Craniomaxillofacial Trauma: The Past, Present and the Future

Abstract

Reconstruction of facial trauma has seen a significant evolutionary leap in the last 100 years. The current surgical management of facial fractures was made possible by the efforts and creativity of pioneer surgeons, advances in anatomic understanding, and the continued development of biomaterials and imaging technologies. Virtual surgical planning (VSP) and 3-dimensional printing (3DP) are being incorporated into the management of acute facial trauma. The integration of this technology at the point of care is rapidly expanding globally. This article reviews the history of the management of craniomaxillofacial trauma, current practices, and future directions. The use of VSP and 3DP in facial trauma care is highlighted with a description of EPPOCRATIS, a rapid point-of-care process incorporating VSP and 3DP at the trauma center.

Evolution of Medical Modeling and 3D Printing in Microvascular Midface Reconstruction: Literature Review and Experience at MD Anderson Cancer Center

“…Microvascular reconstruction of the midface has witnessed tremendous advances over time, from generic titanium plates and bone grafts to microvascular osteocutaneous flaps incorporating cutting-edge technology with preoperative imaging and computerassisted design and modeling [36]. The growth in virtual surgical planning technology has revolutionized reconstruction of the craniofacial skeleton in congenital pediatric cases as well as traumatic defects [37][38][39][40]. The present review offers a summary of the most up-to-date studies in the literature, and also offers some insights from the authors' early experience in oncologic reconstruction, where extensive resections are performed in order to obtain the highest chance for cure.…”

3D Printing Applications for Craniomaxillofacial Reconstruction: A Sweeping Review

“…As it stands, extended manufacturing and transport times due to distant third-party manufacturers bottleneck widespread use of the technology. For example, 3DMD cannot be used in acute CMF trauma cases, although if available it would alleviate many of the challenges associated with reconstruction of extensive facial traumas . Additionally, the tendency to incorporate biologics (e.g., stem cells) into 3D printed scaffolds is not conducive to transport across great distances.…”

“…For example, 3DMD cannot be used in acute CMF trauma cases, although if available it would alleviate many of the challenges associated with reconstruction of extensive facial traumas. 4 Additionally, the tendency to incorporate biologics (e.g., stem cells) into 3D printed scaffolds is not conducive to transport across great distances. Thus, HCFs can differentiate themselves by having such capabilities in-house.…”

“…A large portion of our self-identity is housed within facial features. Patients with facial differences as a result of cranio­maxillofacial (CMF) trauma, such as sports injuries and road accidents, congenital anomalies, infectious disease, tumor resection, or edentulism have reported associated stressors of self-acceptance, negative responses of others, and difficulty coping with associated impairments. − These associated impairments can include compromised sensory organ function, speech, and mastication . The field of CMF surgery treats a diverse range of ages and pathologies, both of which must be considered when CMF surgeons form and execute their surgical plan.…”

Off-Label Use of an External Hand Fixator for Craniomaxillofacial Fractures—An Anatomical Feasibility Study

“…Some clinics even use an intraoperative 3-D CT scan to verify the reduction [ 11 , 12 , 13 ]. While surgical care for CMF in HIC has changed and improved significantly over the past 100 years, there have been few improvements in LIC [ 14 ]. In LIC, 3D scans or material for osteosynthesis are often not available.…”