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Skull base and maxillofacial fractures: two centre study with correlation of clinical findings with a comprehensive craniofacial classification system
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2009 (English)In: Journal of Cranio-Maxillofacial Surgery, ISSN 1010-5182, E-ISSN 1878-4119, Vol. 37, no 6, 305-11 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: A comprehensive classification based on high resolution computed tomography (CT) of the whole craniofacial region was correlated with clinical findings of combined skull base and maxillofacial fractures. MATERIAL AND METHODS: In a study of two clinical centres, 70 patients with such injuries were admitted at the Universities of Basel (n=29) and Uppsala (n=41). Clinical signs (rhinorrhoea, periorbital haematoma and pneumencephalus) and surgical versus conservative treatment were correlated with a cranio-maxillofacial injury severity score (CMF-ISS) calculated from the classification system. Fracture classifications were decided in consensus on the basis of CT and semiautomatic classification software. The classification system defined 3 fracture types (A, B, C), 3 groups (A1, A2, A3), and 3 subgroups (A1.1, A1.2, A1.3) with increasing severity from A1.1 (lowest) to C3.3 (highest). RESULTS: Of 70 patients, 43 were operated upon and 27 conservatively treated. The operated patients had significantly higher severity scores than non-operated. Patients with or without periorbital haematoma do not differ significantly in the severity score. The severity of the CMF-ISS score was significantly associated (two sample T-test P<0.01) with the occurrence of pneumencephalus, rhinorrhoea and treatment approach. CONCLUSION: Based on our present results, this system seems to be clinical useful for operative decisions and interventions.

Place, publisher, year, edition, pages
2009. Vol. 37, no 6, 305-11 p.
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Medical and Health Sciences
URN: urn:nbn:se:uu:diva-107777DOI: 10.1016/j.jcms.2009.01.008ISI: 000270046800001PubMedID: 19264499OAI: oai:DiVA.org:uu-107777DiVA: diva2:232891
Available from: 2009-08-26 Created: 2009-08-26 Last updated: 2013-08-15Bibliographically approved

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Hirsch, Jan
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Department of NeuroscienceOral and Maxillofacial Surgery
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