Surgical Management of Panfacial Fractures

Wang, Lexie; Lee, Thomas S.; Wang, Weitao; Yi, Dae Ik; Sokoya, Mofiyinfolu; Ducic, Yadranko

doi:10.1055/s-0039-1700800

Cited by 19 publications

(12 citation statements)

References 32 publications

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“…La evaluación y el tratamiento de las fracturas panfaciales puede ser un desafío clínico, ya que involucra simultáneamente huesos de dos o más tercios faciales, en las que el grado de fragmentación dificulta la restauración de la arquitectura original facial (Kim et al;Wang et al, 2019). Además, suelen estar asociadas a lesiones de columna cervical y/o craneocerebrales y obstrucción de la vía aérea, arriesgando así la vida del paciente (Yang et al).…”

Section: Discussionunclassified

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Sistemática en el Tratamiento Quirúrgico de las Fracturas Panfaciales Aplicado a un Caso Clínico De Alta Complejidad

Mardones-M

Bravo-A

Fernández-T

et al. 2020

Int. J. Odontostomat.

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RESUMEN: Las fracturas panfaciales son aquellas que afectan de forma simultánea al tejido óseo de dos o más tercios del rostro. El manejo inicial de estos pacientes es resolver o estabilizar las urgencias médico-quirúrgicas que puedan presentar, debido a que la gran mayoría de estas fracturas están asociadas a traumatismos de alta energía cinética, las que determinan la presencia de lesiones concomitantes que pueden comprometer la vida del paciente. El tratamiento quirúrgico de las fracturas panfaciales puede abarcar desde la intervención quirúrgica inicial de control de daños, estabilización, reducción y fijación quirúrgica de los segmentos fracturados mediante osteosíntesis hasta intervenciones mediatas para la reconstrucción de los tejidos afectados por el traumatismo. Para el tratamiento de las fracturas panfaciales existe una sistemática quirúrgica que tiene por objeto contener y/o minimizar daños agudos y permitir una reducción morfológica y funcional. Reportamos un caso clínico de fractura panfacial cuyo tratamiento siguió esta sistemática terapeútica. PALABRAS CLAVE: fractura panfacial, politraumatizado, manejo inicial del trauma.

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Section: Discussionunclassified

“…Las alternativas a la intubación orotraqueal incluyen intubación nasotraqueal, intubación orotraqueal con derivación submental y traqueostomía. (Nwoku et al, 2002;Wang et al).…”

Section: Discussionunclassified

Sistemática en el Tratamiento Quirúrgico de las Fracturas Panfaciales Aplicado a un Caso Clínico De Alta Complejidad

Mardones-M

Bravo-A

Fernández-T

et al. 2020

Int. J. Odontostomat.

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“…These traumas are significantly more challenging to manage compared to isolated facial or dentoalveolar fractures since there is limited intact and unharmed framework to guide with anatomic reductions. Furthermore, oftentimes, due to the high impact of force that caused these traumas in the first place, these patients present with other significant concomitant traumas that must be managed concurrently 3 . The appropriate surgical approach to a maxillofacial trauma must follow a systematic scheme, necessitating systemic evaluations such as the hemodynamic evaluation, wound extensions, presence or absence of foreign bodies, neural or vascular or glandular ducts involvements, and other requisite evaluations which must be carefully undertaken with preoperative examinations 4 .…”

Section: Introductionmentioning

confidence: 99%

Conferred with a new life: A case report of management of a severe midface trauma and subsequent oral rehabilitation

Pournabi

Moslemi

Shafiei

et al. 2021

Clinical Case Reports

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Maxillofacial traumas have been associated with 14%‐17% of all facial injuries. The most common etiology of mid‐facial traumas is motor vehicle accidents followed by interpersonal assaults. The devastating nature of maxillofacial defects makes reconstruction of the midface challenging, due to multiple required surgeries and extensive rehabilitation phase. The midface has been defined as the area between the zygomaticofrontal sutures and the maxillary occlusal plane. Midface traumas are significantly more challenging to manage compared to isolated facial since there is limited intact and unharmed framework to guide with anatomic reductions. Therefore, the appropriate surgical approach to a maxillofacial trauma must follow a systematic scheme. Besides, one of the main consequences of maxillofacial traumas is destruction of the teeth and teeth bearing alveolar bone. Oral rehabilitation utilizing dental implants of these patients must be considered to provide the higher quality of life. Here, we report the management and further oral rehabilitation of a case suffering severe midface trauma following a motor vehicle accident where the patient was hit by a lorry.

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“…Orotracheal intubation is the primary choice in securing the airway, though cricothyrotomy may be indicated in patients with panfacial fractures, airway compromise, and inability to visualize the vocal cords by laryngoscopy. 5 In patients with comminuted mandibular fractures, the mandibular symphysis may posteriorly displace, decreasing support of the genioglossus and geniohyoid muscles, which can lead to collapse of the tongue base to the posterior pharynx. 6 An emergent airway may be necessary in patients with neurologic compromise, a severely comminuted mandible, or significant midfacial bleeding.…”

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confidence: 99%

Management of Panfacial Trauma: Sequencing and Pitfalls

Massenburg

Lang

2021

Semin Plast Surg

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Panfacial trauma refers to high-energy mechanism injuries involving two or more areas of the craniofacial skeleton, the frontal bone, the midface, and the occlusal unit. These can be distracting injuries in an unstable patient and, as in any trauma, Advanced Trauma Life Support (ATLS) protocols should be followed. The airway should be secured, bleeding controlled, and sequential examinations should take place to avoid overlooking injuries. When indicated, neurosurgery and ophthalmology should be consulted as preservation of brain, vision, and hearing function should be prioritized. Once the patient is stabilized, reconstruction aims to reduce panfacial fractures, restore the horizontal and vertical facial buttresses, and resuspend the soft tissue to avoid the appearance of premature aging. Lost or comminuted bone can be replaced with bone grafts, although adequate reduction should be ensured prior to any grafting. Operative sequencing can be performed from top-down and outside-in or from bottom-up and inside-out depending on patient presentation. All protocols can successfully manage panfacial injuries, and the emphasis should be placed on a systematic approach that works from known areas to unknown areas.

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Surgical Management of Panfacial Fractures

Cited by 19 publications

References 32 publications

Sistemática en el Tratamiento Quirúrgico de las Fracturas Panfaciales Aplicado a un Caso Clínico De Alta Complejidad

Sistemática en el Tratamiento Quirúrgico de las Fracturas Panfaciales Aplicado a un Caso Clínico De Alta Complejidad

Conferred with a new life: A case report of management of a severe midface trauma and subsequent oral rehabilitation

Management of Panfacial Trauma: Sequencing and Pitfalls

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