Diagnostic and therapeutic aspects in the treatment of gunshot wounds of the viscerocranium.
Gunshot wounds of the viscerocranium are a rare occurrence during times of peace in Europe. The removal of projectiles is recommended; in some cases, however, this is controversial. The material properties of projectiles and destruction of anatomical landmarks make it difficult to determine their pr...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 37; no. 1; pp. 41 - 48 |
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| Autores principales: | , , , , |
| Formato: | diagnostic images pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Feb2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104815657&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104815657 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Feb2011 vid: 37 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104815657 58132811 10.1007/s00068-010-0023-z 104815657 ppf: 41 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Diagnostic and therapeutic aspects in the treatment of gunshot wounds of the viscerocranium. aug: au: Gröbe, A. Klatt, J. Heiland, M. Schmelzle, R. Pohlenz, P. affil: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52 20246 Hamburg Germany sug: subj: Wounds, Gunshot Diagnosis Wounds, Gunshot Therapy Skull Pathology Human Wounds, Gunshot Surgery Image Interpretation, Computer Assisted Tomography, X-Ray Computed Data Analysis Software Adolescence Adult Middle Age Aged Male Female Treatment Outcomes Foreign Bodies Surgery Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Gunshot wounds of the viscerocranium are a rare occurrence during times of peace in Europe. The removal of projectiles is recommended; in some cases, however, this is controversial. The material properties of projectiles and destruction of anatomical landmarks make it difficult to determine their precise location. Therefore, navigation systems and cone-beam computed tomography (CT) provide the surgeon with continuous intraoperative orientation in real-time. The aim of this study was to report our experiences for image-guided removal of projectiles, the use of cone-beam computed tomography and the resulting intra- and postoperative complications. We investigated 50 patients with gunshot wounds of the facial skeleton retrospectively, 32 had image-guided surgical removal of projectiles in the oral and maxillofacial region, 18 had surgical removal of projectiles without navigation assistance and in 28 cases we used cone-beam CT in the case of dislocated projectiles and fractured bones. There was a significant correlation ( p = 0.0136) between the navigated versus not navigated surgery and complication rate (8 vs. 32%, p = 0.0132) including major bleeding, soft tissue infections and nerve damage. Furthermore, we could reduce operating time while using a navigation system and cone-beam CT ( p = 0.038). A high tendency between operating time and navigated surgery ( p = 0.1103) was found. In conclusion, there is a significant correlation between reduced intra- and postoperative complications including wound infections, nerve damage and major bleeding and the appropriate use of a navigation system. In all these cases we were able to present reduced operating time. Cone-beam CT plays a key role as a useful diagnostic tool in detecting projectiles or metallic foreign bodies intraoperatively. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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