RESUMEN
BACKGROUND: Fractures of the facial skeleton are relatively uncommon in children and adolescents, and only a few reports review a significant number of patients. The authors performed a retrospective study to analyze the different characteristics of such fractures in the pediatric population of Portugal. METHODS: The authors reviewed the clinical records of a series of 912 patients 18 years of age or younger with facial fractures treated by the Departments of Plastic, Reconstructive, and Aesthetic Surgery and of Maxillofacial Surgery, São João Hospital, in Porto, Portugal, between the years 1993 and 2002. The following parameters were evaluated: age; sex; cause of accident; hour, day, and month of hospital admission; location and type of fractures; presence and location of associated injuries; treatment methods; length of in-hospital stay; and complications. RESULTS: A total of 1251 fractures were treated. The ratio of boys to girls was 3.1:1. Patients between 16 and 18 years old were the major group (47.8 percent). Motor vehicle accident was the most common cause of injury (53.3 percent of patients). Mandibular fracture was the most common type of fracture (48.8 percent). Associated injuries occurred in 558 patients (64.5 percent). CONCLUSIONS: Pediatric facial fractures are usually associated with severe trauma. The number of fractures caused by automobile accidents has decreased (p < 0.05). The incidence of this type of fracture is high in Portugal.
Asunto(s)
Huesos Faciales/lesiones , Huesos Faciales/cirugía , Fracturas Óseas/cirugía , Fracturas Mandibulares/cirugía , Accidentes por Caídas/estadística & datos numéricos , Accidentes de Tránsito/estadística & datos numéricos , Adolescente , Distribución por Edad , Proceso Alveolar/lesiones , Proceso Alveolar/cirugía , Niño , Preescolar , Traumatismos Faciales/complicaciones , Traumatismos Faciales/epidemiología , Traumatismos Faciales/cirugía , Femenino , Fracturas Óseas/complicaciones , Fracturas Óseas/epidemiología , Humanos , Lactante , Tiempo de Internación , Masculino , Traumatismo Múltiple/epidemiología , Órbita/lesiones , Órbita/cirugía , Paladar Duro/lesiones , Cigoma/lesiones , Cigoma/cirugíaRESUMEN
Tumors of the parotid gland are uncommon. We performed a retrospective study to analyze the clinical, diagnostic, and therapeutic features of a group of patients. We reviewed the clinical and the surgical records of a series of 109 patients who were recommended for surgery because of parotid tumors by the Plastic and Reconstructive Service of São João Hospital, Portugal, between 1990 and 2002. The following parameters were evaluated: age, sex, gland afflicted, symptoms, and duration of symptoms, diagnostic procedures, treatment methods, follow-up, and recurrences. Pleomorphic adenoma was the most common tumor (63.5%). In the majority of cases, fine-needle aspiration cytology was used. Swelling was the most frequent clinical finding. In 68.2%, superficial parotidectomy was performed. There were five cases of permanent facial palsy, and 10 patients developed Frey's syndrome. Recurrent disease was seen in six patients. For the majority of tumors, superficial parotidectomy is an effective treatment with acceptable morbidity.
Asunto(s)
Glándula Parótida/cirugía , Neoplasias de la Parótida/cirugía , Adenolinfoma/epidemiología , Adenolinfoma/cirugía , Adenoma Pleomórfico/epidemiología , Adenoma Pleomórfico/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Parálisis Facial/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Parótida/epidemiología , Neoplasias de la Parótida/patología , Neoplasias de la Parótida/radioterapia , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Sudoración Gustativa/etiologíaRESUMEN
OBJECTIVE: To determine the pattern of occurrence of mandibular fractures in the pediatric population in Portugal. MATERIALS AND METHODS: This retrospective study reviews the records of patients 18 years of age or younger from the 10-year period 1993 to 2002. Age, gender, anatomic site, cause of the accident, weekly and monthly variation, location and type of fractures, presence and location of associated injuries, treatment methods, and complications were reviewed. RESULTS: During this 10-year period, 521 patients with 681 mandibular fractures were treated. Motor-vehicle accident (MVA) was the most common (53.9% patients) cause of fracture. Almost half of the patients (48.8%) were in the oldest age group (16 to 18 years old). The condyle of the mandible was involved in 31.0% of the fractures. Maxillomandibular (MMF) fixation was used in 534 (78.4%) fractures. Overall mortality in this series was 0.6% (3 patients); mortality was caused by multiple traumas, mainly head trauma. CONCLUSION: There is a need to reinforce legislation aimed to prevent MVA and the total enforcement of existing laws to reduce maxillofacial injuries among children and adolescents.