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Biomedical subjects

Edward Ellis

Publications and source records attributed to Edward Ellis.

At least 19 recordsLinked to original sources
PubMed2006

The efficacy of postoperative antibiotic regimens in the open treatment of mandibular fractures: a prospective randomized trial.

PURPOSE: The purpose of this study was to determine the necessity and/or effectiveness of postoperative antibiotics in the treatment of mandible fractures. MATERIALS AND METHODS: This study is a prospective, randomized trial composed of patients who presented for operative treatment of open mandibular fractures and subsequently underwent open reduction and internal fixation at 1 institution. Mandibular fractures treated by an intraoral and/or extraoral open reduction with internal fixation were included in this study. The patients were randomly divided into 2 groups based on whether or not they received postoperative antibiotics. Both groups received preoperative antibiotics of various regimens as well as intraoperative antibiotics on the day of surgery. Group Ab patients received 2.4 mIU of intramuscular penicillin G benzathine, or if allergic, a 5- to 7-day regimen of oral clindamycin. Group non-Ab patients received no antibiotics postoperatively. Patients followed between 5 and 8 weeks were included in the data set. RESULTS: A total of 291 patients were enrolled in the study, of which 181 patients met the inclusion criteria. Group Ab included 81 and group non-Ab 100 patients. Twenty-two patients had evidence of infection noted within the 8-week follow-up period. There were 8 infections in group Ab and 14 infections in group non-Ab. Statistical analysis with the Pearson Chi-square and Student's t test showed no statistically significant difference (P = .399) between groups Ab and non-Ab. CONCLUSION: This study could not prove any statistically significant benefit to the administration of postoperative antibiotics in patients undergoing open reduction and internal fixation of mandibular fractures.

Administration, Oral↗
PubMed2006

The "antilingula"--fact or fiction?

PURPOSE: The "antilingula" is a term that is only used in oral and maxillofacial surgery publications. It is not found in anatomy texts. This paper examines the origin of the term "antilingula" and explores the literature to determine why there is a bony lump on the lateral surface of the mandible. METHODS: The English literature was searched for references to this bony lump on the lateral surface of the mandible to find its origin and intent. Discussion with anatomists about the "antilingula" were undertaken to determine their understanding of it. RESULTS: Oral and Maxillofacial surgeons began using this bony prominence as a guide to the position of the entrance of the inferior alveolar nerve on the medial surface of the mandible in the 1950s. Beginning in 1976, many descriptions of ramus osteotomies refer to the "antilingula" and recommend it as a guide for making bone cuts safely without injuring the inferior alveolar nerve. However, research studies that have been performed reveal no evidence that the "antilingula" has any relationship to the entrance of the inferior alveolar nerve. Discussions with anatomists suggest it is a bony response to the muscles and tendons that insert in that area rather than having a relationship to the entrance of the inferior alveolar nerve. CONCLUSION: The use of the "antilingula" for marking the location of ramus osteotomies is illogical.

Animals↗
PubMed2006

Aesthetic management of the nasal component of naso-orbital ethmoid fractures.

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Discuss the critical anatomic structures of the nose that are affected in naso-orbital ethmoid fractures. 2. Discuss the advantages of early, complete nasal reconstruction of these fractures. 3. Apply a clinical algorithm to such nasal reconstruction. 4. List the techniques used in aesthetic reconstruction of the nose in naso-orbital ethmoid fractures. BACKGROUND: Fractures of the naso-orbital ethmoid complex pose challenging management issues. Although basic treatment principles have been well described, the aesthetic management of the nasal component has not been adequately addressed in the literature. METHODS: When secondary nasal deformities occur, they are difficult to correct. Optimal primary correction of the nasal deformity is accomplished using the following four principles: (1) rigid fixation of the nasal pyramid and restoration of nasal height and length; (2) restoration of tip projection; (3) septal reduction/reconstruction; and (4) lateral nasal wall augmentation. RESULTS: Successful management of naso-orbital ethmoid fractures is a complex and challenging task. Both the bony and soft-tissue components must be addressed and the extent of the injury must be adequately diagnosed to avoid omission of critical steps in the reconstruction. Inadequate treatment of naso-orbital ethmoid fractures can produce a severe cosmetic deformity that is very difficult to correct secondarily. CONCLUSION: The authors discuss the nasal component of naso-orbital ethmoid complex injuries and detail the key principles in their algorithm for aesthetic nasal reconstruction.

Algorithms↗
PubMed2006

Efficacy of an early intervention for patients with acute temporomandibular disorder-related pain: a one-year outcome study.

BACKGROUND: The authors conducted a randomized clinical trial to evaluate the efficacy of a biopsychosocial intervention for patients who were at high risk (HR) of progressing from acute to chronic temporomandibular disorder (TMD)-related pain. METHODS: The authors classified subjects' risk using a predictive algorithm and randomized them into an early-intervention (EI) or a nonintervention (NI) group. The EI included cognitive behavioral skills training and biofeedback. The authors assessed pain and psychosocial measures at intake and at a one-year follow-up. Subjects' self-reported pain levels were measured on an analog scale and as a response to palpation. RESULTS: At one year, EI-group subjects had significantly lower levels of self-reported pain and depression. At one year, more NI-group subjects than EI-group subjects had utilized health care for jaw-related pain. NI-group subjects were 12.5 times as likely to have a somatoform disorder, more than seven times as likely to have an anxiety disorder, and 2.7 times more likely to have an affective disorder at one year, compared with EI-group subjects. CONCLUSIONS: EI-group subjects had reduced pain levels, improved coping abilities and reduced emotional distress at one year. CLINICAL IMPLICATIONS: The TMD-related pain experience is complex and requires early identification with a biopsychosocial EI to achieve maximal, sustainable results.

Adolescent↗
PubMed2005

Treatment of mandibular condylar process fractures: biological considerations.

The topic of condylar injury in adults has generated more discussion and controversy than any other in the field of maxillofacial trauma. It is an important subject because such injuries are common and complications of trauma to the temporomandibular joint (TMJ) are far-reaching in their effects. Why are there so many different methods to treat this injury? How can seemingly disparate treatment options all produce satisfactory outcomes in the majority of patients? The reason lies with the biological adaptations that occur within the masticatory system that are poorly understood, not readily quantifiable, and variable from one person to the next. This discussion presents our current understanding of the adaptations that must occur to provide the patient with a satisfactory outcome. The adaptations for patients treated open are different than for those treated closed. However, it is when these adaptations fail to occur that unsatisfactory outcomes occur, regardless of how they were treated.

Adaptation, Physiological↗
PubMed2004

Masticatory motion after surgical or nonsurgical treatment for unilateral fractures of the mandibular condylar process.

PURPOSE: We sought to compare mandibular motion during mastication in patients treated in either an open or a closed fashion for unilateral fractures of the mandibular condylar process. PATIENTS AND METHODS: Eighty-one male patients with unilateral condylar process fractures were treated either with (n = 37) or without (n = 44) surgical reduction and rigid fixation of their condylar process fractures. At 6 weeks, 6 months, 1 year, and 2 years after treatment, the subjects' chewing cycles were recorded using a magnetic sensor array (Sirognathograph; Siemens Corp, Bensheim, Germany) while chewing Gummi-Bears (HARIBO, Bonn, Germany) unilaterally on the same side as the fracture and on the opposite side. The chewing cycles were analyzed using a custom computer program, and the duration, excursive ranges, and 3-dimensional cycle shape were compared between the 2 treatment groups at each time interval using multilevel linear modeling statistics. RESULTS: The 2 treatment groups did not differ significantly for any measure of cycle duration or any excursive range (except lateral excursions at 1 year post-treatment) at any of the time intervals. However, the 3-dimensional cycle shapes of the 2 groups did differ significantly at all time intervals. CONCLUSION: Surgical correction of unilateral condylar process fractures has relatively little effect on the more standard measures (duration and excursive ranges) of masticatory function. However, surgical correction better normalizes opening incisor pathways during mastication on the side opposite the fracture.

Adolescent↗
PubMed2004

Status of the internal orbit after reduction of zygomaticomaxillary complex fractures.

PURPOSE: We sought to determine the status of the internal orbit before and after reduction of zygomaticomaxillary complex (ZMC) fractures when treated without internal orbital reconstruction. PATIENTS AND METHODS: We conducted a retrospective study of preoperative and postoperative computed tomography (CT) scans in 65 patients with unilateral ZMC fractures who were treated by reduction of the ZMC complex without internal orbital reconstruction. The size and location of the internal orbital defects, orbital soft tissue displacement, and orbital volume were assessed in the preoperative and postoperative CT scans. RESULTS: Reduction in the ZMC fractures was considered ideal in 58 of the 65 patients. Only minor malpositions occurred in the remaining 7 patients. The size of the internal orbital defects increased slightly with ZMC reduction but the internal orbital fractures were realigned, and few had increases in orbital volume or soft tissue sagging into the sinuses. Examination of follow-up CT scans in several patients taken weeks to months later showed that the residual defects became smaller and that none of these patients had an increase in orbital volume or soft tissue sagging. CONCLUSION: The preoperative CT scan can be used to assess the amount of internal orbital disruption for purposes of developing a treatment plan in patients with ZMC fractures. When there is minimal or no soft tissue herniation and minimal disruption of the internal orbit, ZMC reduction is adequate treatment.

Adolescent↗
PubMed2004

Mandibular third molars and angle fractures.

PURPOSE: The study purpose was to measure associations between mandibular third molar (M3) status/position and risk for angle fracture. MATERIALS AND METHODS: We designed a multicenter retrospective cohort study composed of patients who presented for operative management of mandible fractures. The primary predictor variable was M3 (present/absent). The secondary predictor variable was M3 position classified using the Pell and Gregory system. The outcome variable was angle fracture (present/absent). Appropriate univariate, bivariate, and multivariate logistic regression analyses were computed. The level of statistical significance was set at P </=.05. RESULTS: The study sample was composed of 1,450 subjects with a mean age of 30.6 +/- 10.4 years (range, 2 to 87 years). The risk of an angle fracture with and without M3s was 30.1% and 13.7%, respectively (adjusted odds ratio, 2.8; 95% confidence interval, 2.3 to 3.4; P <.001). Based on the Pell and Gregory classification, varying M3 position was associated with varying risks of angle fracture (P <.001). CONCLUSION: The presence of M3s was associated with a 2.8-fold increased risk for angle fractures. M3 position was associated with a variable risk for angle fracture. Notably, the deep impactions were not associated with an increased risk for fracture.

Adolescent↗
PubMed2004

Passive repositioning of maxillary fractures: an occasional impossibility without osteotomy.

PURPOSE: To present cases where passive repositioning of maxillary fractures was not achievable during surgery, and a method to provide passive occlusal positioning in those cases. PATIENTS AND METHODS: Over a 10-year period, the maxillae of 24 patients with fractures of the maxilla could not be passively repositioned during surgery. In these cases, a Le Fort I osteotomy was performed in addition to reduction and fixation of the other midfacial fractures. RESULTS: All patients had passive restoration of their pretrauma occlusion during surgery. All patients except 1 had maintenance of their pretrauma occlusion at the last follow-up visit (6 weeks or more) following surgery. CONCLUSION: When passive positioning of the maxilla is not possible, a concomitant Le Fort I osteotomy can provide passive positioning of the occlusion.

Follow-Up Studies↗