Maxillofacial Osseous Reconstruction in One-stage Operation Combined with Craniotomy for Moderate Craniocerebral Injury_West China Medical Journal

Authors：

 WANGJuan ¹ , WANGJun-hong ² , ZHAOJi-yuan ³ ,  LIRui-chun ¹

1. Department of Neurosurgery, the First A liated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P. R. China;
2. Huxian Hospital of Xi'an, Xi'an, Shaanxi 710300, P. R. China;
3. Department of Otolaryngology, the First A liated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P. R. China;

Corresponding?author：

LIRui-chun, Email: lrckhz@126.com

Keywords：

Craniocerebral injury; Maxillofacial reconstruction; Leakage of cerebrospinal fluid

DOI：

10.7507/1002-0179.20150534

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Objective To explore the value of maxillofacial osseous reconstruction in one-stage operation combined with craniotomy for moderate craniocerebral injury. Methods A retrospective study was conducted by analyzing the clinical and radiographic results of 13 patients treated between January 2008 and February 2015. Among them, 7 patients admitted into the hospital between January 2008 and December 2009 were regarded as the control group. Among the 7 patients, 5 were males and 2 were females, aged between 22 and 66 years old, averaging (44.3±15.9) years old. The patients of the control group underwent craniotomy within 24 hours after admission, and accepted the second stage operation for maxillofacial reconstruction 3 to 5 weeks later. The other 6 patients including 4 males and 2 females aged between 27 and 57 years old, averaging (40.2±10.7) years old, admitted into the hospital between January 2010 and February 2015 were designated into the observation group. They underwent maxillofacial osseous reconstruction in one-stage operation combined with craniotomy within 24 hours after admission. The treatment effect, leakage of cerebrospinal fluid, intracranial infection and average length of stay were analyzed and compared. Results In the control group, there were 5 cases of cerebrospinal rhinorrhea preoperatively, and all were cured after craniotomy. During the second stage operation for maxillofacial reconstruction, bone callus and scar tissue presented in all cases and poor reconstruction occurred to 3 cases. After reconstruction, cerebrospinal rhinorrhea recurred in 2 cases. The average length of stay was (43.4±4.5) days. For the observation group there were 3 cases of cerebrospinal rhinorrhea preoperatively, and one of them remained after the operation and cured 7 days later. The average length of stay was (22.7±2.7) days. None of the 13 patients suffered intracranial infection. Conclusion Maxillofacial osseous reconstruction should be considered in one-stage operation combined with craniotomy for moderate craniocerebral injury

Citation： WANGJuan, WANGJun-hong, ZHAOJi-yuan, LIRui-chun. Maxillofacial Osseous Reconstruction in One-stage Operation Combined with Craniotomy for Moderate Craniocerebral Injury. West China Medical Journal, 2015, 30(10): 1857-1861. doi: 10.7507/1002-0179.20150534 Copy

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2.	胡錦, 姚海軍, 劉永, 等. 華東六省一市顱腦創傷合并顱面損傷住院患者調查[J]. 中華神經外科疾病研究雜志, 2009, 8(1):47-52.
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6.	Mulligan RP, Friedman JA, Mahabir RC. A nationwide review of the associations among cervical spine injuries, head injuries, and facial fractures[J]. J Trauma, 2010, 68(3):587-592.
7.	Bellamy JL, Mundinger GS, Flores JM, et al. Facial Fractures of the upper craniofacial skeleton predict mortality and occult intracranial injury after blunt trauma:an analysis[J]. J Craniofac Surg, 2013, 24(6):1922-1926.
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9.	Salentijn EG, Collin JD, Boffano P, et al. A ten year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam:complications and treatment[J]. J Cranio-Maxillo-facial Surg, 2014, 42(6):1717-1722.
10.	劉斌, 張健強, 李巖峰. 頜面骨折合并中型顱腦損傷37例早期救治分析[J]. 人民軍醫, 2009, 52(8):530.
11.	Huempfner-Hierl H, Schaller A, Hierl T. Maxillofacial fractures and craniocerebral injuries-stress propagation from face to neurocranium in a finite element analysis[J]. Scand J Trauma Resusc Emerg Med, 2015, 23:35.
12.	Stam LH, Wolvius EB, Schubert W, et al. Natural course of orbital roof fractures[J]. Craniomaxillofac Trauma Reconstr, 2014, 7(4):294-297.
13.	李逸松, 田衛東, 李聲偉, 等. 頜面創傷3958例回顧[J]. 中華口腔醫學雜志, 2006, 41(7):385-387.
14.	丁國偉, 周正炎. 面中部骨折的治療(附87例臨床總結)[J]. 口腔頜面外科雜志, 1995, 5(1):6-10.
15.	Louis PJ. Maxillofacial Reconstruction[J]. Oral Maxillofac Surg Clin, 2013, 25(2):105-340.

1. Teasdale G, Jennet B. Assessment of coma and impaired consciousness:a practical scale[J]. Lancet, 1974, 2(7872):81-84.
2. 胡錦, 姚海軍, 劉永, 等. 華東六省一市顱腦創傷合并顱面損傷住院患者調查[J]. 中華神經外科疾病研究雜志, 2009, 8(1):47-52.
3. 梁亮, 梁新強, 陳慧溪, 等. 中型顱腦損傷患者臨床特點分析[J]. 北方藥學, 2014, 11(7):132-133.
4. Rassovsky Y, Levi Y, Agranov E, et al. Predicting long-term outcome following traumatic brain injury (TBI)[J]. J Clin Exp Neuropsychol, 2015, 37(4):354-366.
5. 陳煉, 呂超. 單純性中型顱腦損傷的臨床特征與預后分析[J]. 中國臨床神經外科雜志, 2012, 10(10):634-635.
6. Mulligan RP, Friedman JA, Mahabir RC. A nationwide review of the associations among cervical spine injuries, head injuries, and facial fractures[J]. J Trauma, 2010, 68(3):587-592.
7. Bellamy JL, Mundinger GS, Flores JM, et al. Facial Fractures of the upper craniofacial skeleton predict mortality and occult intracranial injury after blunt trauma:an analysis[J]. J Craniofac Surg, 2013, 24(6):1922-1926.
8. Salentijn EG, Peerdeman SM, Boffano P, et al. A ten-year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam. Incidence and aetiology[J]. J Cranio-Maxillofac Surg, 2014, 42(6):705-710.
9. Salentijn EG, Collin JD, Boffano P, et al. A ten year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam:complications and treatment[J]. J Cranio-Maxillo-facial Surg, 2014, 42(6):1717-1722.
10. 劉斌, 張健強, 李巖峰. 頜面骨折合并中型顱腦損傷37例早期救治分析[J]. 人民軍醫, 2009, 52(8):530.
11. Huempfner-Hierl H, Schaller A, Hierl T. Maxillofacial fractures and craniocerebral injuries-stress propagation from face to neurocranium in a finite element analysis[J]. Scand J Trauma Resusc Emerg Med, 2015, 23:35.
12. Stam LH, Wolvius EB, Schubert W, et al. Natural course of orbital roof fractures[J]. Craniomaxillofac Trauma Reconstr, 2014, 7(4):294-297.
13. 李逸松, 田衛東, 李聲偉, 等. 頜面創傷3958例回顧[J]. 中華口腔醫學雜志, 2006, 41(7):385-387.
14. 丁國偉, 周正炎. 面中部骨折的治療(附87例臨床總結)[J]. 口腔頜面外科雜志, 1995, 5(1):6-10.
15. Louis PJ. Maxillofacial Reconstruction[J]. Oral Maxillofac Surg Clin, 2013, 25(2):105-340.

West China Medical Journal

Maxillofacial Osseous Reconstruction in One-stage Operation Combined with Craniotomy for Moderate Craniocerebral Injury

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