{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T06:51:54Z","timestamp":1793429514341,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,3,27]],"date-time":"2015-03-27T00:00:00Z","timestamp":1427414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Airway stabilization is critical in combat maxillofacial injury as normal anatomical landmarks can be obscured. The study objective was to characterize the epidemiology of airway management in maxillofacial trauma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective database analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Military treatment facilities in Iraq and Afghanistan and stateside tertiary care centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>In total, 1345\u00a0military personnel with combat\u2010related maxillofacial injuries sustained March 2004 to August 2010 were identified from the Expeditionary Medical Encounter Database using <jats:italic>International Classification of Diseases, 9th Revision, Clinical Modification<\/jats:italic> (<jats:italic>ICD\u20109\u2010CM<\/jats:italic>) codes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Descriptive statistics, including basic demographics, injury severity, associated injuries, and airway interventions, were collected. A logistic regression was performed to determine factors associated with the need for tracheostomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 239 severe maxillofacial injuries were identified. The most common mechanism of injury was improvised explosive devices (66%), followed by gunshot wounds (8%), mortars (5%), and landmines (4%). Of the subjects, 51.4% required intubation on their initial presentation. Of tracheostomies, 30.4% were performed on initial presentation. Of those who underwent bronchoscopy, 65.2% had airway inhalation injury. There was a significant relationship between the presence of head and neck burn and association with airway inhalation injury (<jats:italic>P<\/jats:italic> &lt;. 0001). There was also a significant relationship between the severity of facial injury and the need for intubation (<jats:italic>P<\/jats:italic> =. 002), as well as the presence of maxillofacial fracture and the need for tracheostomy (<jats:italic>P<\/jats:italic> =. 0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is a high incidence of airway injury in combat maxillofacial trauma, which may be underestimated. Airway management in this population requires a high degree of suspicion and low threshold for airway stabilization.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599815576916","type":"journal-article","created":{"date-parts":[[2015,3,29]],"date-time":"2015-03-29T00:53:00Z","timestamp":1427590380000},"page":"532-537","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Airway Management in Severe Combat Maxillofacial Trauma"],"prefix":"10.1002","volume":"153","author":[{"given":"Matthew W.","family":"Keller","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery Naval Medical Center San Diego San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy P.","family":"Han","sequence":"additional","affiliation":[{"name":"Naval Health Research Center San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael 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