Suriye sivil savaşında meydan gelen maksillofasiyal yaralanmalara cerrahi yaklaşım

Year 2019, Volume: 44 Issue: 4, 1203 - 1207, 29.12.2019

Murat Uçak

https://doi.org/10.17826/cumj.511684

Abstract

Amaç: Suriye sivil savaşında yaşanan çatışmalar ve patlamalar maksillofasiyal yaralanmaları (MFY) önemli ölçüde arttırdı. Bu çalışmada Suriye’de yaralanarak ülkemize getirilen ve opere edilen maksillofasiyal yaralanmaları değerlendirdik.

Gereç ve Yöntem: Temmuz 2016'den Şubat 2018'e kadar tedavi gören toplamda 42 Suriyeli MFY hastası çalışmaya alındı. Maksillofasiyal yaralanmaları hastalarının demografik verileri, hastane yatış süreleri ve yaralanma şiddetleri değerlendirildi.

Bulgular: Maksillofasiyal yaralanmalar füze ve şarapnellerden kaynaklanıyordu. Yaralanma tipleri; penetran 38 (90,4%), perfore edici 36 (85,7%) ve ateşli 8 (19%) şeklindeydi. Dört MFY hastasında ağız içi ve diş yaralanmaları mevcuttu. Yaralanmalar 17 olguda orta ve 22 hastada şiddetli olarak değerlendirildi. Hastaların 31’ünde LeFort II ve III tipi kırık mevcuttu.

Sonuç: Suriye Savaşında penetran ve perfore edici LeFort tipi kırık ve yaralanmalardaki yüksek oran, acil durumlarda müdahale ve cerrahi yaklaşımın ideal şekilde uygulanabilmesi için maksillofasiyal yaralanma cerrahisinde tecrübenin artması gerekmektedir.

Keywords

Maksilloasyal Yaralanma, Suriye Savaşı, Savaş Yarası

Surgical approach to the maxillofacial injuries occurred in the Syrian civil war

Abstract

Purpose: Conflicts and explosions in the Syrian civil war have significantly increased maxillofacial injuries (MFI). In this study, we evaluated the wounded Syrians that were brought from to Turkey and operated due to the maxillofacial injuries.

Materials and Methods: A total of 42 Syrian MFI patients who were treated from July 2016 to February 2018 were included in the study. Demographic data, duration of hospital stay and severity of injury were all evaluated.

Results: The maxillofacial injuries were mostly caused by missiles and shrapnel. Types of injuries were penetrating 38 (90.4%), perforating 36 (85.7%) and fiery 8 (19%). Four MFY patients had intraoral and dental injuries. The injuries were observed as moderate in 17 cases and severe in 22 patients. Of 31 patients, there were LeFort II and III injuries.

Conclusion: The high rate of penetrating and perforating LeFort injuries in the Syrian War shows that the experience of maxillofacial injury surgery must be increased in order to achieve the ideal surgical approach to these cases.

Keywords

Maxillofacial Injuries, Syrian Civil War, War wound

References

• 1. Susic M, Brozovic J, Zore IF, Milenovic A, Strinovic D, Brkic H, et al. Jaw injuries of independence victims from the 1991 War in Croatia. Coll Antropol. 2014;38(1):255-60.2. Kummoona RK. Missile war injuries of the face. J Craniofac Surg. 2011;22(6):2017-21.3. Ahmed FT, Aljeuary MT. The Strategy of Delayed Reconstruction of the Mandible in War Injuries. J Craniofac Surg. 2017;28(3):826-30.4. Sayer NA, Chiros CE, Sigford B, Scott S, Clothier B, Pickett T, et al. Characteristics and rehabilitation outcomes among patients with blast and other injuries sustained during the Global War on Terror. Arch Phys Med Rehabil. 2008;89(1):163-70.5. Salama OM. Craniofacial war injuries. East Mediterr Health J. 2006;12(6):919-22.6. Zola M. World War I maxillofacial fracture splints. J Oral Maxillofac Surg. 2004;62(5):643.7. Akhlaghi F, Aframian-Farnad F. Management of maxillofacial injuries in the Iran-Iraq War. J Oral Maxillofac Surg. 1997;55(9):927-30;discussion 30-1.8. Shuker ST. Prevention of tongue prolapse by immediate stabilization in severely avulsed mandibular war injuries. J Maxillofac Surg. 1986;14(6):317-20.9. Bahouth H, Ghantous Y, Rachmiel A, Amodi O, Abu-Elnaaj I. Maxillofacial Injuries Related to the Syrian War in the Civilian Population. J Oral Maxillofac Surg. 2017;75(5):995-1003.10. Motamedi MH, Hashemi HM, Shams MG, Nejad AN. Rehabilitation of war-injured patients with implants: analysis of 442 implants placed during a 6-year period. J Oral Maxillofac Surg. 1999;57(8):907-13; discussion 14-5.11. Delaporte S. [Medical progress and maxillofacial surgery during World War I]. Rev Stomatol Chir Maxillofac. 2005;106(2):121-3.12. Simpson DA, David DJ. Herbert Moran Memorial Lecture. World War I: the genesis of craniomaxillofacial surgery? ANZ J Surg. 2004;74(1-2):71-7.13. Akbay E, Aydogan F, Ucak M. Orbitomaxillomandibular reconstruction with free osteomyocutaneous fibular flap and lower trapezius myocutaneous flap. J Craniofac Surg. 2013;24(4):e438-41.14. Wang Z, Liu Y, Lei D, Bai Z, Zhou S. A new model of blast injury from a spherical explosive and its special wound in the maxillofacial region. Mil Med. 2003;168(4):330-2.