A Little Something Different

Today in class I decided to go in another direction and research face transplant news. I found an article done by US News (Health), I will attach it below. In summary it talked about the new challenges that face transplant is facing and most of it is on improving the technique which is fascinating because now its definitely an option! Before it was only considered but recently they performed the 10th ever face transplant in the United States. These results have exceeded the prediction of various surgeons and is only getting better with time. I have also provided pictures of one of the ten facial transplants.

http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2014/11/21/face-transplants-raise-new-challenges-and-opportunities

Article

Today I spent my time watching a video for facial trauma and reading the following article which states the process to assess and manage patients with facial trauma. As well as their patient care. I have provided a link to the article.

http://www.jems.com/article/assess-manage-patients-facial

Maxillofacial Injuries: Pathophysiology

Today I used the class period to review for a test in AP Calculus AB but he majority of the time was spent on thesis and studying kinetic energy and its relation to Maxillofacial Injuries. 

The kinetic energy present in a moving object is a function of the mass multipled by the velocity: Below I listed some fractures. 

• Frontal bone fractures: These result from a severe blow to the forehead. The anterior and/or posterior table of the frontal sinus may be involved. Assume a dural tear is present if the posterior wall of the frontal sinus is fractured. The nasofrontal duct often is disrupted.

• Orbital floor fractures: Injury to the orbital floor can result in an isolated fracture or can be accompanied by a medial wall fracture. When a force strikes the globe or orbital rim, the intraorbital pressure increases with transmission of this force and damages the weakest aspects of the orbit, the floor and medial wall. Herniation of the orbital contents into the maxillary sinus is possible. The incidence of ocular injury is high, but globe rupture is rare.

• Nasal fractures: These are the result of the forces transmitted during direct trauma.
• Nasoethmoidal fractures (NOE): These extend from the nose to the ethmoid bones and can result in damage to the medial canthus, lacrimal apparatus, or nasofrontal duct. They also can result in a dural tear at the cribriform plate.
• Zygomatic arch fractures: A direct blow to the zygomatic arch can result in an isolated fracture involving the zygomaticotemporal suture.
• Zygomaticomaxillary complex fractures (ZMC): These fractures result from direct trauma. Fracture lines extend through zygomaticotemporal, zygomaticofrontal, and zygomaticomaxillary sutures and the articulation with the greater wing of the sphenoid bone. The fracture lines usually extend through the infraorbital foramen and orbital floor. Concurrent ocular injuries are common.

Jacqueline Saburido

Today I decided to split my time between doing a case study on Jacqueline Saburido and going over my Calculus AB material for the study check that I have later today.

The story of Jacqueline Saburido is a burn survivor due to being hit by a drunk driver. She accepted a ride home from her classmate, Natalia Chpytchak-Bennett. At the same time 18 year old Reginald Stephey was heading home after a couple of beers. On the outskirts of Austin, his car veered into Natalia's. Guerrero and Chpytchak-Bennett died instantly and Saburido was pinned under the seat preventing her from escaping. Saburido suffered second and third degree burns to over 60 percent of her body, but survived despite her doctor's expectations. All of her fingers had to be amputated, but there was enough bone left on her thumb to construct an opposable thumb. She lost her hair, ears, nose, lips, left eyelid and much of her vision. She has undergone more than 40 operations since the crash, including cornea transplants, which have restored her left eye. Below is a picture of the before and after of Jacqueline Saburido.

Upper Facial, Mid Facial, and Mandibular Trauma

Today I went in depth on the topics as stated in my title:

Upper Facial Trauma:
This particular trauma is caused the majority of the times by car accidents, the implementation of seat belt harnesses has reduced the number of these injuries. Ethiologies may range among the motor vehicle accidents to sports and falls, but both the force and focus of the blow determine the extent of the injuries located to this region of the face.

Mid Facial Trauma:
Fractures of the midfacial bones are most common in trauma relating to fallas, altercations as well as motor vehicle accidents. The treatment for midfacial trauma is to provide the patient the best aesthetic and functional result with only one procedure versus multiple. Nasal fractures are also commonly encountered and an often isolated form of facial fractures.

Mandibular Trauma:
Mandible fractures are among the most comon skeletal injuries in man due to blunt or penetrating trauma. They are associated with other craniofacial, cervical and systemic trauma. Mandibular fractures destabilize the airway and may create malocclusion, joint dysfunction, pain, infection, as well as paresthesia.

Bilateral Fracture Zygoma

Thesis class period constituted of me watching a video of reconstructive facial trauma surgery for bilateral fracture zygoma. The video was approximately 15 minutes long and it included the entire surgical process. Bilateral fracture zygoma is a rare case in which the zygoma is altered, the integrity of the zygoma is critical in mantaining normal facial width and prominence of the cheek. Traffic accidents are often the cause of this fracture to the zygomatic structure.

Below is the link to the video:

[WARNING: VIEWER DISCRETION IS ADVISED]

https://m.youtube.com/watch?v=08h73YJg4Jc#

I also found an article that related to the topic of bilateral fracture zygoma that provided me with additional information. It also analyzed the case of a 31 year old male patient.

 The link is the following:
http://www.theprofesional.com/article/vol-21-no-04/prof-2436.pdf

Videos Continued

Today I decided to use the period as a study period for my calculus test that constitutes 30% of my grade and the rest was devoted to watching the rest of the facial reconstuctive procedure since it had 4 parts.

Videos

Today I watched some videos on patients who have undergone reconstructive surgery for the majority of the period. Below are the links:

http://youtu.be/bEvVveWfU3c

https://m.youtube.com/watch?v=ERWeIKzLgyM#

https://m.youtube.com/watch?v=jqCP2KjBlco#

https://m.youtube.com/watch?v=sNsAJOxt2w8#