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标题：A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts
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作者：Chan Min Chung ; Seung Wan Tak ; Hyoseob Lim 等
期刊名称：Archives of Craniofacial Surgery
印刷版ISSN：2287-1152
出版年度：2019
卷号：20
期号：6
页码：370-375
DOI：10.7181/acfs.2019.00528
出版社：KoreaMed Synapse
摘要：BACKGROUND :Some parts of a maxillary fracture-for example, the medial and posterior walls-may remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal computed tomography (CT) analysis of cases of unilateral facial bone injuries involving the maxillary sinus walls. METHODS :Thirty-two patients who had undergone unilateral facial bone reduction surgery involving the maxillary sinus walls without reduction of the medial and posterior walls were analyzed in this retrospective chart review. Preoperative, immediate postoperative, and 3-month postoperative CT scans were analyzed. The maxillary sinus volume was calculated and improvements in bone continuity and alignment were evaluated. RESULTS :The volume of the traumatized maxillary sinuses increased after surgery, and expanded significantly by 3 months postoperatively (p 0.05), and this resolution was maintained at 3 months postoperatively (p > 0.05). The unreduced parts of the maxillary bone showed improved alignment and continuity (in 75.0% and 90.6% of cases, respectively), and improvements in bone alignment and bone continuity were found to be correlated using the Pearson chi-square test (p= 0.002). CONCLUSION :Maxillary wall remodeling through self-healing occurred concomitantly with an increase in sinus volume and simultaneous improvements in bone alignment and continuity. Midfacial surgeons should be aware of the natural course of unreduced fractured medial and posterior maxillary walls in complex maxillary fractures.
关键词：Facial bones;Fracture healing;Fractures; bone;Maxillary sinus;Periosteum