trauma (FAST) protocol is considered beneficial in emergent evaluation of trauma patients with blunt or penetrating injury and has become integrated into the Advanced Trauma Life Support (ATLS) protocol. No guidelines exist as to the use...... of ultrasonography in trauma in Denmark. We aimed to determine the current use of ultrasonography for assessing trauma patients in Denmark. METHODS: We conducted a nation-wide cross-sectional investigation of ultrasonography usage in trauma care. The first phase consisted of an Internet-based investigation....... Twenty-one (95.5%) of the guidelines included and recommended FAST as part of trauma assessment. The recommended person to perform the examination was the radiologist in n = 11 (50.0%), the surgeon in n = 6 (27.3%), the anesthesiologist in n = 1 (4.5%), and unspecified in n = 3 (13.6%) facilities. FAST...

  14. Interaction between facial expression and color

    OpenAIRE

    Kae Nakajima; Tetsuto Minami; Shigeki Nakauchi

    2017-01-01

    Facial color varies depending on emotional state, and emotions are often described in relation to facial color. In this study, we investigated whether the recognition of facial expressions was affected by facial color and vice versa. In the facial expression task, expression morph continua were employed: fear-anger and sadness-happiness. The morphed faces were presented in three different facial colors (bluish, neutral, and reddish color). Participants identified a facial expression between t...

  15. Facial Firework Injury: A Case Series

    Directory of Open Access Journals (Sweden)

    Kashyap Tadisina

    2014-07-01

    Full Text Available Fireworks are used to celebrate a variety of religious, patriotic, and cultural holidays and events around the world. Fireworks are common in the United States, with the most popular holiday for their use being national Independence Day, also known as July Fourth. The use of fireworks within the context of celebrations and holidays presents the ideal environment for accidents that lead to severe and dangerous injuries. Injuries to the face from explosions present a challenging problem in terms of restoring ideal ocular, oral, and facial function. Despite the well documented prevalence of firework use and injury, there is a relatively large deficit in the literature in terms of firework injury that involves the face. We present a unique case series that includes 4 adult male patients all with severe firework injuries to the face that presented at an urban level 1 trauma center. These four patients had an average age of 26.7 years old and presented within 5 hours of each other starting on July Fourth. Two patients died from their injuries and two patients underwent reconstructive surgical management, one of which had two follow up surgeries. We explore in detail their presentation, management, and subsequent outcomes as an attempt to add to the very limited data in the field of facial firework blast injury. In addition, the coincidence of their presentation within the same 5 hours brings into question the availability of the fireworks involved, and the possibility of similar injuries related to this type of firework in the future.

  16. Recovery of Facial Nerve Paralysis After Temporal Nerve Reconstruction: A Case Report

    Directory of Open Access Journals (Sweden)

    Emamhadi

    2015-11-01

    Full Text Available Introduction Facial paralysis is common following accidents, trauma, viral infection or tumors. Case Presentation A 24-year-old male patient was referred to us with a history of sharp penetrating trauma to the right temporal region causing unilateral paralysis of the muscles of the right forehead. He was unable to scowl or elevate his right eyebrow and there were no folds on his right forehead. Anastomosis of branches of the temporal nerve was done one month after trauma following regular physical therapy sessions, outcome was good and paralysis of the muscles of the right forehead improved after several months. Conclusions Immediate repair of the facial nerve injury will improve the process of recovery and rehabilitation of the face and forehead muscles and may play a very important role in the patient’s mental satisfaction and improve their quality of life.

  17. Art and trauma.

    Science.gov (United States)

    Laub, D; Podell, D

    1995-10-01

    The authors of this paper attempt to show that 'the art of trauma', because of its indirect, unaestheticised and dialogic nature, may be the only possible medium for effective representations of trauma. The real witnessing presence created in the art of trauma can act as an antidote to the annihilation of the internal 'other' that occurs in the traumatic experience and to the resulting absence, which both constitutes the core of trauma and precludes its representation. Important elements of the art of trauma are illustrated using the work of Paul Celan, Anselm Kiefer, Claude Lanzmann, Art Spiegelman, and Anne-Marie Levine and texts by Aharon Appelfeld. Examining more closely what Holocaust survivors say in their testimonies, the authors contend that survival itself should be considered as a type of art of trauma when it is made possible by a creative comprehension of reality analogous to that which characterises more conventional forms of the art of trauma. The authors proceed to explore both the possible limits to the extent that trauma may be represented and the continuous struggle involved in attempting to 'know' trauma. They also discuss how art dealing with trauma may circumscribe a double locus: one of witnessing as well as one of emptiness or execution.

  18. Prevalence of whiplash trauma in TMD patients: a systematic review.

    Science.gov (United States)

    Häggman-Henrikson, B; Rezvani, M; List, T

    2014-01-01

    The purpose of this systematic review was to describe the prevalence of whiplash trauma in patients with temporomandibular disorders (TMDs) and to describe clinical signs and symptoms in comorbid TMD/whiplash compared with TMD localised to the facial region. A systematic literature search of the PubMed, Cochrane Library and Bandolier databases was carried out for articles published from 1 January 1966 to 31 December 2012. The systematic search identified 129 articles. After the initial screening of abstracts, 32 articles were reviewed in full text applying inclusion and exclusion criteria. Six studies on the prevalence of neck trauma in patients with TMD met the inclusion criteria and were included in the review. Two of the authors evaluated the methodological quality of the included studies. The reported prevalence of whiplash trauma ranged from 8·4% to 70% (median 35%) in TMD populations, compared with 1·7-13% in the non-TMD control groups. Compared with patients with TMD localised to the facial region, TMD patients with a history of whiplash trauma reported more TMD symptoms, such as limited jaw opening and more TMD pain, and also more headaches and stress symptoms. In conclusion, the prevalence of whiplash trauma is higher in patients with TMD compared with non-TMD controls. Furthermore, patients with comorbid TMD/whiplash present with more jaw pain and more severe jaw dysfunction compared with TMD patients without a history of head-neck trauma. These results suggest that whiplash trauma might be an initiating and/or aggravating factor as well as a comorbid condition for TMD.

  19. Unrecognized hospital trauma as a source of complex psychiatric symptoms: a systematic case study with implications for children's rights and evidence-based practice.

    Science.gov (United States)

    Raby, Carly; Edwards, David

    2011-09-01

    This article describes the psychological assessment and treatment of Paul (12). For several years, he had received numerous diagnoses from a range of specialists and been unsuccessfully treated for epilepsy and obsessive-compulsive disorder. Treatment was based on a formulation-driven transdiagnostic approach. Soon it was clear that the correct diagnosis was posttraumatic stress disorder (PTSD) precipitated by an event in hospital when Paul was 6. Two sessions of Children's Accelerated Trauma Treatment (CATT) led to rapid resolution of the main symptoms and gains were consolidated and maintained in further treatment and follow-up sessions. The case material is used to examine why the correct case formulation had been missed, evidence for the efficacy of CATT, and implications for evidence-based practice and children's rights.

  20. Urogenital trauma: imaging upper GU trauma

    Energy Technology Data Exchange (ETDEWEB)

    Goldman, Stanford M. E-mail: Stanford.M.Goldman@uth.tmc.edu; Sandler, Carl M

    2004-04-01

    Objectives: This article will define the current controversies and concepts in the classification, clinical presentation, imaging approaches and management of upper urinary tract trauma. Materials and methods, results: This review will include the experience of the authors in the field of renal trauma over a 32-year period. Current thinking accepts the view that significant renal trauma is generally present when there is gross hematuria, signs of shock, or other clinical signs of severe injury. In most patients, suspected renal injury will be evaluated as a part of the overall assessment of the patient for suspected intraperitoneal injury. The authors will stress some exceptions to the rule. Conclusions: Most trauma experts now advocate conservative management, unless the patient is unstable or a renal vascular thrombosis or avulsion is suspected. Similarly, penetrating trauma to the kidney in and of itself no longer requires mandatory surgery. In the United States, computed tomography (CT), especially spiral CT, is considered the best diagnostic study, if available. Intravenous pyelography (IVP) is adequate if this is the only imaging modality available and if no concomitant injuries to the abdominal structure are suspected. Ultrasound, although strongly advocated in some countries, can lead to some significant false negatives. The diagnosis and management of unusual problems such as the traumatic AV fistula, the patient with an absent kidney or injury to the congenitally abnormal kidney, the serendipitous renal tumor in a patient with trauma, or serious bleeding after an apparent minor injury (i.e., spontaneous hemorrhage) are also reviewed in this article.

  1. Retinotopy of facial expression adaptation.

    Science.gov (United States)

    Matsumiya, Kazumichi

    2014-01-01

    The face aftereffect (FAE; the illusion of faces after adaptation to a face) has been reported to occur without retinal overlap between adaptor and test, but recent studies revealed that the FAE is not constant across all test locations, which suggests that the FAE is also retinotopic. However, it remains unclear whether the characteristic of the retinotopy of the FAE for one facial aspect is the same as that of the FAE for another facial aspect. In the research reported here, an examination of the retinotopy of the FAE for facial expression indicated that the facial expression aftereffect occurs without retinal overlap between adaptor and test, and depends on the retinal distance between them. Furthermore, the results indicate that, although dependence of the FAE on adaptation-test distance is similar between facial expression and facial identity, the FAE for facial identity is larger than that for facial expression when a test face is presented in the opposite hemifield. On the basis of these results, I discuss adaptation mechanisms underlying facial expression processing and facial identity processing for the retinotopy of the FAE.

  2. Realistic facial animation generation based on facial expression mapping

    Science.gov (United States)

    Yu, Hui; Garrod, Oliver; Jack, Rachael; Schyns, Philippe

    2014-01-01

    Facial expressions reflect internal emotional states of a character or in response to social communications. Though much effort has been taken to generate realistic facial expressions, it still remains a challenging topic due to human being's sensitivity to subtle facial movements. In this paper, we present a method for facial animation generation, which reflects true facial muscle movements with high fidelity. An intermediate model space is introduced to transfer captured static AU peak frames based on FACS to the conformed target face. And then dynamic parameters derived using a psychophysics method is integrated to generate facial animation, which is assumed to represent natural correlation of multiple AUs. Finally, the animation sequence in the intermediate model space is mapped to the target face to produce final animation.

  3. Other facial neuralgias.

    Science.gov (United States)

    O'Neill, Francis; Nurmikko, Turo; Sommer, Claudia

    2017-01-01

    Premise In this article we review some lesser known cranial neuralgias that are distinct from trigeminal neuralgia, trigeminal autonomic cephalalgias, or trigeminal neuropathies. Included are occipital neuralgia, superior laryngeal neuralgia, auriculotemporal neuralgia, glossopharyngeal and nervus intermedius neuralgia, and pain from acute herpes zoster and postherpetic neuralgia of the trigeminal and intermedius nerves. Problem Facial neuralgias are rare and many physicians do not see such cases in their lifetime, so patients with a suspected diagnosis within this group should be referred to a specialized center where multidisciplinary team diagnosis may be available. Potential solution Each facial neuralgia can be identified on the basis of clinical presentation, allowing for precision diagnosis and planning of treatment. Treatment remains conservative with oral or topical medication recommended for neuropathic pain to be tried before more invasive procedures are undertaken. However, evidence for efficacy of current treatments remains weak.

  4. Facial resemblance enhances trust.

    Science.gov (United States)

    DeBruine, Lisa M

    2002-07-07

    Organisms are expected to be sensitive to cues of genetic relatedness when making decisions about social behaviour. Relatedness can be assessed in several ways, one of which is phenotype matching: the assessment of similarity between others' traits and either one's own traits or those of known relatives. One candidate cue of relatedness in humans is facial resemblance. Here, I report the effects of an experimental manipulation of facial resemblance in a two-person sequential trust game. Subjects were shown faces of ostensible playing partners manipulated to resemble either themselves or an unknown person. Resemblance to the subject's own face raised the incidence of trusting a partner, but had no effect on the incidence of selfish betrayals of the partner's trust. Control subjects playing with identical pictures failed to show such an effect. In a second experiment, resemblance of the playing partner to a familiar (famous) person had no effect on either trusting or betrayals of trust.

  5. Congenital Facial Teratoma

    OpenAIRE

    Rai, Manjunath; Hegde, Padmaraj; Devaraju, Umesh M.

    2011-01-01

    Teratomas are neoplasm composed of three germinal layers of the embryo that form tissues not normally found in the organ in which they arise. These are most common in the sacrococcygeal region and are rare in the head and neck, which account for less than 6%. An unusual case of facial teratoma in a new born, managed successfully is described here with postoperative follow up of 2 years without any recurrence.

  6. Detection of feline herpes virus 1 via polymerase chain reaction and immunohistochemistry in cats with ulcerative facial dermatitis, eosinophilic granuloma complex reaction patterns and mosquito bite hypersensitivity.

    Science.gov (United States)

    Persico, Paola; Roccabianca, Paola; Corona, Antonio; Vercelli, Antonella; Cornegliani, Luisa

    2011-12-01

    Ulcerative dermatitis caused by feline herpes virus 1 (FHV-1) is an uncommon disease characterized by cutaneous ulcers secondary to epidermal, adnexal and dermal necrosis. Differential diagnoses for FHV-1 lesions include, but are not limited to, mosquito bite hypersensitivity and eosinophilic granuloma complex. Histopathological diagnosis of FHV-1 dermatitis is based on the detection of the intranuclear inclusion bodies. In cases where intranuclear inclusions are missing but clinical and histological findings are compatible with FHV-1 dermatitis, immunohistochemistry (IHC) and PCRs have been used. In this retrospective study, we evaluated the presence of FHV-1 by IHC and PCR in skin biopsies and compared the results of the two tests. Sixty-four skin biopsy specimens from cats with compatible lesions were reviewed and tested via PCR and IHC for evidence of FHV-1. Polymerase chain reaction was positive in 12 of 64 biopsies; PCR and IHC were positive only in two of 64 biopsies, and these cases were considered true positive cases. The higher number of PCR-positive cases was possibly attributed to amplification of viral DNA from a live attenuated vaccination, but a previous FHV-1 infection with subsequent amplification of latently inserted FHV-1 could not be excluded. If clinical signs and histopathology suggest FHV-1 infection in the absence of typical inclusion bodies, IHC is the preferred diagnostic test; PCR may be useful for initial screening, but due to false positives is not sufficient for a definitive diagnosis.

  7. Multiracial Facial Golden Ratio and Evaluation of Facial Appearance.

    Directory of Open Access Journals (Sweden)

    Mohammad Khursheed Alam

    Full Text Available This study aimed to investigate the association of facial proportion and its relation to the golden ratio with the evaluation of facial appearance among Malaysian population. This was a cross-sectional study with 286 randomly selected from Universiti Sains Malaysia (USM Health Campus students (150 females and 136 males; 100 Malaysian Chinese, 100 Malaysian Malay and 86 Malaysian Indian, with the mean age of 21.54 ± 1.56 (Age range, 18-25. Facial indices obtained from direct facial measurements were used for the classification of facial shape into short, ideal and long. A validated structured questionnaire was used to assess subjects' evaluation of their own facial appearance. The mean facial indices of Malaysian Indian (MI, Malaysian Chinese (MC and Malaysian Malay (MM were 1.59 ± 0.19, 1.57 ± 0.25 and 1.54 ± 0.23 respectively. Only MC showed significant sexual dimorphism in facial index (P = 0.047; P<0.05 but no significant difference was found between races. Out of the 286 subjects, 49 (17.1% were of ideal facial shape, 156 (54.5% short and 81 (28.3% long. The facial evaluation questionnaire showed that MC had the lowest satisfaction with mean score of 2.18 ± 0.97 for overall impression and 2.15 ± 1.04 for facial parts, compared to MM and MI, with mean score of 1.80 ± 0.97 and 1.64 ± 0.74 respectively for overall impression; 1.75 ± 0.95 and 1.70 ± 0.83 respectively for facial parts.1 Only 17.1% of Malaysian facial proportion conformed to the golden ratio, with majority of the population having short face (54.5%; 2 Facial index did not depend significantly on races; 3 Significant sexual dimorphism was shown among Malaysian Chinese; 4 All three races are generally satisfied with their own facial appearance; 5 No significant association was found between golden ratio and facial evaluation score among Malaysian population.

  8. Geriatric trauma: demographics, injuries, and mortality.

    Science.gov (United States)

    Keller, Julie M; Sciadini, Marcus F; Sinclair, Elizabeth; O'Toole, Robert V

    2012-09-01

    To identify injuries that elderly sustain during high-energy trauma and determine which are associated with mortality. Retrospective review of prospectively collected database. Academic trauma center. Patients selected from database of all trauma admissions from January 2004 through June 2009. Study population consisted of patients directly admitted from scene of injury who sustained high-energy trauma with at least one orthopaedic injury and were 65 years or older (n = 597). Review of demographics, trauma markers, injuries, and disposition statuses. Statistical analysis using χ test, Student t test, and logistic regression analysis. The most common fractures were of the rib, distal radius, pelvic ring, facial bones, proximal humerus, clavicle, ankle, and sacrum. The injuries associated with the highest mortality rates were fractures of the cervical spine with neurological deficit (47%), at the C2 level (44%), and of the proximal femur (25%), pelvic ring (25%), clavicle (24%), and distal humerus (24%). The fractures significantly associated with mortality were fractures of the clavicle (P = 0.001), foot joints (P = 0.001), proximal humerus or shaft and head of the humerus (P = 0.002), sacroiliac joint (P = 0.004), and distal ulna (P = 0.002). Elderly patients present with significantly worse injuries, remain in the hospital longer, require greater use of resources after discharge, and die at 3 times the rate of the younger population. Although the high mortality rates associated with cervical spine, hip, and pelvic ring fractures were not unexpected, the injuries that were statistically associated with mortality were unexpected. Injuries such as clavicle fracture were statistically associated with mortality. As our population ages and becomes more active, the demographic may gain in clinical importance. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

  9. Facial Asymmetry in a Crying Newborn: A Comparison of Two Cases and Review of Literature

    Science.gov (United States)

    Jain, Sunil K.; Richardson, Carol J.

    2017-01-01

    Facial asymmetry in a crying newborn can be due to a variety of different causes. Neonatal asymmetric crying facies (NACF) is a specific phenotype, which is often underrecognized. It is defined as asymmetry of the mouth and lips with grimacing or smiling, but a symmetric appearance at rest. NACF needs to be differentiated from complete facial palsy in a newborn, which can occur due to traumatic or developmental etiologies. Developmental causes can be present in isolation or may be a part of a recognized syndrome. While asymmetric lower lip depression may be seen in both conditions, complete facial palsy is also associated with upper and mid face deformities. We present a case of NACF and compare it to a case of facial palsy due to perinatal trauma. The purpose of this case series is to clarify some of the confusing nomenclatures and highlight the differences in the physical exam findings, diagnosis, and eventual prognosis of these cases. PMID:28337354

  10. Facial Asymmetry in a Crying Newborn: A Comparison of Two Cases and Review of Literature

    Directory of Open Access Journals (Sweden)

    Shreyas Arya

    2017-01-01

    Full Text Available Facial asymmetry in a crying newborn can be due to a variety of different causes. Neonatal asymmetric crying facies (NACF is a specific phenotype, which is often underrecognized. It is defined as asymmetry of the mouth and lips with grimacing or smiling, but a symmetric appearance at rest. NACF needs to be differentiated from complete facial palsy in a newborn, which can occur due to traumatic or developmental etiologies. Developmental causes can be present in isolation or may be a part of a recognized syndrome. While asymmetric lower lip depression may be seen in both conditions, complete facial palsy is also associated with upper and mid face deformities. We present a case of NACF and compare it to a case of facial palsy due to perinatal trauma. The purpose of this case series is to clarify some of the confusing nomenclatures and highlight the differences in the physical exam findings, diagnosis, and eventual prognosis of these cases.

  11. Overview of pediatric peripheral facial nerve paralysis: analysis of 40 patients.

    Science.gov (United States)

    Özkale, Yasemin; Erol, İlknur; Saygı, Semra; Yılmaz, İsmail

    2015-02-01

    Peripheral facial nerve paralysis in children might be an alarming sign of serious disease such as malignancy, systemic disease, congenital anomalies, trauma, infection, middle ear surgery, and hypertension. The cases of 40 consecutive children and adolescents who were diagnosed with peripheral facial nerve paralysis at Baskent University Adana Hospital Pediatrics and Pediatric Neurology Unit between January 2010 and January 2013 were retrospectively evaluated. We determined that the most common cause was Bell palsy, followed by infection, tumor lesion, and suspected chemotherapy toxicity. We noted that younger patients had generally poorer outcome than older patients regardless of disease etiology. Peripheral facial nerve paralysis has been reported in many countries in America and Europe; however, knowledge about its clinical features, microbiology, neuroimaging, and treatment in Turkey is incomplete. The present study demonstrated that Bell palsy and infection were the most common etiologies of peripheral facial nerve paralysis.

  12. Study Of 50 Cases With Craniofacial Trauma Who Experienced Head Injuries

    Directory of Open Access Journals (Sweden)

    Ali Mesgarzadeh

    2016-01-01

    Full Text Available Background: It has been shown that cranial injuries associated with facial fractures may cause a great risk of mortality and neurological morbidity, which mainly occurs in young adults. Aims and objectives: Study of the features of facial injuries associated with head injuries, discussing the management options and detecting the outcomes following craniofacial trauma. Methods: This is a retrospective study carried out at Imam reza and Shohada Hospitals. Radiographs and hospital data of 50 patients with craniofacial trauma between January 2013 and December 2014, managed at the Oral and Maxillofacial surgery department were gathered and analyzed. Results: The greatest number of the patients had 20 to 50 years old (68% and most of them were male. (M/F ratio was 6.09:1. The most prevalent causes of the trauma in this study were the motor vehicle accidents (44% and falling from height (36%, respectively. The most common bone fracture among the patients was the zygomatic bone fx (38.2%. Among the symptoms which the patients presented, Loss of the consciousness (52% and headache (43% showed the highest prevalence. Compound depressed fractures, contusions and intracranial hematoma were the leading causes of the surgical intervention for intracranial lesions. A high number of patients who have died in this study had associated systemic injuries. Displaced facial bone fracture were the indications for operation in facial fractures. Conclusions: The majority of the patients with craniofacial trauma were the adult males and the leading cause of trauma were road traffic accidents. A high number of the patients had mild head injuries and required only a conservational therapy.     Keywords:  head injury; craniofacial trauma; facial fracture

  13. Dextrocardia, atrial septal defect, severe developmental delay, facial anomalies, and supernumerary ribs in a child with a complex unbalanced 8;22 translocation including partial 8p duplication.

    Science.gov (United States)

    Pope, Kathleen; Samanich, Joy; Ramesh, K H; Cannizzaro, Linda; Pan, Qiulu; Babcock, Melanie

    2012-03-01

    We report on a child with dextrocardia, atrial septal defect (ASD), severe developmental delay, hypotonia, 13 pairs of ribs, left preauricular choristoma, hirsutism, and craniofacial abnormalities. Prenatal cytogenetic evaluation showed karyotype 46,XY,?dup(8p)ish del(8)pter. Postnatal array CGH demonstrated a 6.8 Mb terminal deletion at 8p23.3-p23, an interstitial 31.1 Mb duplication within 8p23.1-p11, and a terminal duplication of 0.24 Mb at 22q13.33, refining the karyotype to 46,XY,der(8)dup(8)(p23.1p11.1)t(8;22)(p23.1;q13.1).ish der(8)dup(8)(p23.1p11.1)t(8;22)(p23.1;q13.1) (D8S504-,MS607 + ,ARSA + ,D8Z1 + , RP115713 + +). Previous reports of distal 8p deletion, 8p duplication, and distal 22q duplication have shown similar manifestations, including congenital heart disease, intellectual impairment, and multiple minor anomalies. We correlate the patient's clinical findings with these particular areas of copy number. This case study supports the use of aCGH to identify subtle chromosomal rearrangement in infants with cardiac malformation as their most significant or only apparent birth defect. Additionally, it illustrates why aCGH is essential in the description of chromosome rearrangements, even those seemingly visible via routine karyotype. This method shows that there is often greater complexity submicroscopically, essential to an adequate understanding of a patient's genotype and phenotype.

  14. Orbital apex injury: trauma at the junction between the face and the cranium

    Energy Technology Data Exchange (ETDEWEB)

    Linnau, Ken F.; Hallam, Danial K.; Lomoschitz, Friedrich M.; Mann, F.A. E-mail: famann@u.washington.edu

    2003-10-01

    Orbital apex injury is usually seen in multiply and severely injured patients who are subject to high-energy trauma. Orbital apex injury rarely occurs in isolation. By proximity, the face, the skull base, or their combination are the most likely regions to be injured in association with orbital apex trauma. The vast majority of these injuries occur as an extension of orbital, LeFort, naso-orbito-ethmoid, panfacial, sphenoid, or temporal bone fractures of the skull. Complex osseous anatomic structures with intimately related multiple neurovascular organs make injuries to the orbital apex diagnostically and therapeutically challenging. Often other facial fractures extend into the orbital apex, or the orbital apex is damaged in conjunction with fractures of the skull base. Therefore abnormal imaging findings within the orbital apex may be indicators of traumatic injury to the entire junctional zone of face and cranium. In this article, we will give an overview of normal CT anatomy, review clinical syndromes, which may indicate traumatic injury of the orbital apex and present an imaging strategy for evaluation of the orbital apex.

  15. Trauma e temporalidade

    Directory of Open Access Journals (Sweden)

    Ana Maria Rudge

    Full Text Available O trauma tem sido abordado na literatura psicanalítica especialmente como um trauma infantil de natureza sexual. A neurose traumática é tomada como modelo para a circunscrição de uma acepção de trauma que não se confunde com o trauma estrutural eficaz na constituição do psiquismo, e cuja sintomatologia não pode ser diretamente remetida à experiência infantil de natureza sexual.

  16. About Military Sexual Trauma

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  17. About Military Sexual Trauma

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  19. [Scrotal trauma: management strategy].

    Science.gov (United States)

    Culty, T; Ravery, V

    2006-04-01

    Scrotal traumas are rare. Most are blunt traumas caused by a direct blow on the scrotum. The testicle is projected against the pubic arch. Early surgical investigation has considerably improved the prognosis of testicular trauma, and reduced orchidectomy rate. ULtrasonography has also improved the management of scrotal trauma. But there is a controversy about accuracy of ultrasonography in predicting presence or absence of testicular disruption. ULtrasonography should not challenge the dogma regarding systematic surgical investigation of hematocele and enlarged scrotum. Long term outcomes (testicular atrophy, infertility) may be more frequent as previously thought and should be detected.

  20. Negative body experience in women with early childhood trauma: associations with trauma severity and dissociation.

    Science.gov (United States)

    Scheffers, Mia; Hoek, Maike; Bosscher, Ruud J; van Duijn, Marijtje A J; Schoevers, Robert A; van Busschbach, Jooske T

    2017-01-01

    Background: A crucial but often overlooked impact of early life exposure to trauma is its far-reaching effect on a person's relationship with their body. Several domains of body experience may be negatively influenced or damaged as a result of early childhood trauma. Objective: The aim of this study was to investigate disturbances in three domains of body experience: body attitude, body satisfaction, and body awareness. Furthermore, associations between domains of body experience and severity of trauma symptoms as well as frequency of dissociation were evaluated. Method: Body attitude was measured with the Dresden Body Image Questionnaire, body satisfaction with the Body Cathexis Scale, and body awareness with the Somatic Awareness Questionnaire in 50 female patients with complex trauma and compared with scores in a non-clinical female sample (n = 216). Patients in the clinical sample also filled out the Davidson Trauma Scale and the Dissociation Experience Scale. Results: In all measured domains, body experience was severely affected in patients with early childhood trauma. Compared with scores in the non-clinical group, effect sizes in Cohen's d were 2.7 for body attitude, 1.7 for body satisfaction, and 0.8 for body awareness. Associations between domains of body experience and severity of trauma symptoms were low, as were the associations with frequency of dissociative symptoms. Conclusions: Early childhood trauma in women is associated with impairments in self-reported body experience that warrant careful assessment in the treatment of women with psychiatric disorders.

  1. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    Directory of Open Access Journals (Sweden)

    Maria W. Mauritz

    2013-04-01

    Full Text Available Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI are often not recognized in clinical practice. Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods: We conducted a systematic review of four databases (1980–2010 and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders. Results: Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25–72%, sexual abuse 37% (range 24–49%, and posttraumatic stress disorder (PTSD 30% (range 20–47%. Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI. Conclusions: Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI.

  2. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    Science.gov (United States)

    Mauritz, Maria W.; Goossens, Peter J. J.; Draijer, Nel; van Achterberg, Theo

    2013-01-01

    Background Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. Objective To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods We conducted a systematic review of four databases (1980–2010) and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders. Results Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25–72%), sexual abuse 37% (range 24–49%), and posttraumatic stress disorder (PTSD) 30% (range 20–47%). Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI. Conclusions Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI. PMID:23577228

  3. The role of trauma scoring in developing trauma clinical governance in the Defence Medical Services

    Science.gov (United States)

    Russell, R. J.; Hodgetts, T. J.; McLeod, J.; Starkey, K.; Mahoney, P.; Harrison, K.; Bell, E.

    2011-01-01

    This paper discusses mathematical models of expressing severity of injury and probability of survival following trauma and their use in establishing clinical governance of a trauma system. There are five sections: (i) Historical overview of scoring systems—anatomical, physiological and combined systems and the advantages and disadvantages of each. (ii) Definitions used in official statistics—definitions of ‘killed in action’ and other categories and the importance of casualty reporting rates and comparison across conflicts and nationalities. (iii) Current scoring systems and clinical governance—clinical governance of the trauma system in the Defence Medical Services (DMS) by using trauma scoring models to analyse injury and clinical patterns. (iv) Unexpected outcomes—unexpected outcomes focus clinical governance tools. Unexpected survivors signify good practice to be promulgated. Unexpected deaths pick up areas of weakness to be addressed. Seventy-five clinically validated unexpected survivors were identified over 2 years during contemporary combat operations. (v) Future developments—can the trauma scoring methods be improved? Trauma scoring systems use linear approaches and have significant weaknesses. Trauma and its treatment is a complex system. Nonlinear methods need to be investigated to determine whether these will produce a better approach to the analysis of the survival from major trauma. PMID:21149354

  4. Three-year-olds' rapid facial electromyographic responses to emotional facial expressions and body postures.

    Science.gov (United States)

    Geangu, Elena; Quadrelli, Ermanno; Conte, Stefania; Croci, Emanuela; Turati, Chiara

    2016-04-01

    Rapid facial reactions (RFRs) to observed emotional expressions are proposed to be involved in a wide array of socioemotional skills, from empathy to social communication. Two of the most persuasive theoretical accounts propose RFRs to rely either on motor resonance mechanisms or on more complex mechanisms involving affective processes. Previous studies demonstrated that presentation of facial and bodily expressions can generate rapid changes in adult and school-age children's muscle activity. However, to date there is little to no evidence to suggest the existence of emotional RFRs from infancy to preschool age. To investigate whether RFRs are driven by motor mimicry or could also be a result of emotional appraisal processes, we recorded facial electromyographic (EMG) activation from the zygomaticus major and frontalis medialis muscles to presentation of static facial and bodily expressions of emotions (i.e., happiness, anger, fear, and neutral) in 3-year-old children. Results showed no specific EMG activation in response to bodily emotion expressions. However, observing others' happy faces led to increased activation of the zygomaticus major and decreased activation of the frontalis medialis, whereas observing others' angry faces elicited the opposite pattern of activation. This study suggests that RFRs are the result of complex mechanisms in which both affective processes and motor resonance may play an important role. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Facial pain and temporomandibular disorders

    OpenAIRE

    2002-01-01

    Abstract The study was undertaken to determine the prevalence of facial pain and the association of facial pain with temporomandibular disorders (TMD) as well as with other factors, in a geographically defined population-based sample consisting of subjects born in 1966 in northern Finland, and in a case-control study including subjects with facial pain and their healthy controls. In addition, the influence of conservative stomatognathic and necessary prosthetic treatme...

  6. Botulinum toxin (Botox) to enhance facial macroesthetics: a literature review.

    Science.gov (United States)

    Dastoor, Sarosh F; Misch, Carl E; Wang, Hom-Lay

    2007-01-01

    Dental implants have emerged as a predictable treatment option for partial edentulism. Their ability to preserve bone and soft tissue yields highly esthetic results in the long term. Increasingly, patients are demanding not only enhancements to their dental (micro) esthetics but also to their overall facial (macro) esthetics. Dynamic wrinkles (caused by hyperfunctional muscles) in the perioral, glabellar, and forehead regions can cause a patient's expressions to be misinterpreted as angry, anxious, fearful, or fatigued. An emerging treatment option to address these issues is the use of a paralyzing material such as botulinum toxin A (Botox) to decrease the appearance of the wrinkles, which yields a more esthetic and youthful facial appearance. Botox is a deadly poison that is produced by the bacterium Clostridium botulinum and causes muscle paralysis by inhibiting acetylcholine release at the neuromuscular junction. When used in areas of hyperfunctional muscles, a transient partial paralysis occurs that diminishes the appearances of wrinkles, Therefore, wrinkles not attributable to hyperfunctional muscles (e.g., wrinkles caused by aging, gravity, photodamage, trauma, and scarring) will not be amenable to treatment with the toxin. As a result, proper case selection is essential. A thorough understanding of the indications, techniques, dosages, and complications and their management is imperative to achieve a satisfactory result. This article will review the pathogenesis of facial wrinkles as well as the history, techniques, clinical controversies, and other important considerations for successful treatment of facial wrinkles with Botox.

  7. Facial asymmetry in subjects with skeletal Class III deformity.

    Science.gov (United States)

    Haraguchi, Seiji; Takada, Kenji; Yasuda, Yoshitaka

    2002-02-01

    We investigated the frequency, site, amount, and direction of facial asymmetry in human adults with mandibular prognathism and examined if these characteristics were associated postnatally with cardinal clinical signs that may indicate a predisposition to facial asymmetry. Two hundred twenty young Japanese adults (69 men and 151 women) who exhibited skeletal Class III malocclusions were selected. The sample was divided into a Postnatal Factor Group and a Nonpostnatal Factor Group. The former group included those who had: (1) received orthodontic treatment using a chin cap; (2) exhibited clinical symptoms of temporomandibular joint (TMJ) disorder; (3) reported a history of maxillofacial trauma; or (4) radiographic abnormality of the condyles. Subjects with a deviation of more than 2 mm from the facial midline associated with any of the 4 landmarks (ANS, U1, L1 and Me) were classified as asymmetric and the asymmetry was measured on a postero-anterior (P-A) cephalogram. Radiographic facial asymmetry was found frequently (70%-85%, for Menton), and most obviously in the lower jaw (P Factor Group showed a higher proportion of subjects with lateral deviation toward the right side (P = .0031) and a greater amount (P factor showed no directional uniqueness in jaw deviation and exhibited a longer distance of deviation.

  8. [Prosopagnosia and facial expression recognition].

    Science.gov (United States)

    Koyama, Shinichi

    2014-04-01

    This paper reviews clinical neuropsychological studies that have indicated that the recognition of a person's identity and the recognition of facial expressions are processed by different cortical and subcortical areas of the brain. The fusiform gyrus, especially the right fusiform gyrus, plays an important role in the recognition of identity. The superior temporal sulcus, amygdala, and medial frontal cortex play important roles in facial-expression recognition. Both facial recognition and facial-expression recognition are highly intellectual processes that involve several regions of the brain.

  9. Virtual 3-D Facial Reconstruction

    Directory of Open Access Journals (Sweden)

    Martin Paul Evison

    2000-06-01

    Full Text Available Facial reconstructions in archaeology allow empathy with people who lived in the past and enjoy considerable popularity with the public. It is a common misconception that facial reconstruction will produce an exact likeness; a resemblance is the best that can be hoped for. Research at Sheffield University is aimed at the development of a computer system for facial reconstruction that will be accurate, rapid, repeatable, accessible and flexible. This research is described and prototypical 3-D facial reconstructions are presented. Interpolation models simulating obesity, ageing and ethnic affiliation are also described. Some strengths and weaknesses in the models, and their potential for application in archaeology are discussed.

  10. History of facial pain diagnosis

    Science.gov (United States)

    Jensen, Troels S

    2017-01-01

    Premise Facial pain refers to a heterogeneous group of clinically and etiologically different conditions with the common clinical feature of pain in the facial area. Among these conditions, trigeminal neuralgia (TN), persistent idiopathic facial pain, temporomandibular joint pain, and trigeminal autonomic cephalalgias (TAC) are the most well described conditions. Conclusion TN has been known for centuries, and is recognised by its characteristic and almost pathognomonic clinical features. The other facial pain conditions are less well defined, and over the years there has been confusion about their classification. PMID:28181442

  11. Cranial nerve injury after minor head trauma.

    Science.gov (United States)

    Coello, Alejandro Fernández; Canals, Andreu Gabarrós; Gonzalez, Juan Martino; Martín, Juan José Acebes

    2010-09-01

    There are no specific studies about cranial nerve (CN) injury following mild head trauma (Glasgow Coma Scale Score 14-15) in the literature. The aim of this analysis was to document the incidence of CN injury after mild head trauma and to correlate the initial CT findings with the final outcome 1 year after injury. The authors studied 49 consecutive patients affected by minor head trauma and CN lesions between January 2000 and January 2006. Detailed clinical and neurological examinations as well as CT studies using brain and bone windows were performed in all patients. Based on the CT findings the authors distinguished 3 types of traumatic injury: no lesion, skull base fracture, and other CT abnormalities. Patients were followed up for 1 year after head injury. The authors distinguished 3 grades of clinical recovery from CN palsy: no recovery, partial recovery, and complete recovery. Posttraumatic single nerve palsy was observed in 38 patients (77.6%), and multiple nerve injuries were observed in 11 (22.4%). Cranial nerves were affected in 62 cases. The most affected CN was the olfactory nerve (CN I), followed by the facial nerve (CN VII) and the oculomotor nerves (CNs III, IV, and VI). When more than 1 CN was involved, the most frequent association was between CNs VII and VIII. One year after head trauma, a CN deficit was present in 26 (81.2%) of the 32 cases with a skull base fracture, 12 (60%) of 20 cases with other CT abnormalities, and 3 (30%) of 10 cases without CT abnormalities. Trivial head trauma that causes a minor head injury (Glasgow Coma Scale Score 14-15) can result in CN palsies with a similar distribution to moderate or severe head injuries. The CNs associated with the highest incidence of palsy in this study were the olfactory, facial, and oculomotor nerves. The trigeminal and lower CNs were rarely damaged. Oculomotor nerve injury can have a good prognosis, with a greater chance of recovery if no lesion is demonstrated on the initial CT scan.

  12. Botulinum Toxin (Botox) for Facial Wrinkles

    Science.gov (United States)

    ... Stories Español Eye Health / Eye Health A-Z Botulinum Toxin (Botox) for Facial Wrinkles Sections Botulinum Toxin (Botox) ... Facial Wrinkles How Does Botulinum Toxin (Botox) Work? Botulinum Toxin (Botox) for Facial Wrinkles Written by: Kierstan Boyd ...

  13. Elevated Admission Base Deficit Is Associated with a Complex Dynamic Network of Systemic Inflammation Which Drives Clinical Trajectories in Blunt Trauma Patients

    Directory of Open Access Journals (Sweden)

    Othman Abdul-Malak

    2016-01-01

    Full Text Available We hypothesized that elevated base deficit (BD ≥ 4 mEq/L upon admission could be associated with an altered inflammatory response, which in turn may impact differential clinical trajectories. Using clinical and biobank data from 472 blunt trauma survivors, 154 patients were identified after excluding patients who received prehospital IV fluids or had alcohol intoxication. From this subcohort, 84 patients had a BD ≥ 4 mEq/L and 70 patients with BD < 4 mEq/L. Three samples within the first 24 h were obtained from all patients and then daily up to day 7 after injury. Twenty-two cytokines and chemokines were assayed using Luminex™ and were analyzed using two-way ANOVA and dynamic network analysis (DyNA. Multiple mediators of the innate and lymphoid immune responses in the BD ≥ 4 group were elevated differentially upon admission and up to 16 h after injury. DyNA revealed a higher, sustained degree of interconnectivity of the inflammatory response in the BD ≥ 4 patients during the initial 16 h after injury. These results suggest that elevated admission BD is associated with differential immune/inflammatory pathways, which subsequently could predispose patients to follow a complicated clinical course.

  14. COMPARATIVE STUDY OF CLINICAL MANIFESTATION, PLAIN FILM RADIOGRAPHY AND COMPUTED TOMOGRAPHY FOR DIAGNOSIS OF MAXILLOFACIAL TRAUMA

    Directory of Open Access Journals (Sweden)

    Amit

    2014-09-01

    Full Text Available OBJECTIVE: Maxillofacial injuries are one of commonest injuries encountered. Roentgenographic evaluation of maxillofacial trauma is of prime importance for diagnosis and treatment of these injuries. STUDY DESIGN: Forty patients were evaluated in prospective four year study. We studied and evaluated the demography and diagnostic efficacy of clinical, plain radiography, and computed scan in maxillofacial trauma. RESULT: Road traffic accidents were commonest cause of maxillofacial injuries. Patients having multiple fractures, mandibular fractures was commonest. CONCLUSION: Computed tomography proved a useful adjunct in mid facial trauma.

  15. Perioperative management of facial bipartition surgery

    Directory of Open Access Journals (Sweden)

    Caruselli M

    2015-11-01

    Full Text Available Marco Caruselli,1 Michael Tsapis,1,2 Fabrice Ughetto,1 Gregoire Pech-Gourg,3 Dario Galante,4 Olivier Paut1 1Anesthesia and Intensive Care Unit, La Timone Children’s Hospital, 2Pediatric Transport Team, SAMU 13, La Timone Hospital, 3Pediatric Neurosurgery Unit, La Timone Children’s Hospital, Marseille, France; 4Anesthesia and Intensive Care Unit, University Hospital Ospedali Riuniti of Foggia, Foggia, Italy Abstract: Severe craniofacial malformations, such as Crouzon, Apert, Saethre-Chotzen, and Pfeiffer syndromes, are very rare conditions (one in 50,000/100,000 live births that often require corrective surgery. Facial bipartition is the more radical corrective surgery. It is a high-risk intervention and needs complex perioperative management and a multidisciplinary approach. Keywords: craniofacial surgery, facial bipartition surgery, craniofacial malformations, pediatric anesthesia

  16. The Functionality of Facial Appearance and Its Importance to a Korean Population

    Directory of Open Access Journals (Sweden)

    Young Jun Kim

    2013-11-01

    Full Text Available BackgroundMany people have an interest in the correction of facial scars or deformities caused by trauma. The increasing ability to correct such flaws has been one of the reasons for the increase in the popularity of facial plastic surgery. In addition to its roles in communication, breathing, eating, olfaction and vision, the appearance of the face also plays an important role in human interactions, including during social activities. However, studies on the importance of the functional role of facial appearance. As a function of the face are scare. Therefore, in the present study, we evaluated the importance of the functions of the face in Korea.MethodsWe conducted an online panel survey of 300 participants (age range, 20-70 years. Each respondent was administered the demographic data form, Facial Function Assessment Scale, Rosenberg Self-Esteem Scale, and standard gamble questionnaires.ResultsIn the evaluation on the importance of facial functions, a normal appearance was considered as important as communication, breathing, speech, and vision. Of the 300 participants, 85% stated that a normal appearance is important in social activities.ConclusionsThe results of this survey involving a cross-section of the Korean population indicated that a normal appearance was considered one of the principal facial functions. A normal appearance was considered more important than the functions of olfaction and expression. Moreover, a normal appearance was determined to be an important facial function for leading a normal life in Korea.

  17. Design and fabrication of facial prostheses for cancer patient applying computer aided method and manufacturing (CADCAM)

    Science.gov (United States)

    Din, Tengku Noor Daimah Tengku; Jamayet, Nafij; Rajion, Zainul Ahmad; Luddin, Norhayati; Abdullah, Johari Yap; Abdullah, Abdul Manaf; Yahya, Suzana

    2016-12-01

    Facial defects are either congenital or caused by trauma or cancer where most of them affect the person appearance. The emotional pressure and low self-esteem are problems commonly related to patient with facial defect. To overcome this problem, silicone prosthesis was designed to cover the defect part. This study describes the techniques in designing and fabrication for facial prosthesis applying computer aided method and manufacturing (CADCAM). The steps of fabricating the facial prosthesis were based on a patient case. The patient was diagnosed for Gorlin Gotz syndrome and came to Hospital Universiti Sains Malaysia (HUSM) for prosthesis. The 3D image of the patient was reconstructed from CT data using MIMICS software. Based on the 3D image, the intercanthal and zygomatic measurements of the patient were compared with available data in the database to find the suitable nose shape. The normal nose shape for the patient was retrieved from the nasal digital library. Mirror imaging technique was used to mirror the facial part. The final design of facial prosthesis including eye, nose and cheek was superimposed to see the result virtually. After the final design was confirmed, the mould design was created. The mould of nasal prosthesis was printed using Objet 3D printer. Silicone casting was done using the 3D print mould. The final prosthesis produced from the computer aided method was acceptable to be used for facial rehabilitation to provide better quality of life.

  18. Brief pain inventory--facial minimum clinically important difference.

    Science.gov (United States)

    Sandhu, Sukhmeet K; Halpern, Casey H; Vakhshori, Venus; Mirsaeedi-Farahani, Keyvan; Farrar, John T; Lee, John Y K

    2015-01-01

    Neurosurgeons are frequently the primary physicians measuring pain relief in patients with trigeminal neuralgia (TN). Unfortunately, the measurement of pain can be complex. The Brief Pain Inventory-Facial (BPI-Facial) is a reliable and validated multidimensional tool that consists of 18 questions. It measures 3 domains of pain: 1) pain intensity (worst and average pain intensity), 2) interference with general activities of daily living (ADL), and 3) face-specific pain interference. The objective of this paper is to determine the patient-reported minimum clinically important difference (MCID) using the BPI-Facial. The authors conducted a retrospective study of 234 patients with TN seen in a single neurosurgeon's office. Patients completed baseline and 1-month follow-up BPI-Facial questionnaires. The MCID was calculated using an anchor-based approach in which the defined anchor was the 7-point patient global impression of change (PGIC). Two statistical methods were employed: mean change score and optimal cutoff point. Using the mean change score method, the investigators calculated the MCID for the 3 domains of the BPIFacial: 44% and 30% improvement in pain intensity at its worst and average, respectively, 54% improvement in interference with general ADL, and 63% improvement in interference with facial ADL. Using the optimal cutoff point method, they also calculated the MCID for the 3 domains of the BPI-Facial: 57% and 28% improvement in pain intensity at its worst and average, respectively, 75% improvement in interference with general ADL, and 62% improvement in interference with facial ADL. The BPI-Facial is a multidimensional pain scale that measures 3 domains of pain. Although 2 statistical methods were used to calculate the MCID, the optimal cutoff point method was the superior one because it used data from the majority of subjects included in this study. A 57% improvement in pain intensity at its worst and a 28% improvement in pain intensity at its average were

  19. iFace: Facial Expression Training System

    OpenAIRE

    Ito, Kyoko; Kurose, Hiroyuki; Takami, Ai; Nishida, Shogo

    2008-01-01

    In this study, a target facial expression selection interface for a facial expression training system and a facial expression training system were both proposed and developed. Twelve female dentists used the facial expression training system, and evaluations and opinions about the facial expression training system were obtained from these participants. In the future, we will attempt to improve both the target facial expression selection interface and the comparison of a current and a target f...

  20. Cephalometric soft tissue facial analysis.

    Science.gov (United States)

    Bergman, R T

    1999-10-01

    My objective is to present a cephalometric-based facial analysis to correlate with an article that was published previously in the American Journal of Orthodontic and Dentofacial Orthopedics. Eighteen facial or soft tissue traits are discussed in this article. All of them are significant in successful orthodontic outcome, and none of them depend on skeletal landmarks for measurement. Orthodontic analysis most commonly relies on skeletal and dental measurement, placing far less emphasis on facial feature measurement, particularly their relationship to each other. Yet, a thorough examination of the face is critical for understanding the changes in facial appearance that result from orthodontic treatment. A cephalometric approach to facial examination can also benefit the diagnosis and treatment plan. Individual facial traits and their balance with one another should be identified before treatment. Relying solely on skeletal analysis, assuming that the face will balance if the skeletal/dental cephalometric values are normalized, may not yield the desired outcome. Good occlusion does not necessarily mean good facial balance. Orthodontic norms for facial traits can permit their measurement. Further, with a knowledge of standard facial traits and the patient's soft tissue features, an individualized norm can be established for each patient to optimize facial attractiveness. Four questions should be asked regarding each facial trait before treatment: (1) What is the quality and quantity of the trait? (2) How will future growth affect the trait? (3) How will orthodontic tooth movement affect the existing trait (positively or negatively)? (4) How will surgical bone movement to correct the bite affect the trait (positively or negatively)?

  1. Plastic Changes of Synapses and Excitatory Neurotransmitter Receptors in Facial Nucleus Following Facial-facial Anastomosis

    Institute of Scientific and Technical Information of China (English)

    Pei CHEN; Jun SONG; Linghui LUO; Shusheng GONG

    2008-01-01

    The remodeling process of synapses and eurotransmitter receptors of facial nucleus were observed. Models were set up by facial-facial anastomosis in rat. At post-surgery day (PSD) 0, 7, 21 and 60, synaptophysin (p38), NMDA receptor subunit 2A and AMPA receptor subunit 2 (GIuR2) were observed by immunohistochemical method and emi-quantitative RT-PCR, respectively. Meanwhile, the synaptic structure of the facial motorneurons was observed under a transmission electron microscope (TEM). The intensity of p38 immunoreactivity was decreased, reaching the lowest value at PSD day 7, and then increased slightly at PSD 21. Ultrastructurally, the number of synapses in nucleus of the operational side decreased, which was consistent with the change in P38 immhnoreactivity. NMDAR2A mRNA was down-regulated significantly in facial nucleus after the operation (P000.05). The synapses innervation and the expression of NMDAR2A and AMPAR2 mRNA in facial nucleus might be modified to suit for the new motor tasks following facial-facial anastomosis, and influenced facial nerve regeneration and recovery.

  2. Outcome after vascular trauma in a deployed military trauma system.

    Science.gov (United States)

    Stannard, A; Brown, K; Benson, C; Clasper, J; Midwinter, M; Tai, N R

    2011-02-01

    Military injuries to named blood vessels are complex limb- and life-threatening wounds that pose significant difficulties in prehospital and surgical management. The aim of this study was to provide a comprehensive description of the epidemiology, treatment and outcome of vascular injury among service personnel deployed on operations in Afghanistan and Iraq. Data from the British Joint Theatre Trauma Registry were combined with hospital records to review all cases of vascular trauma in deployed service personnel over a 5-year interval ending in January 2008. Of 1203 injured service personnel, 110 sustained injuries to named vessels; 66 of them died before any surgical intervention. All 25 patients who sustained an injury to a named vessel in the abdomen or thorax died; 24 did not survive to undergo surgery and one casualty in extremis underwent a thoracotomy, but died. Six of 17 patients with cervical vascular injuries survived to surgical intervention; two died after surgery. Of 76 patients with extremity vascular injuries, 37 survived to surgery with one postoperative death. Interventions on 38 limbs included 19 damage control procedures (15 primary amputations, 4 vessel ligations) and 19 definitive limb revascularization procedures (11 interposition vein grafts, 8 direct repairs), four of which failed necessitating three amputations. In operable patients with extremity injury, amputation or ligation is often required for damage control and preservation of life. Favourable limb salvage rates are achievable in casualties able to withstand revascularization. Despite marked progress in contemporary battlefield trauma care, torso vascular injury is usually not amenable to surgical intervention.

  3. Children's Facial Trustworthiness Judgments: Agreement and Relationship with Facial Attractiveness.

    Science.gov (United States)

    Ma, Fengling; Xu, Fen; Luo, Xianming

    2016-01-01

    This study examined developmental changes in children's abilities to make trustworthiness judgments based on faces and the relationship between a child's perception of trustworthiness and facial attractiveness. One hundred and one 8-, 10-, and 12-year-olds, along with 37 undergraduates, were asked to judge the trustworthiness of 200 faces. Next, they issued facial attractiveness judgments. The results indicated that children made consistent trustworthiness and attractiveness judgments based on facial appearance, but with-adult and within-age agreement levels of facial judgments increased with age. Additionally, the agreement levels of judgments made by girls were higher than those by boys. Furthermore, the relationship between trustworthiness and attractiveness judgments increased with age, and the relationship between two judgments made by girls was closer than those by boys. These findings suggest that face-based trait judgment ability develops throughout childhood and that, like adults, children may use facial attractiveness as a heuristic cue that signals a stranger's trustworthiness.

  4. Ultrasound in trauma.

    Science.gov (United States)

    Rippey, James C R; Royse, Alistair G

    2009-09-01

    Point-of-care ultrasound is well suited for use in the emergency setting for assessment of the trauma patient. Currently, portable ultrasound machines with high-resolution imaging capability allow trauma patients to be imaged in the pre-hospital setting, emergency departments and operating theatres. In major trauma, ultrasound is used to diagnose life-threatening conditions and to prioritise and guide appropriate interventions. Assessment of the basic haemodynamic state is a very important part of ultrasound use in trauma, but is discussed in more detail elsewhere. Focussed assessment with sonography for Trauma (FAST) rapidly assesses for haemoperitoneum and haemopericardium, and the Extended FAST examination (EFAST) explores for haemothorax, pneumothorax and intravascular filling status. In regional trauma, ultrasound can be used to detect fractures, many vascular injuries, musculoskeletal injuries, testicular injuries and can assess foetal viability in pregnant trauma patients. Ultrasound can also be used at the bedside to guide procedures in trauma, including nerve blocks and vascular access. Importantly, these examinations are being performed by the treating physician in real time, allowing for immediate changes to management of the patient. Controversy remains in determining the best training to ensure competence in this user-dependent imaging modality.

  5. Advances in forefoot trauma.

    Science.gov (United States)

    Clements, J Randolph; Schopf, Robert

    2013-07-01

    Forefoot traumas, particularly involving the metatarsals, are commonly occurring injuries. There have been several advances in management of these injuries. These advances include updates in operative technique, internal fixation options, plating constructs, and external fixation. In addition, the advances of soft tissue management have improved outcomes. This article outlines these injuries and provides an update on techniques, principles, and understanding of managing forefoot trauma.

  6. Treating childhood trauma.

    Science.gov (United States)

    Terr, Lenore C

    2013-01-01

    This review begins with the question "What is childhood trauma?" Diagnosis is discussed next, and then the article focuses on treatment, using 3 basic principles-abreaction, context, and correction. Treatment modalities and complications are discussed, with case vignettes presented throughout to illustrate. Suggestions are provided for the psychiatrist to manage countertransference as trauma therapy proceeds.

  7. Virtual Trauma Team

    NARCIS (Netherlands)

    Jones, Valerie M.; Bults, Richard G.A.

    2001-01-01

    The clinical motivation for Virtual Trauma Team is to improve quality of care in trauma care in the vital first "golden hour" where correct intervention can greatly improve likely health outcome. The motivation for Virtual Homecare Team is to improve quality of life and independence for patients by

  8. Quantification of facial contamination with blood during orthopaedic procedures.

    LENUS (Irish Health Repository)

    Collins, D

    2012-02-03

    Operative surgery exposes the surgeon to possible blood-borne infections. Risks include pen-etrating injuries and conjunctival contact with infected blood. Visor masks worn during orthopaedic trauma procedures were assessed for blood contamination using computer analysis. This was found to be present on 86% of masks, of which only 15% was recognized by the surgeon intraoperatively. Of the blood splashes 80% were less than 0.6mm in diameter. We conclude that power instrumentation produces a blood particulate mist causing considerable microscopic, facial contamination which is a significant risk to the surgeon.

  9. [Rehabilitation of facial paralysis].

    Science.gov (United States)

    Martin, F

    2015-10-01

    Rehabilitation takes an important part in the treatment of facial paralysis, especially when these are severe. It aims to lead the recovery of motor activity and prevent or reduce sequelae like synkinesis or spasms. It is preferable that it be proposed early in order to set up a treatment plan based on the results of the assessment, sometimes coupled with an electromyography. In case of surgery, preoperative work is recommended, especially in case of hypoglossofacial anastomosis or lengthening temporalis myoplasty (LTM). Our proposal is to present an original technique to enhance the sensorimotor loop and the cortical control of movement, especially when using botulinum toxin and after surgery.

  10. Haemostatic resuscitation in trauma

    DEFF Research Database (Denmark)

    Stensballe, Jakob; Ostrowski, Sisse Rye; Johansson, Par I.

    2016-01-01

    PURPOSE OF REVIEW: To discuss the recent developments in and evolvement of next generation haemostatic resuscitation in bleeding trauma. RECENT FINDINGS: Mortality from major trauma is a worldwide problem, and massive haemorrhage remains a major cause of potentially preventable deaths. Development...... of coagulopathy further increases trauma mortality emphasizing that coagulopathy is a key target in the phase of bleeding. The pathophysiology of coagulopathy in trauma reflects at least three distinct mechanisms that may be present isolated or coexist: acute traumatic coagulopathy, coagulopathy associated...... with the lethal triad, and consumptive coagulopathy. The concepts of 'damage control surgery' and 'damage control resuscitation' have been developed to ensure early control of bleeding and coagulopathy to improve outcome in bleeding trauma. Haemostatic resuscitation aims at controlling coagulopathy and consists...

  11. Trauma pattern in a level I east-European trauma center

    Institute of Scientific and Technical Information of China (English)

    Bogdan Stoica; Sorin Paun; Ioan Tanase; Ionut Negoi; Mircea Beuran

    2015-01-01

    Objective:To analyze trauma epidemiology, pattern of lesions or death profile in a level I east-European trauma center. Methods:Prospective observational study of patients admitted to a level I east-European trauma center and enrolled in our trauma registry, between January 2012 to January 2013, was conducted, with the inclusion criteria: (1) trauma lesions, (2) new injury severity score (NISS) higher than 15. Results: There were 141 patients admitted during the study interval, including 102 (72.3%) males, with a mean age of (43.52 ± 19.00) years, and a meanNISS of 27.58 ± 11.32. The trauma etiology was traffic-related injuries 101 (71.6%), falls 28 (19.9%) and crushing injuries 7 (5.0%). Only one case of gunshot wound was encountered in our study. Out of traffic-related injuries, the automobiles were involved in 56 (55.4%) and motorcycles in 9 (8.9%) patients. The bicyclists accounted for 2 (2.0%) of patients and pedestrians hit by vehicles were in 33 (32.7%) cases. High-velocity falls were found in 7 (25.0%) patients, whereas low-velocity falls accounted for 21 (75.0%) of cases. The overall mortality was 30.00%, and these patients presented the meanNISS of 37.63. Conclusions: Our trauma pattern profile is similar to the one found in west-European countries, with a predominance of traffic-related injuries and falls. The severity and anatomical puzzle for trauma lesions were more complex secondary to motorcycle or bicycle-to-auto vehicles collisions. A trauma registry, with prospective enrollment of patients, is a very effective tool for constant improvements in trauma care.

  12. Survivors of early childhood trauma: evaluating a two-dimensional diagnostic model of the impact of trauma and neglect

    Directory of Open Access Journals (Sweden)

    Marleen Wildschut

    2014-04-01

    Full Text Available Background: A two-dimensional diagnostic model for (complex trauma-related and personality disorders has been proposed to assess the severity and prognosis of the impact of early childhood trauma and emotional neglect. An important question that awaits empirical examination is whether a distinction between trauma-related disorders and personality disorders reflects reality when focusing on survivors of early childhood trauma. And, is a continuum of trauma diagnoses a correct assumption and, if yes, what does it look like? Objective: We describe the design of a cross-sectional cohort study evaluating this two-dimensional model of the impact of trauma and neglect. To provide the rationale of our study objectives, we review the existing literature on the impact of early childhood trauma and neglect on trauma-related disorders and personality disorders. Aims of the study are to: (1 quantify the two-dimensional model and test the relation with trauma and neglect; and (2 compare the two study groups. Method: A total of 200 consecutive patients referred to two specific treatment programs (100 from a personality disorder program and 100 from a trauma-related disorder program in the north of Holland will be included. Data are collected at the start of treatment. The assessments include all DSM-5 trauma-related and personality disorders, and general psychiatric symptoms, trauma history, and perceived emotional neglect. Discussion: The results will provide an evaluation of the model and an improvement of the understanding of the relationship between trauma-related disorders and personality disorders and early childhood trauma and emotional neglect. This may improve both diagnostic as well as indication procedures. We will discuss possible strengths and limitations of the design.

  13. Trauma: the seductive hypothesis.

    Science.gov (United States)

    Reisner, Steven

    2003-01-01

    In much of contemporary culture, "trauma" signifies not so much terrible experience as a particular context for understanding and responding to a terrible experience. In therapy, in the media, and in international interventions, the traumatized are seen not simply as people who suffer and so are deserving of concern and aid; they are seen also as people who suffer for us, who are given special dispensation. They are treated with awe if they tell a certain kind of trauma story, and are ignored or vilified if they tell another. Trauma has become not simply a story of pain and its treatment, but a host of sub-stories involving the commodification of altruism, the justification of violence and revenge, the entry point into "true experience," and the place where voyeurism and witnessing intersect. Trauma is today the stuff not only of suffering but of fantasy. Historically, trauma theory and treatment have shown a tension, exemplified in the writings of Freud and Janet, between those who view trauma as formative and those who view it as exceptional. The latter view, that trauma confers exceptional status deserving of special privilege, has gained ground in recent years and has helped to shape the way charitable dollars are distributed, how the traumatized are presented in the media, how governments justify and carry out international responses to trauma, and how therapists attend to their traumatized patients. This response to trauma reflects an underlying, unarticulated belief system derived from narcissism; indeed, trauma has increasingly become the venue, in society and in treatment, where narcissism is permitted to prevail.

  14. [Blood reinfusion in treatment of thoracic and abdominal trauma].

    Science.gov (United States)

    Baramiia, N M; Antoniuk, M H; Dorosh, V M; Zavorits'kyĭ, O O; Sheptyts'kyĭ, V V; Pachkoriia, A V

    2001-01-01

    The experience of application of the blood reinfusion in complex of reanimational measures in treatment of 280 injured persons with thoracoabdominal damage in an acute period of trauma was summarized. Reinfusion was done in 42.8% of operated injured persons, promoting to preserve 243.1 l of preserved blood and simplifying rendering the assistance in an acute period of trauma.

  15. Advances in Violence and Trauma: Toward Comprehensive Ecological Models

    Science.gov (United States)

    Hughes, Honore M.; Humphrey, Natalie N.; Weaver, Terri L.

    2005-01-01

    The most important things learned about violence and trauma in the past 20 years are that interpersonal violence is prevalent, with different forms co-occurring, and that victims' reactions are complex. Researchers are called to consider models that include the ecological context within which victims experience violence and trauma to gain a better…

  16. Maxillofacial trauma in the emergency department: a review.

    Science.gov (United States)

    Tuckett, J W; Lynham, A; Lee, G A; Perry, M; Harrington, U

    2014-04-01

    In 1978 the Advanced Trauma Life Support guidelines were first implemented and are viewed by many as the gold standard of care in the emergency setting. It may not be immediately obvious where assessment and management of maxillofacial injuries fits within these trauma guidelines. This article aims to provide a concise, contemporary guide for the treatment of maxillofacial trauma in the emergency setting. An electronic database search was conducted in PubMed and Science Direct on articles from 1970 to the present day. The key search terms were Maxillofacial, Trauma, ATLS, Advanced Trauma Life Support, EMST, Early Management of Severe Trauma, Airway, Eye, Ophthalmic and Management. The findings were compiled into a review article. The article was then reviewed by experts in the fields of Maxillofacial Surgery and Ophthalmology to ensure content and contextual accuracy. Physicians are becoming increasingly exposed to major maxillofacial injuries. Resuscitative measures can be complex and require prompt decisions especially in gaining a secure airway. A proposed treatment algorithm for maxillofacial trauma patients has been devised by the authors. It is imperative that sight preserving assessment and interventions are not forgotten in the emergency management of maxillofacial trauma. We propose an algorithm for the management of maxillofacial trauma, and recommend the use of CT as a powerful adjunct to clinical examination in patients with maxillofacial trauma. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. All rights reserved.

  17. Processing faces and facial expressions.

    Science.gov (United States)

    Posamentier, Mette T; Abdi, Hervé

    2003-09-01

    This paper reviews processing of facial identity and expressions. The issue of independence of these two systems for these tasks has been addressed from different approaches over the past 25 years. More recently, neuroimaging techniques have provided researchers with new tools to investigate how facial information is processed in the brain. First, findings from "traditional" approaches to identity and expression processing are summarized. The review then covers findings from neuroimaging studies on face perception, recognition, and encoding. Processing of the basic facial expressions is detailed in light of behavioral and neuroimaging data. Whereas data from experimental and neuropsychological studies support the existence of two systems, the neuroimaging literature yields a less clear picture because it shows considerable overlap in activation patterns in response to the different face-processing tasks. Further, activation patterns in response to facial expressions support the notion of involved neural substrates for processing different facial expressions.

  18. Facial Asymmetry and Emotional Expression

    CERN Document Server

    Pickin, Andrew

    2011-01-01

    This report is about facial asymmetry, its connection to emotional expression, and methods of measuring facial asymmetry in videos of faces. The research was motivated by two factors: firstly, there was a real opportunity to develop a novel measure of asymmetry that required minimal human involvement and that improved on earlier measures in the literature; and secondly, the study of the relationship between facial asymmetry and emotional expression is both interesting in its own right, and important because it can inform neuropsychological theory and answer open questions concerning emotional processing in the brain. The two aims of the research were: first, to develop an automatic frame-by-frame measure of facial asymmetry in videos of faces that improved on previous measures; and second, to use the measure to analyse the relationship between facial asymmetry and emotional expression, and connect our findings with previous research of the relationship.

  19. Vascularization of the facial bones by facial artery: implications for full face allotransplantation

    OpenAIRE

    Rampazzo, Antonio

    2014-01-01

    Background-The maxillary artery is recognized as the main vascular supply of the facial bones; nonetheless clinical evidence supports a co-dominant role for the facial artery. This study explores the extent of the facial skeleton within a facial allograft that can be harvested based on the facial artery. Methods-Twenty-three cadaver heads were used in this study. In 12 heads, the right facial, superficial temporal and maxillary arteries were injected. In 1 head, facial artery angiography w...

  20. Odontogenic Facial Cellulitis

    Directory of Open Access Journals (Sweden)

    Yordany Boza Mejias

    2012-11-01

    Full Text Available Background: odontogenic facial cellulitis is an acute inflammatory process manifested in very different ways, with a variable scale in clinical presentation ranging from harmless well defined processes, to diffuse and progressive that may develop complications leading the patient to a critical condition, even risking their lives. Objective: To characterize the behavior of odontogenic facial cellulitis. Methods: A descriptive case series study was conducted at the dental clinic of Aguada de Pasajeros, Cienfuegos, from September 2010 to March 2011. It included 56 patients who met the inclusion criteria. Variables analyzed included: sex, age, teeth and regions affected, causes of cellulite and prescribed treatment. Results: no sex predilection was observed, lower molars and submandibular anatomical region were the most affected (50% and 30 4% respectively being tooth decay the main cause for this condition (51, 7%. The opening access was not performed to all the patients in the emergency service. The causal tooth extraction was not commonly done early, according to the prescribed antibiotic group. Thermotherapy with warm fomentation and saline mouthwash was the most prescribed and the most widely used group of antibiotics was the penicillin. Conclusions: dental caries were the major cause of odontogenic cellulite. There are still difficulties with the implementation of opening access.

  1. Trauma of the midface

    Directory of Open Access Journals (Sweden)

    Kühnel, Thomas S.

    2015-12-01

    Full Text Available Fractures of the midface pose a serious medical problem as for their complexity, frequency and their socio-economic impact. Interdisciplinary approaches and up-to-date diagnostic and surgical techniques provide favorable results in the majority of cases though. Traffic accidents are the leading cause and male adults in their thirties are affected most often. Treatment algorithms for nasal bone fractures, maxillary and zygomatic fractures are widely agreed upon whereas trauma to the frontal sinus and the orbital apex are matter of current debate. Advances in endoscopic surgery and limitations of evidence based gain of knowledge are matters that are focused on in the corresponding chapter. As for the fractures of the frontal sinus a strong tendency towards minimized approaches can be seen. Obliteration and cranialization seem to decrease in numbers. Some critical remarks in terms of high dose methylprednisolone therapy for traumatic optic nerve injury seem to be appropriate. Intraoperative cone beam radiographs and preshaped titanium mesh implants for orbital reconstruction are new techniques and essential aspects in midface traumatology. Fractures of the anterior skull base with cerebrospinal fluid leaks show very promising results in endonasal endoscopic repair.

  2. Trauma of the midface

    Science.gov (United States)

    Kühnel, Thomas S.; Reichert, Torsten E.

    2015-01-01

    Fractures of the midface pose a serious medical problem as for their complexity, frequency and their socio-economic impact. Interdisciplinary approaches and up-to-date diagnostic and surgical techniques provide favorable results in the majority of cases though. Traffic accidents are the leading cause and male adults in their thirties are affected most often. Treatment algorithms for nasal bone fractures, maxillary and zygomatic fractures are widely agreed upon whereas trauma to the frontal sinus and the orbital apex are matter of current debate. Advances in endoscopic surgery and limitations of evidence based gain of knowledge are matters that are focused on in the corresponding chapter. As for the fractures of the frontal sinus a strong tendency towards minimized approaches can be seen. Obliteration and cranialization seem to decrease in numbers. Some critical remarks in terms of high dose methylprednisolone therapy for traumatic optic nerve injury seem to be appropriate. Intraoperative cone beam radiographs and preshaped titanium mesh implants for orbital reconstruction are new techniques and essential aspects in midface traumatology. Fractures of the anterior skull base with cerebrospinal fluid leaks show very promising results in endonasal endoscopic repair. PMID:26770280

  3. Colesteatoma causando paralisia facial Cholesteatoma causing facial paralysis

    Directory of Open Access Journals (Sweden)

    José Ricardo Gurgel Testa

    2003-10-01

    Full Text Available A paralisia facial causada pelo colesteatoma é pouco freqüente. As porções do nervo mais acometidas são a timpânica e a região do 2º joelho. Nos casos de disseminação da lesão colesteatomatosa para o epitímpano anterior, o gânglio geniculado é o segmento do nervo facial mais sujeito à injúria. A etiopatogenia pode estar ligada à compressão do nervo pelo colesteatoma seguida de diminuição do seu suprimento vascular como também pela possível ação de substâncias neurotóxicas produzidas pela matriz do tumor ou pelas bactérias nele contidas. OBJETIVO: Avaliar a incidência, as características clínicas e o tratamento da paralisia facial decorrente da lesão colesteatomatosa. FORMA DE ESTUDO: Clínico retrospectivo. MATERIAL E MÉTODO: Estudo retrospectivo envolvendo dez casos de paralisia facial por colesteatoma selecionados através de levantamento de 206 descompressões do nervo facial com diferentes etiologias, realizadas na UNIFESP-EPM nos últimos dez anos. RESULTADOS: A incidência de paralisia facial por colesteatoma neste estudo foi de 4,85%,com predominância do sexo feminino (60%. A idade média dos pacientes foi de 39 anos. A duração e o grau da paralisia (inicial juntamente com a extensão da lesão foram importantes em relação à recuperação funcional do nervo facial. CONCLUSÃO: O tratamento cirúrgico precoce é fundamental para que ocorra um resultado funcional mais adequado. Nos casos de ruptura ou intensa fibrose do tecido nervoso, o enxerto de nervo (auricular magno/sural e/ou a anastomose hipoglosso-facial podem ser sugeridas.Facial paralysis caused by cholesteatoma is uncommon. The portions most frequently involved are horizontal (tympanic and second genu segments. When cholesteatomas extend over the anterior epitympanic space, the facial nerve is placed in jeopardy in the region of the geniculate ganglion. The aetiology can be related to compression of the nerve followed by impairment of its

  4. Evaluating developmental shape changes in Homo antecessor subadult facial morphology.

    Science.gov (United States)

    Freidline, Sarah E; Gunz, Philipp; Harvati, Katerina; Hublin, Jean-Jacques

    2013-10-01

    The fossil ATD6-69 from Atapuerca, Spain, dated to ca. 900 ka (thousands of years ago) has been suggested to mark the earliest appearance of modern human facial features. However, this specimen is a subadult and the interpretation of its morphology remains controversial, because it is unclear how developmental shape changes would affect the features that link ATD6-69 to modern humans. Here we analyze ATD6-69 in an evolutionary and developmental context. Our modern human sample comprises cross-sectional growth series from four populations. The fossil sample covers human specimens from the Pleistocene to the Upper Paleolithic, and includes several subadult Early Pleistocene humans and Neanderthals. We digitized landmarks and semilandmarks on surface and CT scans and analyzed the Procrustes shape coordinates using multivariate statistics. Ontogenetic allometric trajectories and developmental simulations were employed in order to identify growth patterns and to visualize potential adult shapes of ATD6-69. We show that facial differences between modern and archaic humans are not exclusively allometric. We find that while postnatal growth further accentuates the differences in facial features between Neanderthals and modern humans, those features that have been suggested to link ATD6-69's morphology to modern humans would not have been significantly altered in the course of subsequent development. In particular, the infraorbital depression on this specimen would have persisted into adulthood. However, many of the facial features that ATD6-69 shares with modern humans can be considered to be part of a generalized pattern of facial architecture. Our results present a complex picture regarding the polarity of facial features and demonstrate that some modern human-like facial morphology is intermittently present in Middle Pleistocene humans. We suggest that some of the facial features that characterize recent modern humans may have developed multiple times in human

  5. Analysis of association between posterior crossbite, median line deviation and facial asymmetry

    OpenAIRE

    Santos, R. R.; Garbin,Artênio José Isper; Saliba, O. [UNESP; Garbin, C. A. S. [UNESP

    2014-01-01

    Facial asymmetry is a common human characteristic and can occur on many levels, originate of genetic factors, and can be caused by traumas or due to cross bite and/or muscular disability. The aim of this study was to evaluate the relation between posterior crossbite, median line deviation and facial asymmetry. For this study 70 children aged between 3 and 10 years-old were examined and photographed. Using Microsoft Office Power Point 2007, horizontal lines and one vertical line on median line...

  6. MRI of the facial nerve in idiopathic facial palsy

    Energy Technology Data Exchange (ETDEWEB)

    Saatci, I. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Sahintuerk, F. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Sennaroglu, L. [Dept. of Otolaryngology, Head and Neck Surgery, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Boyvat, F. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Guersel, B. [Dept. of Otolaryngology, Head and Neck Surgery, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey); Besim, A. [Dept. of Radiology, Hacettepe Univ., Hospital Sihhiye, Ankara (Turkey)

    1996-10-01

    The purpose of this prospective study was to define the enhancement pattern of the facial nerve in idiopathic facial paralysis (Bell`s palsy) on magnetic resonance (MR) imaging with routine doses of gadolinium-DTPA (0.1 mmol/kg). Using 0.5 T imager, 24 patients were examined with a mean interval time of 13.7 days between the onset of symptoms and the MR examination. Contralateral asymptomatic facial nerves constituted the control group and five of the normal facial nerves (20.8%) showed enhancement confined to the geniculate ganglion. Hence, contrast enhancement limited to the geniculate ganglion in the abnormal facial nerve (3 of 24) was referred to a equivocal. Not encountered in any of the normal facial nerves, enhancement of other segments alone or associated with geniculate ganglion enhancement was considered to be abnormal and noted in 70.8% of the symptomatic facial nerves. The most frequently enhancing segments were the geniculate ganglion and the distal intracanalicular segment. (orig.)

  7. Urban-rural differences in oral and maxillofacial trauma

    Directory of Open Access Journals (Sweden)

    Anne Margareth Batista

    2012-04-01

    Full Text Available The aim of this research was to assess oral and maxillofacial trauma in urban and rural populations of the same region. The data collected included age, gender, year and month of trauma occurrence, origin (rural and urban, cause of injury, and the type of oral and maxillofacial trauma. Records from 1121 patients with 790 instances of oral and maxillofacial trauma were evaluated. Statistical analysis was performed with the Statistical Package for Social Sciences (SPSS version 17.0 software and involved descriptive statistics and Pearson's chi-squared test. Male patients were more prone to maxillofacial trauma (n = 537; 68%, and the patients were mostly from urban areas (n = 534; 67.6%. The male-to-female ratio was found to be 2.12:1 (urban zone, 1.72:1; rural zone, 3.49:1. The average age was 25.7 years (SD = 14.1. A traffic accident was the most common cause of oral and maxillofacial trauma (27%. The jaw (18% was the most commonly fractured bone in the facial skeleton, followed by the zygoma (12.9%. Avulsion (8.5% was the most common dental trauma. A significant statistical relationship was found between place of origin and gender (p < 0.001. Accidents involving animals were more frequent in rural areas (P < 0.001. Zygomatic fractures (p < 0.001, contusion (p = 0.003, and abrasion (p = 0.051 were the most common injuries among individuals from rural areas. Nasal fracture (p = 0.011 was the most frequent type of trauma in individuals from urban areas. According to these data, it seems reasonable to assume that specific preventive public policy for urban and rural areas must respect the differences of each region.

  8. The Facial Profile in the Context of Facial Aesthetics.

    Science.gov (United States)

    Heppt, Werner J; Vent, Julia

    2015-10-01

    Beauty has been an intriguing issue since the evolving of a culture in mankind. Even the Neanderthals are believed to have applied makeover to enhance facial structures and thus underline beauty. The determinants of beauty and aesthetics have been defined by artists and scientists alike. This article will give an overview of the evolvement of a beauty concept and the significance of the facial profile. It aims at sharpening the senses of the facial plastic surgeon for analyzing the patient's face, consulting the patient on feasible options, planning, and conducting surgery in the most individualized way.

  9. Diplegia facial traumatica Traumatic facial diplegia: a case report

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1975-12-01

    Full Text Available É relatado um caso de paralisia facial bilateral, incompleta, associada a hipoacusia esquerda, após traumatismo cranioencefálico, com fraturas evidenciadas radiológicamente. Algumas considerações são formuladas tentando relacionar ditas manifestações com fraturas do osso temporal.A case of traumatic facial diplegia with left partial loss of hearing following head injury is reported. X-rays showed fractures on the occipital and left temporal bones. A review of traumatic facial paralysis is made.

  10. Paralisia facial bilateral Bilateral facial paralysis: a case report

    Directory of Open Access Journals (Sweden)

    J. Fortes-Rego

    1976-03-01

    Full Text Available É apresentado um caso de diplegia facial surgida após meningite meningocócica e infecção por herpes simples. Depois de discutir as diversas condições que o fenômeno pode apresentar-se, o autor inclina-se por uma etiologia herpética.A case of bilateral facial paralysis following meningococcal meningitis and herpes simplex infection is reported. The author discusses the differential diagnosis of bilateral facial nerve paralysis which includes several diseases and syndromes and concludes by herpetic aetiology.

  11. Closed lung trauma.

    Science.gov (United States)

    Feden, Jeffrey P

    2013-04-01

    Pulmonary injuries from blunt thoracic trauma are seen regularly with high-energy mechanisms but described less frequently in association with sports. Pneumothorax, hemothorax, pneumomediastinum, and pulmonary contusion are uncommon with athletic participation and often follow a benign clinical course. Life-threatening complications may arise, and athletes with chest trauma deserve close attention. Appropriate diagnosis is suggested by history and physical examination; conventional chest radiography is preferred as the initial imaging study but has limitations. Use of CT for trauma has improved diagnostic sensitivity for occult injury, although this may not alter management or outcomes. Return to play is guided by resolution of symptoms and radiographic findings.

  12. Trauma Induced Coagulopathy

    DEFF Research Database (Denmark)

    Genét, Gustav Folmer; Johansson, Per; Meyer, Martin Abild Stengaard

    2013-01-01

    It remains debated whether traumatic brain injury (TBI) induces a different coagulopathy compared to non-TBI. This study investigated traditional coagulation tests, biomarkers of coagulopathy and endothelial damage in trauma patients with and without TBI. Blood from 80 adult trauma patients were...... sampled (median of 68 min (IQR 48-88) post-injury) upon admission to our trauma centre. Plasma/serum were retrospectively analysed for biomarkers reflecting sympathoadrenal activation (adrenaline, noradrenaline), coagulation activation/inhibition and fibrinolysis (protein C, activated protein C, tissue...

  13. Ultraestrutura do nervo facial intratemporal em pacientes com paralisia facial idiopática: estudo de evidências de infecção viral Intratemporal facial nerve ultrastructure in patients with idiopathic facial paralysis: viral infection evidence study

    Directory of Open Access Journals (Sweden)

    Rosangela Aló Maluza Florez

    2010-10-01

    Full Text Available A etiologia da paralisia facial periférica idiopática (PFPI ainda é uma incógnita, no entanto, alguns autores aventam a possibilidade de ser uma infecção viral. OBJETIVO: Analisar a ultraestrutura do nervo facial procurando evidências virais que possam nos fornecer dados etiológicos. MATERIAL E MÉTODO: Foram estudados 20 pacientes com PFP, com graus de moderado a severo, de ambos os sexos, entre 18-60 anos, provenientes de Ambulatório de Distúrbios do Nervo Facial. Os pacientes foram divididos em dois grupos: Estudo, onze pacientes com PFPI e Controle, nove pacientes com Paralisia Facial Periférica Traumática ou Tumoral. Foram estudados fragmentos de bainha do nervo facial ou fragmentos de seus cotos, que durante a cirurgia de reparação do nervo facial, seriam desprezados ou encaminhados para estudo anatomopatológico. O tecido foi fixado em glutaraldeído 2% e analisado em Microscopia Eletrônica de Transmissão. RESULTADO: Observamos no grupo estudo atividade celular intensa de reparação com aumento de fibras colágenas, fibroblastos com organelas desenvolvidas, isentos de partículas virais. No grupo controle esta atividade de reparação não foi evidente, mas também não foram observadas partículas virais. CONCLUSÃO: Não foram encontradas partículas virais, no entanto, houve evidências de intensa atividade de reparação ou infecção viral.The etiology of idiopathic peripheral facial palsy (IPFP is still uncertain; however, some authors suggest the possibility of a viral infection. AIM: to analyze the ultrastructure of the facial nerve seeking viral evidences that might provide etiological data. MATERIAL AND METHODS: We studied 20 patients with peripheral facial palsy (PFP, with moderate to severe FP, of both genders, between 18-60 years of age, from the Clinic of Facial Nerve Disorders. The patients were broken down into two groups - Study: eleven patients with IPFP and Control: nine patients with trauma or tumor

  14. The Dehiscent Facial Nerve Canal

    Directory of Open Access Journals (Sweden)

    Sertac Yetiser

    2012-01-01

    Full Text Available Accidental injury to the facial nerve where the bony canal defects are present may result with facial nerve dysfunction during otological surgery. Therefore, it is critical to know the incidence and the type of facial nerve dehiscences in the presence of normal development of the facial canal. The aim of this study is to review the site and the type of such bony defects in 144 patients operated for facial paralysis, myringoplasty, stapedotomy, middle ear exploration for sudden hearing loss, and so forth, other than chronic suppurative otitis media with or without cholesteatoma, middle ear tumors, and anomaly. Correlation of intraoperative findings with preoperative computerized tomography was also analyzed in 35 patients. Conclusively, one out of every 10 surgical cases may have dehiscence of the facial canal which has to be always borne in mind during surgical manipulation of the middle ear. Computerized tomography has some limitations to evaluate the dehiscent facial canal due to high false negative and positive rates.

  15. Does facial resemblance enhance cooperation?

    Directory of Open Access Journals (Sweden)

    Trang Giang

    Full Text Available Facial self-resemblance has been proposed to serve as a kinship cue that facilitates cooperation between kin. In the present study, facial resemblance was manipulated by morphing stimulus faces with the participants' own faces or control faces (resulting in self-resemblant or other-resemblant composite faces. A norming study showed that the perceived degree of kinship was higher for the participants and the self-resemblant composite faces than for actual first-degree relatives. Effects of facial self-resemblance on trust and cooperation were tested in a paradigm that has proven to be sensitive to facial trustworthiness, facial likability, and facial expression. First, participants played a cooperation game in which the composite faces were shown. Then, likability ratings were assessed. In a source memory test, participants were required to identify old and new faces, and were asked to remember whether the faces belonged to cooperators or cheaters in the cooperation game. Old-new recognition was enhanced for self-resemblant faces in comparison to other-resemblant faces. However, facial self-resemblance had no effects on the degree of cooperation in the cooperation game, on the emotional evaluation of the faces as reflected in the likability judgments, and on the expectation that a face belonged to a cooperator rather than to a cheater. Therefore, the present results are clearly inconsistent with the assumption of an evolved kin recognition module built into the human face recognition system.

  16. Analysis methods for facial motion

    Directory of Open Access Journals (Sweden)

    Katsuaki Mishima

    2009-05-01

    Full Text Available Objective techniques to evaluate a facial movement are indispensable for the contemporary treatment of patients with motor disorders such as facial paralysis, cleft lip, postoperative head and neck cancer, and so on. Recently, computer-assisted, video-based techniques have been devised and reported as measuring systems in which facial movements can be evaluated quantitatively. Commercially available motion analysis systems, in which a stereo-measuring technique with multiple cameras and markers to facilitate search of matching among images through all cameras, also are utilized, and are used in many measuring systems such as video-based systems. The key is how the problems of facial movement can be extracted precisely, and how useful information for the diagnosis and decision-making process can be derived from analyses of facial movement. Therefore, it is important to discuss which facial animations should be examined, and whether fixation of the head and markers attached to the face can hamper natural facial movement.

  17. Acupuncture Treatment of Facial Spasm

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Case History Ms. Zheng from Singapore, aged 51 years, paid her first visit on Aug.30, 2006, with the chief complaint of left facial paralysis accompanied with facial spasm for 5 years. The patient got left facial paralysis in 2001, which was not completely cured, and developed into facial spasm one year later. Although she had received various treatments including surgical operation, the disease was not cured. At the moment she had discomfort and dull sensation in the left facial area, mainly accompanied with twitching of the peripheral nerve of the eye. She was also accompanied with posterior auricular muscle tension and discomfort. She had fairly good sleep and appetite, but slightly quick temper. Physical examination at the moment showed that the patient had a slightly thin body figure, flushing face, and good mental state. The blood pressure was 110/75mmHg and the heart rate was 85 beats/min. No abnormal signs were found in the heart and lungs. The facial examination showed mild swelling of the left side of the face, incomplete closing of the eye lids, disappearance of wrinkles on the forehead, shallow nasolabial groove, and obvious muscle tension and tenderness in the left opisthotic region. Careful observation could find slight facial muscular twitching. The tongue proper was red with little coating, and the pulse thready-wiry.

  18. Investigation of the relationship between facial injuries and traumatic brain injuries using a realistic subject-specific finite element head model.

    Science.gov (United States)

    Tse, Kwong Ming; Tan, Long Bin; Lee, Shu Jin; Lim, Siak Piang; Lee, Heow Pueh

    2015-06-01

    In spite of anatomic proximity of the facial skeleton and cranium, there is lack of information in the literature regarding the relationship between facial and brain injuries. This study aims to correlate brain injuries with facial injuries using finite element method (FEM). Nine common impact scenarios of facial injuries are simulated with their individual stress wave propagation paths in the facial skeleton and the intracranial brain. Fractures of cranio-facial bones and intracranial injuries are evaluated based on the tolerance limits of the biomechanical parameters. General trend of maximum intracranial biomechanical parameters found in nasal bone and zygomaticomaxillary impacts indicates that severity of brain injury is highly associated with the proximity of location of impact to the brain. It is hypothesized that the midface is capable of absorbing considerable energy and protecting the brain from impact. The nasal cartilages dissipate the impact energy in the form of large scale deformation and fracture, with the vomer-ethmoid diverging stress to the "crumpling zone" of air-filled sphenoid and ethmoidal sinuses; in its most natural manner, the face protects the brain. This numerical study hopes to provide surgeons some insight in what possible brain injuries to be expected in various scenarios of facial trauma and to help in better diagnosis of unsuspected brain injury, thereby resulting in decreasing the morbidity and mortality associated with facial trauma.

  19. Dental Trauma Guide: a source of evidence-based treatment guidelines for dental trauma.

    Science.gov (United States)

    Andreasen, Jens Ove; Lauridsen, Eva; Gerds, Thomas Alexander; Ahrensburg, Søren Steno

    2012-10-01

    Diagnosis and treatment for traumatic dental injuries are very complex owing to the multiple trauma entities represented by six luxation types and nine fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and luxation injuries are often combined, the result is that more than 100 trauma scenarios exist, when the two dentitions are combined. Each of these trauma scenarios has a specific treatment demand and prospect for healing. With such a complexity in diagnosis and treatment, it is obvious that even experienced practitioners may have problems in selecting proper treatment for some of these trauma types. To remedy this situation, an Internet-based knowledge base consisting of 4000 dental trauma cases with long-term follow up is now available to the public and the professions on the Internet using the address http://www.DentalTraumaGuide.org. It is the aspiration that the use of this Guide may lead the practitioner to offer an evidence-based diagnosis and treatment.

  20. Facial Action Units Recognition: A Comparative Study

    NARCIS (Netherlands)

    Popa, M.C.; Rothkrantz, L.J.M.; Wiggers, P.; Braspenning, R.A.C.; Shan, C.

    2011-01-01

    Many approaches to facial expression recognition focus on assessing the six basic emotions (anger, disgust, happiness, fear, sadness, and surprise). Real-life situations proved to produce many more subtle facial expressions. A reliable way of analyzing the facial behavior is the Facial Action Coding

  1. Improving outcomes in aesthetic facial reconstruction.

    Science.gov (United States)

    Hofer, Stefan O P; Mureau, Marc A M

    2009-07-01

    Aesthetic facial reconstruction is a challenging art. Improving outcomes in aesthetic facial reconstruction requires a thorough understanding of the basic principles of the functional and aesthetic requirements for facial reconstruction. From there, further refinement and attention to detail can be provided. This paper discusses basic principles of aesthetic facial reconstruction.

  2. Facial Action Units Recognition: A Comparative Study

    NARCIS (Netherlands)

    Popa, M.C.; Rothkrantz, L.J.M.; Wiggers, P.; Braspenning, R.A.C.; Shan, C.

    2011-01-01

    Many approaches to facial expression recognition focus on assessing the six basic emotions (anger, disgust, happiness, fear, sadness, and surprise). Real-life situations proved to produce many more subtle facial expressions. A reliable way of analyzing the facial behavior is the Facial Action Coding

  3. Facial melanoses: Indian perspective

    Directory of Open Access Journals (Sweden)

    Neena Khanna

    2011-01-01

    Full Text Available Facial melanoses (FM are a common presentation in Indian patients, causing cosmetic disfigurement with considerable psychological impact. Some of the well defined causes of FM include melasma, Riehl′s melanosis, Lichen planus pigmentosus, erythema dyschromicum perstans (EDP, erythrosis, and poikiloderma of Civatte. But there is considerable overlap in features amongst the clinical entities. Etiology in most of the causes is unknown, but some factors such as UV radiation in melasma, exposure to chemicals in EDP, exposure to allergens in Riehl′s melanosis are implicated. Diagnosis is generally based on clinical features. The treatment of FM includes removal of aggravating factors, vigorous photoprotection, and some form of active pigment reduction either with topical agents or physical modes of treatment. Topical agents include hydroquinone (HQ, which is the most commonly used agent, often in combination with retinoic acid, corticosteroids, azelaic acid, kojic acid, and glycolic acid. Chemical peels are important modalities of physical therapy, other forms include lasers and dermabrasion.

  4. Craniomaxillofacial trauma in children: a review of 3,385 cases with 6,060 injuries in 10 years.

    Science.gov (United States)

    Gassner, Robert; Tuli, Tarkan; Hächl, Oliver; Moreira, Roger; Ulmer, Hanno

    2004-04-01

    Trauma is the leading cause of diseases and death in children. The goal of this study was to assess the impact of the main causes of accidents among children resulting in pediatric craniomaxillofacial trauma. Between 1991 and 2000, data for 3,385 patients younger than 15 years of age who sustained a total of 6,060 craniomaxillofacial injuries were recorded for cause of injury, age and gender distribution, frequency and type of injury, injury mechanisms, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, and concomitant injuries. Univariate statistical analyses were followed by logistic regression analyses for the 3 injury types to determine the impact of the main injury causes on the type of injury at different ages in pediatric facial trauma patients. Play (58.2%), sport (31.8%), and traffic accidents (5%), acts of violence (3.9%), and other causes (1.1%) were noted. A total of 389 patients (11.5%) had 615 fractures, 2,582 patients (76.3%) had 3,384 dentoalveolar injuries, and 1,697 patients (50.1%) had 2,061 soft tissue injuries. The girl-to-boy ratio was 3:5, and the mean age was 7 +/- 4.4 years. For children sustaining facial trauma, logistic regression analyses revealed increased risks for fractures (+238%) and soft tissue lesions (+89%) in children involved in traffic accidents. Dental trauma was more frequent (>+38%) in both sport and play accidents (all P trauma. Logistic regression analyses revealed statistically highly significant outcome differences in pediatric facial trauma depending on the injury mechanism.

  5. Anaesthesia for trauma patients

    African Journals Online (AJOL)

    ... hypothermia. E. Figure 1: Advance Trauma Life Support® management priorities ... should determine their own algorithm, based on available skills and resources. ... the fastest onset (30 seconds) and shortest duration of action. Therefore ...

  6. Tailbone trauma - aftercare

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000573.htm Tailbone trauma - aftercare To use the sharing features on this ... fractured one of these bones. More about Your Injury Most tailbone injuries lead to bruising and pain. ...

  7. Paediatric trauma care

    African Journals Online (AJOL)

    In this review, paediatric trauma care will be considered primarily for ... to technology increases, injury becomes a major source of childhood ..... reached include the nursing profession, workers in industry, ... New York: Freeman, 1984. 21.

  8. Military Sexual Trauma

    Science.gov (United States)

    ... VHA Forms & Publications Quality & Safety Quality of Care Ethics VA/DOD Clinical Practice Guidelines Hospital ... Trauma Overview Programs & Services Articles & Fact Sheets Other Resources Help with VA Services ...

  9. Platelet aggregation following trauma

    DEFF Research Database (Denmark)

    Windeløv, Nis A; Sørensen, Anne M; Perner, Anders

    2014-01-01

    We aimed to elucidate platelet function in trauma patients, as it is pivotal for hemostasis yet remains scarcely investigated in this population. We conducted a prospective observational study of platelet aggregation capacity in 213 adult trauma patients on admission to an emergency department (ED......). Inclusion criteria were trauma team activation and arterial cannula insertion on arrival. Blood samples were analyzed by multiple electrode aggregometry initiated by thrombin receptor agonist peptide 6 (TRAP) or collagen using a Multiplate device. Blood was sampled median 65 min after injury; median injury...... severity score (ISS) was 17; 14 (7%) patients received 10 or more units of red blood cells in the ED (massive transfusion); 24 (11%) patients died within 28 days of trauma: 17 due to cerebral injuries, four due to exsanguination, and three from other causes. No significant association was found between...

  10. Acute coagulopathy of trauma

    DEFF Research Database (Denmark)

    Johansson, P I; Ostrowski, S R

    2010-01-01

    Acute coagulopathy of trauma predicts a poor clinical outcome. Tissue trauma activates the sympathoadrenal system resulting in high circulating levels of catecholamines that influence hemostasis dose-dependently through immediate effects on the two major compartments of hemostasis, i.......e., the circulating blood and the vascular endothelium. There appears to be a dose-dependency with regards to injury severity and the hemostatic response to trauma evaluated in whole blood by viscoelastic assays like thrombelastography (TEG), changing from normal to hypercoagulable, to hypocoagulable and finally......, is an evolutionary developed response that counterbalances the injury and catecholamine induced endothelial activation and damage. Given this, the rise in circulating catecholamines in trauma patients may favor a switch from hyper- to hypocoagulability in the blood to keep the progressively more procoagulant...

  11. Incidental bony pathology when reporting trauma orthopantomograms

    Energy Technology Data Exchange (ETDEWEB)

    Macanovic, M., E-mail: mladenmaca@gmail.co [Derriford Hospital NHS Trust, Plymouth (United Kingdom); Gangidi, S.; Porter, G.; Brown, S.; Courtney, D. [Derriford Hospital NHS Trust, Plymouth (United Kingdom); Porter, J. [Community Dental Service, Plymouth Primary Care Trust, Plymouth, Devon (United Kingdom)

    2010-10-15

    Radiologists frequently report orthopantomograms (OPTs) and other views of the mandible, most often in patients who have suffered facial trauma. These examinations may reveal incidental pathology. It is important that radiologists are aware of the radiological appearances and the clinical significance of these lesions. In this review we will present examples of the more common odontogenic lesions including: radicular cyst, odontogenic keratocyst, dentigerous cyst, ameloblastoma, and also examples of non-odontogenic pathology: bisphosphonate-related osteonecrosis of the jaw (BRONJ) and chronic osteomyelitis. Although some of the lesions will require computed tomography (CT) or magnetic resonance imaging (MRI) for further lesion characterization and evaluation of the surrounding tissues, we are going to focus on the plain film appearances. We will also briefly discuss the pathogenesis, epidemiology, and treatment of these lesions.

  12. Simple technique for facial dimple

    Directory of Open Access Journals (Sweden)

    Ahmed Hassan El-Sabbagh

    2015-01-01

    Full Text Available Background: Subjects seeking aesthetic surgery for facial dimples are increasing in number. Literature on dimple creation surgery are sparse. Various techniques have been used with their own merits and disadvantages. Materials and Methods: Facial dimples were created in 23 cases. All the subjects were females. Five cases were bilateral and the rest were unilateral. Results: Minor complications such as swelling and hematoma were observed in four cases. Infection occurred in two cases. Most of the subjects were satisfied with the results. Conclusions: Suturing technique is safe, reliable and an easily reproducible way to create facial dimple. Level of Evidence: IV: Case series.

  13. Sleep Wrinkles: Facial Aging and Facial Distortion During Sleep.

    Science.gov (United States)

    Anson, Goesel; Kane, Michael A C; Lambros, Val

    2016-09-01

    Wrinkles are just one indicator of facial aging, but an indicator that is of prime importance in our world of facial aesthetics. Wrinkles occur where fault lines develop in aging skin. Those fault lines may be due to skin distortion resulting from facial expression or may be due to skin distortion from mechanical compression during sleep. Expression wrinkles and sleep wrinkles differ in etiology, location, and anatomical pattern. Compression, shear, and stress forces act on the face in lateral or prone sleep positions. We review the literature relating to the development of wrinkles and the biomechanical changes that occur in response to intrinsic and extrinsic influences. We explore the possibility that compression during sleep not only results in wrinkles but may also contribute to facial skin expansion.

  14. Childhood trauma in bipolar disorder

    OpenAIRE

    Watson, Stuart; Gallagher, Peter; Dougall, Dominic; Porter, Richard; Moncrieff, Joanna; Ferrier, I Nicol; Young, Allan H.

    2014-01-01

    Objective: There has been little investigation of early trauma in bipolar disorder despite evidence that stress impacts on the course of this illness. We aimed to compare the rates of childhood trauma in adults with bipolar disorder to a healthy control group, and to investigate the impact of childhood trauma on the clinical course of bipolar disorder. Methods: Retrospective assessment of childhood trauma was conducted using the Childhood Trauma Questionnaire (CTQ) in 60 outpatients with bipo...

  15. Childhood trauma in bipolar disorder.

    OpenAIRE

    Watson, S; Gallagher, P.; Dougall, D.; Porter, R.; Moncrieff, J; Ferrier, I N; Young, A.H.

    2014-01-01

    Objective:There has been little investigation of early trauma in bipolar disorder despite evidence that stress impacts on the course of this illness. We aimed to compare the rates of childhood trauma in adults with bipolar disorder to a healthy control group, and to investigate the impact of childhood trauma on the clinical course of bipolar disorder.Methods:Retrospective assessment of childhood trauma was conducted using the Childhood Trauma Questionnaire (CTQ) in 60 outpatients with bipolar...

  16. Linear abdominal trauma.

    Science.gov (United States)

    Danto, L A; Wolfman, E F

    1976-03-01

    Three cases of blunt abdominal trauma are presented to exemplify the mechanism of trauma and the problems of diagnosis associated with any linear blow to the abdomen. The mechanisms of visceral injury are reviewed, and special attention is directed to the abdominal wall injury that can be present in these patients. This injury has special implications in directing the operative approach and repair. An unusual aortic occlusion is described which is peculiar to this type of injury.

  17. Dynamic Facial Prosthetics for Sufferers of Facial Paralysis

    Directory of Open Access Journals (Sweden)

    Fergal Coulter

    2011-10-01

    Full Text Available BackgroundThis paper discusses the various methods and the materialsfor the fabrication of active artificial facial muscles. Theprimary use for these will be the reanimation of paralysedor atrophied muscles in sufferers of non-recoverableunilateral facial paralysis.MethodThe prosthetic solution described in this paper is based onsensing muscle motion of the contralateral healthy musclesand replicating that motion across a patient’s paralysed sideof the face, via solid state and thin film actuators. Thedevelopment of this facial prosthetic device focused onrecreating a varying intensity smile, with emphasis ontiming, displacement and the appearance of the wrinklesand folds that commonly appear around the nose and eyesduring the expression.An animatronic face was constructed with actuations beingmade to a silicone representation musculature, usingmultiple shape-memory alloy cascades. Alongside theartificial muscle physical prototype, a facial expressionrecognition software system was constructed. This formsthe basis of an automated calibration and reconfigurationsystem for the artificial muscles following implantation, soas to suit the implantee’s unique physiognomy.ResultsAn animatronic model face with silicone musculature wasdesigned and built to evaluate the performance of ShapeMemory Alloy artificial muscles, their power controlcircuitry and software control systems. A dual facial motionsensing system was designed to allow real time control overmodel – a piezoresistive flex sensor to measure physicalmotion, and a computer vision system to evaluate real toartificial muscle performance.Analysis of various facial expressions in real subjects wasmade, which give useful data upon which to base thesystems parameter limits.ConclusionThe system performed well, and the various strengths andshortcomings of the materials and methods are reviewedand considered for the next research phase, when newpolymer based artificial muscles are constructed

  18. Quality of trauma care and trauma registries.

    Science.gov (United States)

    Pino Sánchez, F I; Ballesteros Sanz, M A; Cordero Lorenzana, L; Guerrero López, F

    2015-03-01

    Traumatic disease is a major public health concern. Monitoring the quality of services provided is essential for the maintenance and improvement thereof. Assessing and monitoring the quality of care in trauma patient through quality indicators would allow identifying opportunities for improvement whose implementation would improve outcomes in hospital mortality, functional outcomes and quality of life of survivors. Many quality indicators have been used in this condition, although very few ones have a solid level of scientific evidence to recommend their routine use. The information contained in the trauma registries, spread around the world in recent decades, is essential to know the current health care reality, identify opportunities for improvement and contribute to the clinical and epidemiological research. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  19. Airway management in trauma

    Directory of Open Access Journals (Sweden)

    Rao B

    2004-01-01

    Full Text Available Airway Management for the victims of major trauma is the first priority in the care of the trauma victim and is a core skill in emergency medicine and critical care. Endotracheal intubation remains the gold standard for trauma airway management. Airway management in trauma patients is not just the capability to insert an oral/nasal airway or endotracheal tube beyond the vocal cords. The five components integral to modern, sophisticated airway management in trauma patients include equipment, pharmacologic adjuncts, manual techniques, physical circumstances, and patient profile. A trauma patient may require airway management in a variety of physical circumstances. Whereas, the commonly used airway management algorithms may not suffice in all these situations, the construction of a truly complete decision tree is also virtually impossible. There is consensus that it is not the intervention per se but rather the conditions, skills, and performance that might be the possible variables that affect outcome. Paramedics have only limited experience and on-the-job skills for invasive airway management. Difficult airway management is best left for the experienced physicians to handle.

  20. Airway management in trauma.

    Science.gov (United States)

    Langeron, O; Birenbaum, A; Amour, J

    2009-05-01

    Maintenance of a patent and prevention of aspiration are essential for the management of the trauma patient, that requires experienced physicians in airway control techniques. Difficulties of the airway control in the trauma setting are increased by the vital failures, the risk of aspiration, the potential cervical spine injury, the combative patient, and the obvious risk of difficult tracheal intubation related to specific injury related to the trauma. Endotracheal intubation remains the gold standard in trauma patient airway management and should be performed via the oral route with a rapid sequence induction and a manual in-line stabilization maneuver, to decrease the risks previously mentioned. Different techniques to control the airway in trauma patients are presented: improvement of the laryngoscopic vision, lighted stylet tracheal intubation, retrograde technique for orotracheal intubation, the laryngeal mask and the intubating laryngeal mask airways, the combitube and cricothyroidotomy. Management of the airway in trauma patients requires regular training in these techniques and the knowledge of complementary techniques allowing tracheal intubation or oxygenation to overcome difficult intubation and to prevent major complications as hypoxemia and aspiration.

  1. Bouncing back - trauma and the HPA-axis in healthy adults

    Directory of Open Access Journals (Sweden)

    Ellen Renée Klaassens

    2010-12-01

    Full Text Available Dysregulation of the hypothalamic–pituitary–adrenal (HPA-axis is thought to underlie stress-related psychiatric disorders such as posttraumatic stress disorder (PTSD. Some studies have reported HPA-axis dysregulation in trauma-exposed (TE adults in the absence of psychiatric morbidity. In this dissertation we set out to unravel part of the mechanism that underlies the complex relations between trauma exposure, stress regulation, and psychopathology. Mentally healthy TE subjects were compared with non-trauma-exposed (NE healthy controls. To distinguish between the potential effects of childhood trauma and adulthood trauma, we included women exposed to childhood trauma as well as men who were exposed to trauma during adulthood. Basal HPA-axis functioning was assessed with salivary cortisol samples. HPA-axis reactivity was assessed with the dexamethasone/corticotropin-releasing hormone (Dex/CRH test. The results show that childhood trauma exposure is associated with an attenuated cortisol response after the Dex/CRH challenge test in women. In contrast, trauma exposure during adulthood was not associated with alterations in HPA-axis regulation after the Dex/CRH test. Neither childhood trauma nor adulthood trauma were associated with basal HPA-axis functioning. Childhood trauma rather than adulthood trauma may chronically affect HPA-axis functioning. Since the association between adulthood trauma and resilience to psychopathology cannot be explained by HPA-axis functioning alone, other factors must play a role.

  2. Topical rapamycin (sirolimus) for facial angiofibromas.

    Science.gov (United States)

    Madke, Bhushan

    2013-01-01

    Rapamycin (sirolimus) is a fungal fermentation product that inhibits the proper functioning of a serine/threonine protein kinase in mammalian cells eponymously named mammalian target of rapamycin, or mTOR. Rapamycin is a novel class of anticancer and immunosuppressant drugs targeting the proteins at molecular level. Rapamycin (sirolimus) is routinely incorporated in drug-eluting stents used for cardiac angioplasty. In recent years, rapamycin was found to be efficacious in managing the symptom complex of tuberous sclerosis, i.e. renal angiomyolipoma, giant cell astrocytoma and pulmonary lymphangiomyomatosis. Various investigators have also proved that topically applied rapamycin causes regression of facial angiofibromas, giving better cosmetic results.

  3. Pediatric facial burns: Is facial transplantation the new reconstructive psychosurgery?

    Science.gov (United States)

    Hanson, Mark D; Zuker, Ronald M; Shaul, Randi Zlotnik

    2008-01-01

    INTRODUCTION: Current pediatric burn care has resulted in survival being the expectation for most children. Composite tissue allotransplantation in the form of face or hand transplantation may present opportunities for reconstructive surgery of patients with burns. The present paper addresses the question “Could facial transplantation be of therapeutic benefit in the treatment of pediatric burns associated with facial disfigurement?” METHODS: Therapeutic benefit of facial transplantation was defined in terms of psychiatric adjustment and quality of life (QOL). To ascertain therapeutic benefit, studies of pediatric burn injury and associated psychiatric adjustment and QOL in children, adolescents and adults with pediatric burns, were reviewed. RESULTS: Pediatric burn injury is associated with anxiety disorders, including post-traumatic stress disorder and depressive disorders. Many patients with pediatric burns do not routinely access psychiatric care for these disorders, including those for psychiatric assessment of suicidal risk. A range of QOL outcomes were reported; four were predominantly satisfactory and one was predominantly unsatisfactory. DISCUSSION: Facial transplantation may reduce the risk of depressive and anxiety disorders other than post-traumatic stress disorder. Facial transplantation promises to be the new reconstructive psychosurgery, because it may be a surgical intervention with the potential to reduce the psychiatric suffering associated with pediatric burns. Furthermore, patients with pediatric burns may experience the stigma of disfigurement and psychiatric conditions. The potential for improved appearance with facial transplantation may reduce this ‘dual stigmata’. Studies combining surgical and psychiatric research are warranted. PMID:19949498

  4. Nablus mask-like facial syndrome

    DEFF Research Database (Denmark)

    Allanson, Judith; Smith, Amanda; Hare, Heather

    2012-01-01

    Nablus mask-like facial syndrome (NMLFS) has many distinctive phenotypic features, particularly tight glistening skin with reduced facial expression, blepharophimosis, telecanthus, bulky nasal tip, abnormal external ear architecture, upswept frontal hairline, and sparse eyebrows. Over the last few...... heterozygous deletions significantly overlapping the region associated with NMLFS. Notably, while one mother and child were said to have mild tightening of facial skin, none of these individuals exhibited reduced facial expression or the classical facial phenotype of NMLFS. These findings indicate...

  5. Facial Expression Recognition Using SVM Classifier

    OpenAIRE

    2015-01-01

    Facial feature tracking and facial actions recognition from image sequence attracted great attention in computer vision field. Computational facial expression analysis is a challenging research topic in computer vision. It is required by many applications such as human-computer interaction, computer graphic animation and automatic facial expression recognition. In recent years, plenty of computer vision techniques have been developed to track or recognize the facial activities in three levels...

  6. Management of Elbow Trauma: Anatomy and Exposures.

    Science.gov (United States)

    Barco, Raul; Antuña, Samuel A

    2015-11-01

    The elbow is a complex joint from the anatomic and biomechanical point of view. A thorough understanding of elbow anatomy greatly aids the surgeon in dealing with elbow trauma. The close vicinity of neurovascular structures should always be kept in mind when selecting a surgical approach. Any approach to the elbow needs to be safe and versatile. Knowledge of the attachment and orientation of elbow ligaments reduces the risk of inadvertent intraoperative injury and/or postoperative instability. Surgeons dealing with elbow trauma should have a good working understanding of elbow anatomy and the available approaches to effectively and efficiently conduct the surgical procedure to maximize outcomes and minimize complications.

  7. Hardware Removal in Craniomaxillofacial Trauma

    Science.gov (United States)

    Cahill, Thomas J.; Gandhi, Rikesh; Allori, Alexander C.; Marcus, Jeffrey R.; Powers, David; Erdmann, Detlev; Hollenbeck, Scott T.; Levinson, Howard

    2015-01-01

    Background Craniomaxillofacial (CMF) fractures are typically treated with open reduction and internal fixation. Open reduction and internal fixation can be complicated by hardware exposure or infection. The literature often does not differentiate between these 2 entities; so for this study, we have considered all hardware exposures as hardware infections. Approximately 5% of adults with CMF trauma are thought to develop hardware infections. Management consists of either removing the hardware versus leaving it in situ. The optimal approach has not been investigated. Thus, a systematic review of the literature was undertaken and a resultant evidence-based approach to the treatment and management of CMF hardware infections was devised. Materials and Methods A comprehensive search of journal articles was performed in parallel using MEDLINE, Web of Science, and ScienceDirect electronic databases. Keywords and phrases used were maxillofacial injuries; facial bones; wounds and injuries; fracture fixation, internal; wound infection; and infection. Our search yielded 529 articles. To focus on CMF fractures with hardware infections, the full text of English-language articles was reviewed to identify articles focusing on the evaluation and management of infected hardware in CMF trauma. Each article’s reference list was manually reviewed and citation analysis performed to identify articles missed by the search strategy. There were 259 articles that met the full inclusion criteria and form the basis of this systematic review. The articles were rated based on the level of evidence. There were 81 grade II articles included in the meta-analysis. Result Our meta-analysis revealed that 7503 patients were treated with hardware for CMF fractures in the 81 grade II articles. Hardware infection occurred in 510 (6.8%) of these patients. Of those infections, hardware removal occurred in 264 (51.8%) patients; hardware was left in place in 166 (32.6%) patients; and in 80 (15.6%) cases

  8. [Establishement for regional pelvic trauma database in Hunan Province].

    Science.gov (United States)

    Cheng, Liang; Zhu, Yong; Long, Haitao; Yang, Junxiao; Sun, Buhua; Li, Kanghua

    2017-04-28

    To establish a database for pelvic trauma in Hunan Province, and to start the work of multicenter pelvic trauma registry.
 Methods: To establish the database, literatures relevant to pelvic trauma were screened, the experiences from the established trauma database in China and abroad were learned, and the actual situations for pelvic trauma rescue in Hunan Province were considered. The database for pelvic trauma was established based on the PostgreSQL and the advanced programming language Java 1.6.
 Results: The complex procedure for pelvic trauma rescue was described structurally. The contents for the database included general patient information, injurious condition, prehospital rescue, conditions in admission, treatment in hospital, status on discharge, diagnosis, classification, complication, trauma scoring and therapeutic effect. The database can be accessed through the internet by browser/servicer. The functions for the database include patient information management, data export, history query, progress report, video-image management and personal information management.
 Conclusion: The database with whole life cycle pelvic trauma is successfully established for the first time in China. It is scientific, functional, practical, and user-friendly.

  9. Fracturas faciales en pacientes menores de veinte anos atendidos en la unidad de cirugia maxilofacial y estomatologia del hospital universitario san vicente de Paul y la facultad de odontologia de la universidad de Antioquia entre los anos 1998 Y 2007.(Perspectiva general de la enfermedad/trastorno)

    National Research Council Canada - National Science Library

    Duque Serna, Francisco Levi; Sanchez Correa, Carlos Alberto; Segura Cardona, Angela Maria

    2010-01-01

    ... de 1.173 fracturas de huesos faciales durante un periodo de diez anos entre 1998 y 2007, considerando la edad, sexo del paciente, tipo y localizacion comun de las fracturas, etiologia del trauma...

  10. [Capabilities of a Multivox hardware-software system in the radiodiagnosis of facial skeleton injury].

    Science.gov (United States)

    Kuznetsov, A A; Klimova, N V

    2013-01-01

    The authors evaluated the efficiency of a Multivox RIS hardware-software system in optimizing the radiodiagnosis of facial skeleton injury. An attempt was undertaken to systematize an approach to the comprehensive radiographic examination of patients with craniofacial polytrauma. It is shown that an image can be postprocessed using the Multivox RIS hardware-software system, which contributes to the comprehensive analysis of obtained images, by applying different radiographic studies; moreover, digital X-ray study has the most diagnostic value and rationality for isolated maxillofacial trauma and multislice spiral computed tomography has them for mixed, concurrent, and multiple injuries. The developed algorithm for examining the patients with facial skeleton trauma unifies and optimizes the diagnosis of craniofascial injuries at different sites.

  11. Sympathicotomy for isolated facial blushing

    DEFF Research Database (Denmark)

    Licht, Peter Bjørn; Pilegaard, Hans K; Ladegaard, Lars

    2012-01-01

    Background. Facial blushing is one of the most peculiar of human expressions. The pathophysiology is unclear, and the prevalence is unknown. Thoracoscopic sympathectomy may cure the symptom and is increasingly used in patients with isolated facial blushing. The evidence base for the optimal level...... of targeting the sympathetic chain is limited to retrospective case studies. We present a randomized clinical trial. Methods. 100 patients were randomized (web-based, single-blinded) to rib-oriented (R2 or R2-R3) sympathicotomy for isolated facial blushing at two university hospitals during a 6-year period...... in all social and mental domains in both groups. Overall, 85% of the patients had an excellent or satisfactory result, with no significant difference between the R2 procedure and the R2-R3 procedure. Mild recurrence of facial blushing occurred in 30% of patients within the first year. One patient...

  12. Spontaneous Emotional Facial Expression Detection

    Directory of Open Access Journals (Sweden)

    Zhihong Zeng

    2006-08-01

    Full Text Available Change in a speaker’s emotion is a fundamental component in human communication. Automatic recognition of spontaneous emotion would significantly impact human-computer interaction and emotion-related studies in education, psychology and psychiatry. In this paper, we explore methods for detecting emotional facial expressions occurring in a realistic human conversation setting—the Adult Attachment Interview (AAI. Because non-emotional facial expressions have no distinct description and are expensive to model, we treat emotional facial expression detection as a one- class classification problem, which is to describe target objects (i.e., emotional facial expressions and distinguish them from outliers (i.e., non-emotional ones. Our preliminary experiments on AAI data suggest that one-class classification methods can reach a good balance between cost (labeling and computing and recognition performance by avoiding non-emotional expression labeling and modeling.

  13. Imaging of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Veillon, F. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France)], E-mail: Francis.Veillon@chru-strasbourg.fr; Ramos-Taboada, L.; Abu-Eid, M. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France); Charpiot, A. [Service d' ORL, Hopital de Hautepierre, 67098 Strasbourg Cedex (France); Riehm, S. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France)

    2010-05-15

    The facial nerve is responsible for the motor innervation of the face. It has a visceral motor function (lacrimal, submandibular, sublingual glands and secretion of the nose); it conveys a great part of the taste fibers, participates to the general sensory of the auricle (skin of the concha) and the wall of the external auditory meatus. The facial mimic, production of tears, nasal flow and salivation all depend on the facial nerve. In order to image the facial nerve it is mandatory to be knowledgeable about its normal anatomy including the course of its efferent and afferent fibers and about relevant technical considerations regarding CT and MR to be able to achieve high-resolution images of the nerve.

  14. Facial Areas and Emotional Information

    Science.gov (United States)

    Boucher, Jerry D.; Ekman, Paul

    1975-01-01

    Provides strong support for the view that there is no one area of the face which best reveals emotion, but that the value of the different facial areas in distinguishing emotions depends upon the emotion being judged. (Author)

  15. Facial Areas and Emotional Information

    Science.gov (United States)

    Boucher, Jerry D.; Ekman, Paul

    1975-01-01

    Provides strong support for the view that there is no one area of the face which best reveals emotion, but that the value of the different facial areas in distinguishing emotions depends upon the emotion being judged. (Author)

  16. Facial emotion recognition in paranoid schizophrenia and autism spectrum disorder.

    Science.gov (United States)

    Sachse, Michael; Schlitt, Sabine; Hainz, Daniela; Ciaramidaro, Angela; Walter, Henrik; Poustka, Fritz; Bölte, Sven; Freitag, Christine M

    2014-11-01

    Schizophrenia (SZ) and autism spectrum disorder (ASD) share deficits in emotion processing. In order to identify convergent and divergent mechanisms, we investigated facial emotion recognition in SZ, high-functioning ASD (HFASD), and typically developed controls (TD). Different degrees of task difficulty and emotion complexity (face, eyes; basic emotions, complex emotions) were used. Two Benton tests were implemented in order to elicit potentially confounding visuo-perceptual functioning and facial processing. Nineteen participants with paranoid SZ, 22 with HFASD and 20 TD were included, aged between 14 and 33 years. Individuals with SZ were comparable to TD in all obtained emotion recognition measures, but showed reduced basic visuo-perceptual abilities. The HFASD group was impaired in the recognition of basic and complex emotions compared to both, SZ and TD. When facial identity recognition was adjusted for, group differences remained for the recognition of complex emotions only. Our results suggest that there is a SZ subgroup with predominantly paranoid symptoms that does not show problems in face processing and emotion recognition, but visuo-perceptual impairments. They also confirm the notion of a general facial and emotion recognition deficit in HFASD. No shared emotion recognition deficit was found for paranoid SZ and HFASD, emphasizing the differential cognitive underpinnings of both disorders.

  17. A REVIEW ON FACIAL NEURALGIAS

    OpenAIRE

    Solanki, Gaurav

    2010-01-01

    Facial neuralgias are produced by a change in neurological structure or function. This type of neuropathic pain affects the mental health as well as quality of life of patients. There are different types of neuralgias affecting the oral and maxillofacial region. These unusual pains are linked to some possible mechanisms. Various diagnostic tests are done to diagnose the proper cause of facial neuralgia and according to it the medical and surgical treatment is done to provide relief to patient.

  18. Animating facial images with drawings

    OpenAIRE

    Tunali, Gamze Dilek

    1996-01-01

    Ankara : Bilkent Univ., 1996. Thesis (Master's) -- Bilkent University, 1996. Includes bibliographical references leaves 54-56. The work presented here describes the power of 2D animation with texture mai^ping controlled by line drawings. Animation is specifically intended for facial animation and not restricted by the human face. We initially have a sequence of facial images which are taken from a video sequence of the same face and an image of another face to be animated...

  19. Cranio-maxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries.

    Science.gov (United States)

    Gassner, Robert; Tuli, Tarkan; Hächl, Oliver; Rudisch, Ansgar; Ulmer, Hanno

    2003-02-01

    Cranio-maxillofacial trauma management requires pertinent documentation. Using a large computerized database, injury surveillance and research data describe the whole spectrum of injuries. The goal of this study was to assess the effect of the five main causes of accidents resulting in facial injury on the severity of cranio-maxillofacial trauma. During a period of 10 years (1991-2000) 9,543 patients were admitted to the Department of Oral and Maxillofacial Surgery, University Hospital of Innsbruck with cranio-maxillofacial trauma. Data of patients were prospectively recorded including cause of injury, age and gender, type of injury, injury mechanisms, location and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures and concomitant injuries. Statistical analyses performed included descriptive analysis, chi square test, Fisher's exact test, and Mann-Whitney's U test. This was followed by logistic regression analyses for the three injury types to determine the impact of the five main causes on the type of injury at different ages in facial trauma patients. Five major categories/mechanisms of injury existed: in 3,613 (38%) cases it was activity of daily life, in 2991 (31%) sports, 1170 (12%) violence, in 1,116 (12%) traffic accidents, in 504 (5%) work accidents and in 149 (2%) other causes. A total of 3,578 patients (37.5%) had 7,061 facial bone fractures, 4,763 patients (49.9%) suffered from 6,237 dentoalveolar, and 5,968 patients (62.5%) from 7,769 soft tissue injuries. Gender distribution showed an overall male-to-female ratio of 2.1 to 1 and the mean age was 25.8+/-19.9 years; but both varied greatly depending on the injury mechanism (facial bone fractures: 35.4+/-19.5 years, higher risk for males; soft tissue injuries: 28.7+/-20.5, no gender preference; dentoalveolar trauma: 18+/-15.6, elevated risk for females). For patients sustaining facial trauma, logistic regression analyses revealed increased risks for facial bone fractures (225

  20. Differential diagnosis of facial pain and guidelines for management.

    Science.gov (United States)

    Zakrzewska, J M

    2013-07-01

    The diagnosis and management of facial pain below the eye can be very different dependant on whether the patient visits a dentist or medical practitioner. A structure for accurate diagnosis is proposed beginning with a very careful history. The commonest acute causes of pain are dental and these are well managed by dentists. Chronic facial pain can be unilateral or bilateral and continuous or episodic. The commonest non-dental pains are temporomandibular disorders (TMDs), especially musculoskeletal involving the muscles of mastication either unilaterally or bilaterally; they may be associated with other chronic pains. A very wide range of treatments are used but early diagnosis, reassurance and some simple physiotherapy is often effective in those with good coping strategies. Dentists will often make splints to wear at night. Neuropathic pain is usually unilateral and of the episodic type; the most easily recognized is trigeminal neuralgia. This severe electric shock like pain, provoked by light touch, responds best to carbamazepine, and neurosurgery in poorly controlled patients. Trauma, either major or because of dental procedures, results in neuropathic pain and these are then managed as for any other neuropathic pain. Red flags include giant cell arteritis which much be distinguished from temporomandibular disorders (TMD), especially in >50 yr olds, and cancer which can present as a progressive neuropathic pain. Burning mouth syndrome is rarely recognized as a neuropathic pain as it occurs principally in peri-menopausal women and is thought to be psychological. Chronic facial pain patients are best managed by a multidisciplinary team.

  1. Trauma experience in children and adolescents: an assessment of the effects of trauma type and role of interpersonal proximity.

    Science.gov (United States)

    Price, Maggi; Higa-McMillan, Charmaine; Kim, Sunyoung; Frueh, B Christopher

    2013-10-01

    The psychiatric sequelae associated with childhood experience(s) of trauma is complex and distinguishable from that of adult trauma exposure. Categories of impairment associated with experiences of early trauma include internalizing and externalizing emotional and behavioral problems, posttraumatic stress symptomatology, and dissociation. The present study assessed the relationship between the type of trauma experience (i.e., non-interpersonal or interpersonal) and the manifestation of a wide range of psychiatric symptomatology using prospective longitudinal data from a community sample of ethnically diverse children and adolescents (N=1676; ages 4-18). The study also examined the relationship between different types of trauma experiences (e.g., direct, vicarious, interpersonal) and levels of various symptom domains (e.g., anxiety, posttraumatic stress, conduct problems). A number of factors relevant to the relationship between early trauma experience and subsequent impairment including temperament, socioeconomic status, sex, and age were included in the analyses. Results indicated that interpersonal traumas involving significant interpersonal proximity were associated with externalizing problems (i.e., oppositional defiant and conduct problems). Direct trauma experiences and emotionality were positively associated with almost all symptom domains. Implications for the relationship between trauma and developmental psychopathology are discussed.

  2. Developmental facial paralysis: a review.

    Science.gov (United States)

    Terzis, Julia K; Anesti, Katerina

    2011-10-01

    The purpose of this study is to clarify the confusing nomenclature and pathogenesis of Developmental Facial Paralysis, and how it can be differentiated from other causes of facial paralysis present at birth. Differentiating developmental from traumatic facial paralysis noted at birth is important for determining prognosis, but also for medicolegal reasons. Given the dramatic presentation of this condition, accurate and reliable guidelines are necessary in order to facilitate early diagnosis and initiate appropriate therapy, while providing support and counselling to the family. The 30 years experience of our center in the management of developmental facial paralysis is dependent upon a thorough understanding of facial nerve embryology, anatomy, nerve physiology, and an appreciation of well-recognized mishaps during fetal development. It is hoped that a better understanding of this condition will in the future lead to early targeted screening, accurate diagnosis and prompt treatment in this population of facially disfigured patients, which will facilitate their emotional and social rehabilitation, and their reintegration among their peers.

  3. Neuro-ophthalmological approach to facial nerve palsy

    Science.gov (United States)

    Portelinha, Joana; Passarinho, Maria Picoto; Costa, João Marques

    2014-01-01

    Facial nerve palsy is associated with significant morbidity and can have different etiologies. The most common causes are Bell’s palsy, Ramsay–Hunt syndrome and trauma, including surgical trauma. Incidence varies between 17 and 35 cases per 100,000. Initial evaluation should include accurate clinical history, followed by a comprehensive investigation of the head and neck, including ophthalmological, otological, oral and neurological examination, to exclude secondary causes. Routine laboratory testing and diagnostic imaging is not indicated in patients with new-onset Bell’s palsy, but should be performed in patients with risk factors, atypical cases or in any case without resolution within 4 months. Many factors are involved in determining the appropriate treatment of these patients: the underlying cause, expected duration of nerve dysfunction, anatomical manifestations, severity of symptoms and objective clinical findings. Systemic steroids should be offered to patients with new-onset Bell’s palsy to increase the chance of facial nerve recovery and reduce synkinesis. Ophthalmologists play a pivotal role in the multidisciplinary team involved in the evaluation and rehabilitation of these patients. In the acute phase, the main priority should be to ensure adequate corneal protection. Treatment depends on the degree of nerve lesion and on the risk of the corneal damage based on the amount of lagophthalmos, the quality of Bell’s phenomenon, the presence or absence of corneal sensitivity and the degree of lid retraction. The main therapy is intensive lubrication. Other treatments include: taping the eyelid overnight, botulinum toxin injection, tarsorrhaphy, eyelid weight implants, scleral contact lenses and palpebral spring. Once the cornea is protected, longer term planning for eyelid and facial rehabilitation may take place. Spontaneous complete recovery of Bell’s palsy occurs in up to 70% of cases. Long-term complications include aberrant regeneration

  4. THE VALUE OF LIPOSTRUCTURE IN RECONSTRUCTION OF THE MAXILLO-FACIAL SOFT TISSUE DEFFECTS

    OpenAIRE

    2012-01-01

    BACKGROUND: Indifferent to the origin (congenital or acquired) the facial deformities are difficult to be accepted by the patients. The ideal technique is a simple procedure, with minimal trauma for the patient and with predictable results. The lipostructure can be considered one of these types of reconstruction method and we present our experience with. METHODS: We had used lipostructure at 8 patients for the plasty of postoperative defects (5 after resection of parotidian or cutaneous malig...

  5. Traumatic pseudolipoma causing facial asymmetry: An uncommon pathology and review of its pathogenesis

    Directory of Open Access Journals (Sweden)

    Kunal Sah

    2011-01-01

    Full Text Available We present an uncommon case of traumatic pseudolipoma in a 24-year-old female, causing facial asymmetry. Literature review suggests trauma as a possible etiology for its pathogenesis, which was present in this case. Microscopically, sometimes it is difficult to differentiate between normal adipose tissue and lipoma. Clinician must provide accurate clinical information in order to make a definitive diagnosis of traumatic pseudolipoma. Its pathogenesis has also been highlighted in this article.

  6. Systemic inflammation after trauma.

    Science.gov (United States)

    Lenz, Andreas; Franklin, Glen A; Cheadle, William G

    2007-12-01

    Trauma is still one of the main reasons for death among the population worldwide. Mortality occurring early after injury is due to "first hits", including severe organ injury, hypoxia, hypovolaemia or head trauma. Massive injury leads to activation of the immune system and the early inflammatory immune response after trauma has been defined as systemic inflammatory response syndrome (SIRS). "Second hits" such as infections, ischaemia/reperfusion or operations can further augment the pro-inflammatory immune response and have been correlated with the high morbidity and mortality in the latter times after trauma. SIRS can lead to tissue destruction in organs not originally affected by the initial trauma with subsequent development of multi-organ dysfunction (MOD). The initial pro-inflammatory response is followed by an anti-inflammatory response and can result in immune suppression with high risk of infection and sepsis. Trauma causes activation of nearly all components of the immune system. It activates the neuroendocrine system and local tissue destruction and accumulation of toxic byproducts of metabolic respiration leads to release of mediators. Extensive tissue injury may result in spillover of these mediators into the peripheral bloodstream to further maintain and augment the pro-inflammatory response. Hormones like ACTH, corticosteroids and catecholamines as well as cytokines, chemokines and alarmins play important roles in the initiation and persistence of the pro-inflammatory response after severe injury. The purpose of this review is therefore to describe the immunological events after trauma and to introduce important mediators and pathways of the inflammatory immune response.

  7. Complexity

    CERN Document Server

    Gershenson, Carlos

    2011-01-01

    The term complexity derives etymologically from the Latin plexus, which means interwoven. Intuitively, this implies that something complex is composed by elements that are difficult to separate. This difficulty arises from the relevant interactions that take place between components. This lack of separability is at odds with the classical scientific method - which has been used since the times of Galileo, Newton, Descartes, and Laplace - and has also influenced philosophy and engineering. In recent decades, the scientific study of complexity and complex systems has proposed a paradigm shift in science and philosophy, proposing novel methods that take into account relevant interactions.

  8. Imaging of high-energy midfacial trauma: what the surgeon needs to know

    Energy Technology Data Exchange (ETDEWEB)

    Linnau, Ken F.; Stanley, Robert B.; Hallam, Danial K.; Gross, Joel A.; Mann, F.A. E-mail: famann@u.washington.edu

    2003-10-01

    Treatment goals in severe midfacial trauma are restoration of function and appearance. Restoration of function is directed at multiple organ systems, which support visual acuity, airway patency, mastication, lacrimation, smelling, tasting, hearing, and facial expression. Victims of blunt facial trauma expect to look the same after surgical treatment as before injury. Delicate soft tissues of the midface often make cosmetic reconstructive surgery technically challenging. Generally, clinical evaluation alone does not suffice to fully characterize facial fractures associated with extensive swelling, and the deeper midface is not accessible to physical examination. Properly performed computed tomography (CT) overcomes most limitations of presurgical examination. Thus, operative approaches and sequencing of surgical repair are guided by imaging information displayed by CT. Restoration of function and appearance relies on recreating normal maxillofacial skeletal anatomy, with particular attention to position of the malar eminences, mandibular condyles, vertical dimension and orbital morphology. Due to its pivotal role in surgical planning, CT scans obtained for the evaluation of severe midfacial trauma should be designed to easily depict the imaging information necessary for clinical decision making. Learning objectives: 1. Understand the facial skeletal buttress system; 2. Understand how the pattern of derangement of the buttress system determines the need for and choice of operative approach for repair of fractures in the middle third of the face; 3. Understand the role and importance of CT and CT reformations in the detection and classification of the pattern of buttress system derangement.

  9. Facial nerve palsy: analysis of cases reported in children in a suburban hospital in Nigeria

    National Research Council Canada - National Science Library

    Folayan, M O; Arobieke, R I; Eziyi, E; Oyetola, E O; Elusiyan, J

    2014-01-01

    The study describes the epidemiology, treatment, and treatment outcomes of the 10 cases of facial nerve palsy seen in children managed at the Obafemi Awolowo University Teaching Hospitals Complex, Ile...

  10. The facial expression of schizophrenic patients applied with infrared thermal facial image sequence

    National Research Council Canada - National Science Library

    Bo-Lin Jian; Chieh-Li Chen; Wen-Lin Chu; Min-Wei Huang

    2017-01-01

    .... Thus, this study used non-contact infrared thermal facial images (ITFIs) to analyze facial temperature changes evoked by different emotions in moderately and markedly ill schizophrenia patients...

  11. Restoration of facial symmetry in a patient with bell palsy using a modified maxillary complete denture: a case report.

    Science.gov (United States)

    Bagchi, Gautam; Nath, Dilip Kumar

    2012-01-01

    Permanent facial paralysis can be devastating for a patient. Modern society's emphasis on appearance and physical beauty contributes to this problem and often leads to isolation of patients embarrassed by their appearance. Lagophthalmos with ocular exposure, loss of oral competence with resultant drooling, alar collapse with nasal airway obstruction, and difficulties with mastication and speech production are all potential consequences of facial paralysis. Affected patients are confronted with both a cosmetic defect and the functional deficits associated with loss of facial nerve function. In this case history report, a modified maxillary complete denture permitted a patient with Bell palsy to carry on daily activities with minimal facial distortion, pain, speech difficulty, and associated emotional trauma.

  12. Temporal bone trauma and complications: computed tomography findings

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Ana Maria Doffemond; Gaiotti, Juliana Oggioni; Couto, Caroline Laurita Batista; Gomes, Natalia Delage; Diniz, Renata Lopes Furletti Caldeira; Motta, Emilia Guerra Pinto Coelho, E-mail: anadoffemond@yahoo.com.br [Hospital Mater Dei, Belo Horizonte, MG (Brazil). Unit of Radiology and Imaging Diagnosis

    2013-03-15

    Most temporal bone fractures result from high-energy blunt head trauma, and are frequently related to other skull fractures or to polytrauma. Fractures and displacements of ossicular chain in the middle ear represent some of the main complications of temporal bone injury, and hence they will be more deeply approached in the present article. Other types of injuries include labyrinthine fractures, dural fistula, facial nerve paralysis and extension into the carotid canal. Computed tomography plays a fundamental role in the initial evaluation of polytrauma patients, as it can help to identify important structural injuries that may lead to severe complications such as sensorineural hearing loss, conductive hearing loss, dizziness and balance dysfunction, perilymphatic fistulas, facial nerve paralysis, vascular injury and others. (author)

  13. RECONSTRUCTION OF FACIAL SKIN DEFECT BY VARIOUS FLAPS : OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Atishkumar B.

    2015-08-01

    Full Text Available INTRODUCTION : Face represents complete personality of human being. Cosmetically it is very important part of a person especially for woman. There are many situations when due to disease or trauma, facial defect arises, which requires reconstruction by either local or distant surgical flaps . METHODS AND MATERIALS : In rural places, we come across many patients suffering from trauma and skin malignancy of face. These patients require reconstruction done esthetically with local flaps. Objective of this study is to share our exper ience of providing esthetically good results at our secondary referral care center. Hereby, we present case series of 14 patients operated at our institute. These patients were analyzed according to the age, sex, nature of injury and anatomical location of lesion on the face. All these patients were operated and reconstruction of defect was done with various local flaps best suited for respective lesion, under local anesthesia or sedation. Post - operative nature of wound was analyzed for flap viability or fl ap necrosis . RESULTS : Amongst them were 7 male and 7 female, ages ranging from 4 to 80 years. 7out of 14 patients were of basal cell carcinoma, 4 were due to trauma, 2 were due to dog bite and 1 case of recurrent pleomorphic adenoma at root of nose. All patients had excellent flap viability at end of 6 months and flap achieving almost similar color and contour as that of surrounding skin. CONCLUSION : Reconstruction of facial defects by local flaps is very easy and cost effective technique. This can be don e even at secondary referral care centre with minimal availability of facilities

  14. Management of peripheral facial nerve palsy.

    Science.gov (United States)

    Finsterer, Josef

    2008-07-01

    Peripheral facial nerve palsy (FNP) may (secondary FNP) or may not have a detectable cause (Bell's palsy). Three quarters of peripheral FNP are primary and one quarter secondary. The most prevalent causes of secondary FNP are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immunological disorders, or drugs. The diagnosis of FNP relies upon the presence of typical symptoms and signs, blood chemical investigations, cerebro-spinal-fluid-investigations, X-ray of the scull and mastoid, cerebral MRI, or nerve conduction studies. Bell's palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary FNP and Bell's palsy may coexist. Treatment of secondary FNP is based on the therapy of the underlying disorder. Treatment of Bell's palsy is controversial due to the lack of large, randomized, controlled, prospective studies. There are indications that steroids or antiviral agents are beneficial but also studies, which show no beneficial effect. Additional measures include eye protection, physiotherapy, acupuncture, botulinum toxin, or possibly surgery. Prognosis of Bell's palsy is fair with complete recovery in about 80% of the cases, 15% experience some kind of permanent nerve damage and 5% remain with severe sequelae.

  15. Trauma in pregnancy

    Directory of Open Access Journals (Sweden)

    A Rudra

    2007-01-01

    Full Text Available Trauma is the most common non-obstetrical cause of death in pregnant women. Pregnancy must always be suspected in any female trauma patient of childbearing age until proved otherwise. Unique changes in anatomy and physiology that takes place during pregnancy alter the pathophysiology and location of maternal injuries in pregnancy, which may be significantly different from the non-pregnant state. Trauma from road traffic accidents, falls and domestic violence are the most common causes of abdominal blunt trauma. As pregnancy progresses, the change of accidental injury increases. Head and neck injuries, respiratory failure, and hypovolemic shock constitute the most frequent causes of trauma related maternal death in pregnancy. Even the pregnant woman with minor injuries should be carefully observed. Initial management is directed at resuscitation and stabilization of the mother that takes precedence over that of the fetus, unless vital signs cannot be maintained and perimortem cesarean section decided upon. Fetal monitoring should be maintained after satisfactory resuscitation and stabilization of the mother. Preventive measures include proper seat belt use and identifying and counseling victims of suspected domestic violence.

  16. Epidemiology of severe trauma.

    Science.gov (United States)

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions.

  17. Ultrasonography in ocular trauma.

    Science.gov (United States)

    Dastevska-Djosevska, Emilija

    2013-01-01

    Ultrasonography is a non-invasive, simple and effective diagnostic method which enables visualization and evaluation of intraocular injury degree in cloudy eye media. The basic aim of this investigation was to find out the frequency of various types of ocular injuries using ultrasonography and to make an analysis of their frequency in relation to gender and age. This retrospective study included 182 patients hospitalized at the Clinic of Ophthalmology in Skopje due to mechanical eye trauma. The patients underwent ultrasonography on the Alcon Ultrascan Imagining System apparatus and Sonomed EZ Scan AB 5500+. B scan technique was used primarily, while the A scan had a positive and correlative role. Ocular trauma was more present in males (85.2%) compared to females (14.8%). 49.5% of the patients had open, and 50.5% had closed globe injuries. The most represented age group in ocular injuries was the age ranged from 51 to 60 years. There was no significant difference between the type of mechanical injury and the age (Chi-Squares=5.52 p=0.47895025). Ultrasonography showed that the most frequent pathologic result, both in open and closed globe injuries, was vitreous hemorrhage. Ultrasonography has an irreplaceable role in the clinical evaluation and management of ocular trauma. It showed that the most frequent finding in ocular trauma was vitreous haemorrhage, and the male gender was more frequently exposed to ocular trauma.

  18. Survival trends and predictors of mortality in severe pelvic trauma

    DEFF Research Database (Denmark)

    Pohlemann, Tim; Stengel, Dirk; Tosounidis, Georgios

    2011-01-01

    STUDY OBJECTIVE: To determine longitudinal trends in mortality, and the contribution of specific injury characteristics and treatment modalities to the risk of a fatal outcome after severe and complex pelvic trauma. METHODS: We studied 5048 patients with pelvic ring fractures enrolled in the German...... Pelvic Trauma Registry Initiative between 1991 and 1993, 1998 and 2000, and 2004 and 2006. Complete datasets were available for 5014 cases, including 508 complex injuries, defined as unstable fractures with severe peri-pelvic soft tissue and organ laceration. Multivariable mixed-effects logistic...... with this type of injury was 18% (95% CI 9-32%) in 2006. CONCLUSION: In contrast to an overall decline in trauma mortality, complex pelvic ring injuries remain associated with a significant risk of death. Awareness of this potentially life-threatening condition should be increased amongst trauma care...

  19. The appraisal of facial beauty is rapid but not mandatory.

    Science.gov (United States)

    Schacht, Annekathrin; Werheid, Katja; Sommer, Werner

    2008-06-01

    Facial attractiveness is an important source of social affective information. Here, we studied the time course and task dependence of evaluating attractive faces from a viewer's perspective. Event-related brain potentials (ERPs) were recorded while participants classified color portraits of unfamiliar persons according to gender and facial attractiveness. During attractiveness classification, enhanced ERP amplitudes for attractive and nonattractive faces relative to faces of intermediate attractiveness were found for an early component around 150 msec and for the late positive complex (LPC). Whereas LPC enhancement conforms to previous studies employing various types of affective stimuli, the finding of an early effect extends earlier research on rapid emotion processing to the dimension of facial attractiveness. Dipole source localization of this early ERP effect revealed a scalp distribution suggesting activation of posterior extrastriate areas. Importantly, attractiveness-related modulations of brain responses were only marginal during the gender decision task, arguing against the automaticity of attractiveness appraisal.

  20. Effects of facial hard tissue surgery on facial aesthetics: changes in facial content and frames.

    Science.gov (United States)

    Choi, Jin-Young; Lee, Sang-Hoon; Baek, Seung-Hak

    2012-11-01

    Aesthetic units of the face can be divided into facial content (FC; eyes, nose, lips, and mouth), anterior facial frame (AFF; a contour line from the trichion, the temporal line of the frontal bone, the lateral orbital rim, the most lateral line of the anterior part of the zygomatic body, the anterior border of the masseter muscle, to the inferior border of the chin), and posterior facial frame (PFF; a contour line from the hairline, the zygomatic arch, to the ramus and gonial angle area of the mandible). The size and shape of each FC and the balance and proportion between FCs create a unique appearance for each person. The facial form can be determined through the combination of AFF and PFF. In the Asian population, clinicians frequently encounter problems of FC (eg, acute nasolabial angle, protrusive and everted lips, nonconsonant lip line, or lip canting), AFF (eg, midface hypoplasia, protrusive and asymmetric chin, vertical deficiency/excess of the anterior maxilla and symphysis, or prominent zygoma), and PFF (eg, square mandibular angle). These problems can be efficiently and effectively corrected through the combination of hard tissue surgery such as anterior segmental osteotomy, genioplasty, mandibular angle reduction, malarplasty, and orthognathic surgery. Therefore, the purposes of this article were to introduce the concepts of FC, AFF, and PFF, and to explain the effects of facial hard tissue surgery on facial aesthetics.