Sridharan Geetha, Panneerselvam Elavenil, Ponvel Keerthana, Tarun Swetha, Krishna Kumar Raja V B
Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai 600089, Tamil Nadu, India.
Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai 600089, Tamil Nadu, India.
Chin J Traumatol. 2020 Apr;23(2):78-83. doi: 10.1016/j.cjtee.2020.02.003. Epub 2020 Feb 19.
Trauma during pregnancy deserves special attention because of its management objectives, i.e. well-being of both pregnant woman and foetus. Maxillofacial trauma directly affects the nutrition of foetus by interfering with the normal functions in a pregnant woman such as mouth opening, mastication and breathing. Hence early restitution of form and function of maxillofacial skeleton is essential. However, the gravid status is associated with numerous anatomical and physiological changes which present with clinical dilemma related to imaging and treatment. A careful scrutiny of the patient's systemic and gestational status is absolutely essential before, during and after instituting any interventional procedures. We present a case of bilateral condyle fracture in a 30-year-old pregnant woman in the third trimester (32 weeks). She was treated with inter maxillary fixation using orthodontic brackets & elastics. After successful restitution of occlusion, the patient was advised aggressive physiotherapy which ensured normal mouth opening. Two weeks later, the patient delivered uneventfully. The patient was followed up at one month and 3 month and demonstrated restitution of normal occlusion, mouth opening and lower facial height. This article aims at analyzing the contemporary principles in management of maxillofacial trauma in a pregnant woman and clarifying the common misconceptions.
孕期创伤因其管理目标,即孕妇和胎儿的健康,而值得特别关注。颌面创伤通过干扰孕妇的正常功能,如张口、咀嚼和呼吸,直接影响胎儿的营养。因此,早期恢复颌面骨骼的形态和功能至关重要。然而,妊娠状态与众多解剖和生理变化相关,这些变化带来了与影像学和治疗相关的临床困境。在实施任何介入性操作之前、期间和之后,仔细检查患者的全身和妊娠状态绝对必要。我们报告一例30岁孕晚期(32周)孕妇双侧髁突骨折的病例。她接受了使用正畸托槽和弹力线的颌间固定治疗。成功恢复咬合后,建议患者积极进行物理治疗,这确保了正常的张口度。两周后,患者顺利分娩。在1个月和3个月时对患者进行随访,结果显示咬合、张口度和面下高度恢复正常。本文旨在分析孕妇颌面创伤管理的当代原则,并澄清常见的误解。