There is no consensus about the surgical treatment of odontogenic myxoma. The aim of the current study was to present our experience and discuss the surgical management and outcome in 10 patients diagnosed with odontogenic myxoma. A retrospective review of charts of patients who were surgically treated for odontogenic myxoma was performed. Patients were recalled, and eventual recurrences were investigated. Eight lesions were mandibular, whereas 2 were maxillary. In 3 patients, enucleation and curettage was performed. Instead, in the remaining 7 patients, segmental resection and immediate reconstruction were decided. At follow-up, no patient showed recurrence of the lesion. Our protocol is to perform conservative surgery by enucleation and curettage when lesions were smaller than 3 cm, whereas a segmental resection with immediate reconstruction is preferred in patients affected by bigger tumors. Long-term follow-up is required, in particular when conservative surgery is preferred.

Background/Aims: Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1‐year period.Methods: The following data were collected: age (preschool [0–6 years], school age [7–12 years], and adolescent [13–18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software.Results: Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0–18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001).Conclusion: The main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0–6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.

By analyzing sports-related maxillofacial fractures, we sought to describe preventive measures and recovery times until sporting activities could be resumed. Between January 2001 and December 2006, 1241 patients were hospitalized as a result of maxillofacial fractures. The patients with sports-related maxillofacial fractures were analyzed based on age, sex, type of sport, injury mechanism, trauma site, presence of associated fractures, hospitalization, treatment method, and recovery time until the resumption of sporting activities. One hundred thirty-eight patients (11.4%) sustained sports-related maxillofacial fractures: 121 males and 17 females (ratio 8:1), aged between 11 and 72 years. The sport producing the greatest number of injuries was soccer (62.3%), followed by skiing (14.5%), and horseback riding (6.5%). The injuries involved mainly the middle third of the face (71.6%), and the mandible was the most affected site (27.2%), followed by the maxillary-zygomatic-orbital complex (25.9%). Treatment was surgery in 93.5% of the patients, with an average hospitalization period of 3.5 days. The protocol created to manage the follow-up of maxillofacial injury patients advised resuming sports activities at least 40 days after the trauma, except in the case of combat sports, when a period of 3 months was required. Although the results of this study indicate a reduction in the total incidence of sports-related maxillofacial injuries, they also show an alarming secondary increase in trauma resulting from the most popular sport in Italy-soccer. Therefore, stricter regulations are needed to discourage violent play, rather than relying on the use of protective equipment. Moreover, patients should be advised when they can resume sports activities, particularly in the case of professionals and semiprofessionals.

Interest in the psychiatric consequences of trauma and the subsequent surgical intervention has been increasing steadily; therefore, the authors assessed the prevalence of acute symptoms of stress in patients who experienced a craniomaxillofacial injury. Fifty patients between the ages of 18 and 65 years were evaluated and assigned a score using the Injury Severity Scale (ISS). Within 48 hours of surgery (T0) and at 3 months after surgery (T1), the authors administered the Davidson Trauma Scale (DTS) to assess post-traumatic symptoms, Spielberger's State-Trait Anxiety Inventory (STAI) to assess symptoms of anxiety, and Zung's Self-rating Depression Scale (SDS) to assess depressive symptoms. Of the subjects, 44% (22 patients at T0) had acute symptoms of stress, and 26% (13 patients at T1) had post-traumatic stress symptoms. The statistical association between demographic variables was significant only for gender, especially for women. There was a significant correlation between the psychopathologic variables and trauma-specific symptoms at both T0 and T1; the same was true for the ISS at T0. Eight of the 13 patients with positive DTS results at 3 months had aesthetic and functional sequelae that might have served as reminders of the traumatic event. It is not only necessary to restitutio ad integrum the anatomy and function, but also to provide psychiatric support for patients experiencing psychiatric symptoms caused by traumatic events.