Functional Anatomic Computer Engineered Surgery Protocol for the Management of Self-Inflicted Gunshot Wounds to the Maxillofacial Skeleton

Khatib, Baber; Cuddy, Karl; Cheng, Allen; Patel, Ashish; Sim, Felix; Amundson, Melissa; Gelesko, Savannah; Bui, Tuan; Dierks, Eric J.; Bell, R. Bryan

doi:10.1016/j.joms.2017.10.017

Cited by 22 publications

(14 citation statements)

References 35 publications

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“…2,[4][5][6] As such, several studies have investigated the use of computer aided technology in the treatment of ballistic injuries to the head and neck. 1,7 However, these studies have focused solely on bony reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…A 19-year-old female presented to our institution with subacute facial wounds secondary to a ballistic injury sustained in an assault. The patient initially presented to an outside FACE 1 (1) facility with significant facial injuries, including fractures of the bilateral orbits, zygomas, maxilla, nasal bones and septum, as well as left globe rupture. There, she was stabilized and taken to the operating room for tracheostomy, multiple facial washouts, fracture fixation and enucleation of the left globe.…”

Section: Methods: Patient Presentationmentioning

confidence: 99%

“…With advances in trauma care, there is increasing survivorship in patients with ballistic injuries to the face, with rates as high as 85% in patients with injuries occurring below the supraorbital rim. 1 Given that a substantial proportion of these patients will return to their pre-injury lifestyle, secondary reconstruction to improve facial appearance is an essential component for treatment and successful reintegration into society. A multidisciplinary approach combining the skills of an anaplastologist, the proficiency of a craniomaxillofacial surgeon, and the latest technology in virtual surgical planning (VSP) holds the greatest promise for an efficient, anatomical, and efficacious restoration of facial form and function.…”

Section: Introductionmentioning

confidence: 99%

“…2 In the literature, there are countless descriptions of computer aided technology in craniofacial surgery, from orthognathic surgery and osteocutaneous free flap reconstruction, 2 to complex panfacial trauma and ballistic injuries. 1,3 However, there is little discussion surrounding the application of VSP for surgical refinement of soft tissue facial deformities. In this report, we present a case integrating VSP, anaplastology and 3D printed surgical guides to optimize secondary soft tissue reconstruction for improved facial symmetry and orbital prosthesis accommodation in a patient who sustained devastating facial injuries from a gunshot wound.…”

Section: Introductionmentioning

confidence: 99%

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Using a 3D Printed “Phantom of the Opera” Soft Tissue Surgical Guide for Complex Facial Reconstruction

Sacks¹,

Ulma²,

Dolphin³

et al. 2020

FACE

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Computer aided technology in the form of virtual surgical planning (VSP) and 3D printed surgical guides can allow for a more accurate reconstruction of complex maxillofacial deformities. While this technology is now routinely used for bony reconstruction, it is rarely utilized for soft tissue. In ballistic injuries there is often disfiguring damage to the soft tissue, with destruction of anatomic landmarks making satisfactory soft tissue reconstruction a unique challenge. In this study, the authors present the application of virtual surgical planning and 3D printed guides, in conjunction with anaplastology, for complex soft tissue reconstruction resulting from a gunshot injury. By combining tangible surgical models and aesthetic judgment in a team setting, it is possible to optimize the efficiency and accuracy of soft tissue reconstruction in the setting of complex facial deformities.

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Section: Discussionmentioning

confidence: 99%

Section: Methods: Patient Presentationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Using a 3D Printed “Phantom of the Opera” Soft Tissue Surgical Guide for Complex Facial Reconstruction

Sacks¹,

Ulma²,

Dolphin³

et al. 2020

FACE

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show abstract

“…VSP continues to evolve into common practice and much has been published about its success. [17][18][19][20] Operative Principles…”

Section: Surgical Planningmentioning

confidence: 99%

Facial Gunshot Wounds

et al. 2019

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Craniomaxillofacial gunshot injuries, resulting from assault, suicide attempts, and accidental trauma, represent a major public health dilemma in the United States. Due to the extent of injury and resulting osseous and soft tissue loss, facial gunshot wounds pose a unique challenge to the reconstructive surgeon. Initial management should use advanced trauma life support principles with the goal of patient stabilization. Acute operative management should center around wound decontamination, debridement, and temporary closure. Historically, definitive surgical management focused on delayed reconstruction secondary to high rates of wound infections, necrosis, and ischemia. With improvements in imaging modalities, the advent of virtual surgical planning, and the popularization of microvascular free flaps, contemporary methods have shifted toward earlier more definitive reconstruction. Autologous free tissue transfer has resulted in a decrease in hospital stay and the number of overall surgeries. Importantly, due to the variability in injury pattern and complexity in reconstruction, a systematic approach toward intervention is needed to mitigate complications and optimize overall functional and aesthetic outcomes.

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