Maksillofasiyal Travmaların Epidemiyolojisi ve Tedavi Sonuçları: 9 Yıllık Retrospektif Çalışma

Öz

AMAÇ Maksillofasiyal travmaların epidemiyolojik özellikleri, oluş mekanizmaları, travmanın lokalizasyonu, tedavi yöntemi ve komplikasyonları ortaya konarak, bu yaralanmaların gerek önlenmesi, gerek etkili tedavisi için klinik ve araştırma önceliklerinin belirlenmesine katkı sunulması, bireylere yönelik tedavinin kalitesinin değerlendirilmesi ve geliştirilmesine yardımcı olması amaçlanmaktadır. GEREÇ VE YÖNTEM Kliniğimize Ocak 2015-Ocak 2024 tarihleri arasında maksillofasiyal travma nedeniye başvuran hastalar retrospektif olarak dahil edildi. Hastaların yaşı, cinsiyeti, ek hastalıkları, travma etyolojisi, kırıkların lokalizasyonu, tedavi yöntemleri ve ameliyat sonrası komplikasyonları kaydedildi. Kırıkların tanısı anamnez ve fizik muayene sonrası, 3 boyutlu ince kesitli bilgisayarlı tomografi incelemeleri ile konuldu ve anatomik lokalizasyonuna göre sınıflandırıldı. BULGULAR Bu retrospektif çalışmada toplam 392 hastada meydana gelen 538 maksillofasiyal fraktür dahil edilmiştir. Bu hastaların 319’u erkek, 73’ü kadındır. Yaşları 1 ile 96 arasında sıralanmış olup, ortalama yaş 36,9 olarak bulunmuştur. Oluş mekanizmasına göre gruplandırıldığında, 169 hastada darp ile en sık sebep olarak görülürken, fraktür lokalizasyonuna göre sınıflandırıldığında, 106 hasta ile nazal kemik, maksillofasiyal bölgede en sık görülen kırık lokalizasyonu olarak bulunmuştur. TARTIŞMA Maksillofasiyal travmalar daha çok üretken yaşlarda meydana gelmesi nedeniyle, ciddi iş gücü kaybına neden olmaktadır. Ayrıca bu hastalar uzun dönem takiplerinde, kemik deformiteleri, görme sorunları, koku almada değişiklik, çiğneme ve nefes almada zorluk gibi yaralanmaya bağlı geç dönem sorunlar yaşayabilmektedir. Maksillofasiyal travmaların tedavisinin amacı, fonksiyon ve estetiğin tam olarak geri kazandırılmasıdır. Bu amaç doğrultusunda birçok tedavi modalitesi uygulanabilmekle birlikte, kullanılacak olan yöntem, kırığın türüne ve yerine, hasta özelliklerine ve cerrahın deneyimine ve tercihine göre değişebilmektedir. SONUÇ Her hastanın ve kırığın kendine özgü özellikleri olmakla birlikte, tedavi sürecinde hasta ve eşlik eden travmaları ayrı ayrı değerlendirilmelidir. Bu değerlendirme sonucunda, hastaya ve yaralanmasına uygun tedavi planı oluşturulmalıdır. Bu çalışma, maksillofasiyal yaralanma önleme stratejilerinin geliştirilmesi ve ameliyat sonrası komplikasyon geliştirme riski taşıyan hastaların belirlenmesi açısından ışık tutmaktadır.

Anahtar Kelimeler

• Epidemiyoloji
• Etiyoloji
• Fraktür
• Fiksasyon
• Travma

Epidemiology and Treatment Outcomes of Maxillofacial Trauma: A 9-year Retrospective Study.

Öz

AIM The aim of this study is to determine the epidemiological characteristics, injury mechanisms, localization of the injury, treatment method and complications of maxillofacial traumas, to contribute to the determination of clinical and research priorities for surgical intervention, and to evaluate and improve the quality of treatment for individuals. MATERIAL AND METHOD Patients were admitted to our clinic due to maxillofacial trauma between January 2015 and January 2024 were included retrospectively. Patients' age, gender, comorbidities, trauma etiology, fracture localization, treatment methods and postoperative complications were recorded. Fractures were diagnosed after history and physical examination, with 3D thin-section computed tomography examinations and classified according to anatomic localization. RESULTS This retrospective study included 538 maxillofacial fractures occurring in 392 patients. 319 of these patients were male and 73 were female. Their ages ranged from 1 to 96, with a mean age of 36.9. According to the mechanism of injury, the most common cause was assault in 169 patients, while classified according to fracture localization, the nasal bone was found the most common fracture localization in the maxillofacial region in 106 patients. DISCUSSION Maxillofacial traumas may cause labor losses because they occur more often in productive ages. In addition, these patients may experience late-term problems related to the injury, such as bone deformities, vision problems, changes in smell, difficulty chewing and breathing in the long-term follow-up. The aim of the treatment of maxillofacial traumas is to fully restore function and aesthetics. Although many treatment modalities can be applied for this purpose, the method to be used may vary depending on the type and location of the fracture, patient characteristics, and the experience and preference of the surgeon. CONCLUSION Each patient and fracture has its own characteristics and the patient and additional traumas should be evaluated completely during the treatment process. As a result of this evaluation, a treatment protocol for the patient should be planned. This study sheds light on the development of maxillofacial injury prevention strategies and the identification of patients at risk of developing postoperative complications.

Anahtar Kelimeler

• Epidemiology
• etiology
• fracture
• fixation
• trauma

Kaynakça

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