Oral and Maxillofacial Injuries Associated With E-Cigarette Explosions: A Systematic Review and Management Guidelines...

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Public Health

Background:

• E-cigarettes are increasingly popular nicotine delivery devices.
• Spontaneous explosions of e-cigarettes pose a significant risk, causing severe burn and projectile injuries.
• Oral and maxillofacial region injuries from e-cigarette explosions require specific attention and management strategies.

Approach:

• A comprehensive literature review was conducted to identify and summarize injuries to the oral and maxillofacial region resulting from e-cigarette explosions.
• Data from 28 studies (20 case reports, 8 case series) involving 32 patient explosions were analyzed.
• Statistical analysis was performed to explore associations between injury types/locations and the need for intubation or surgical management.

Key Points:

• E-cigarette explosions resulted in 105 facial injuries across 32 patients, with projectile injuries (73.3%) being more common than burns (26.7%).
• The lower facial third was the most common site for projectile injuries (81.8%), and fractures occurred in 62.5% of patients.
• Surgical management was required for 62.5% of patients, with a notable complication rate of 44.4%.

Conclusions:

• E-cigarette explosions frequently cause severe oral and maxillofacial injuries, particularly affecting the lower face and often necessitating surgical intervention.
• The study found no statistically significant association between specific injury patterns (burn vs. projectile, location) and the need for intubation or surgery.
• Enhanced user education and regulatory measures are recommended to improve the safety of e-cigarette devices.