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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentations 2 - Facial Plastic and Reconstructive Surgery

Common Adverse Outcomes Following Facial Fractures Managed With Surgical Intervention vs Clinical Observation Alone

Monday, September 30, 2024
9:42 AM – 9:48 AM EDT
Location: MBCC, 232
Disclosure(s):
Aaron L. Zebolsky, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Emily R. Baker, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Sarit Dhar, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Nina M. Gallo, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Travis Jonathan Clarke, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Anas A. Eid, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Major complications and surgical success rates are well established in facial trauma, but there is a paucity of data on common symptoms. This study compared common adverse outcomes between patients managed with surgical intervention (SI) and clinical observation alone (CO).

Methods: A cohort study was performed on patients with facial fractures at a safety-net hospital from July 2022 to March 2023. All adverse outcomes within 3 months of discharge were recorded. Management approach (CO versus SI) and potential confounders were tested for association with adverse outcomes.

Results: 128/213 patients (60.1%) had at least one documented adverse outcome. This was more common in those requiring SI (n=97/140, 69.3%) compared to the CO group (n=31/73, 42.5%; Odds Ratio: 3.1, 95% Confidence Interval: 1.6 – 5.7, p= < 0.001). Most adverse outcomes were mild and self-resolving, including facial numbness (n=75, 35.2%), hematoma (n=3, 1.4%), trismus (n=19, 8.9%), and uncontrolled pain (n=14, 6.6%). More sinister adverse outcomes included wound infection (n=30, 14.1%), intracranial infection (n=1, 0.47%), malocclusion (n=15, 7.0%), facial nerve weakness (n=9, 4.2%), visual impairment (n=18, 8.5%), hearing loss (n=16, 7.5%), and aesthetic complaints (n=10, 4.7%). Specific adverse outcomes including wound infections and numbness were more common in the SI group (p < 0.05); however, mandible, naso-orbito-ethmoid, zygomaticomaxillary, and Le Fort fracture types each had a specific adverse outcome profile whether managed with SI or CO.

Conclusions: Patients with facial fractures requiring SI experience more overall and subsite-specific adverse outcomes compared to CO; however, most are mild and self-resolving.

    Presenting Author(s)

  • Aaron L. Zebolsky, MD

    Resident
    University of Tennessee Health Science Center
    Memphis, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Emily R. Baker, BS

    Research Fellow
    University of Tennessee Health Science Center
    Nashville, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Sarit Dhar, BS

    Research Fellow
    University of Tennessee Health Science Center
    Memphis, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Nina M. Gallo, MD

    Resident
    LSU Health Science Center
    Baton Rouge , Louisiana, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Travis Jonathan Clarke, MD

    Resident
    University of Tennessee Health Science Center
    Memphis, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • RD

    Raj Dedhia, MD

    Chief, Division of Facial Plastic Surgery
    University of Tennessee Health Science Center
    Memphis, Tennessee, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Anas A. Eid, MD

    Division Director, Assistant Professor in Facial Plastic & Reconstructive Microsurgery
    University of Tennessee
    memphis, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.