Secondary reconstruction of panfacial fractures

Khader, Ruba; Wallender, Aaron; Sickels, Joseph E. Van; Cunningham, Larry L.

doi:10.1007/s10006-013-0403-8

Cited by 12 publications

(12 citation statements)

References 12 publications

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“…ZMC has definitive landmarks than NOE complex for the fractured segment reconstruction [15,21,33]. The ZMC fixation also provides the control for transverse and anteroposterior dimension, stability of lateral pillars, and prevents asymmetry of face [19,20,30]. This bottom-top and outside-in approach is based on the basic principle of fracture management-''simple to complex'' [23].…”

Section: Sequencing In Fixationmentioning

confidence: 99%

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Sequencing of Fixation in Panfacial Fracture: A Systematic Review

Rajendran

Palanivel

Narayanan

et al. 2020

J. Maxillofac. Oral Surg.

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Objective In panfacial fracture management, the controversy still exists in the sequencing of fixation. The purpose of this systematic review is to establish the best sequence pattern which assists in achieving definite facial width, vertical height and anteroposterior projection. Methods The review was conducted according to the ''Preferred Reporting Items for Systematic Reviews and Meta-Analyses'' (PRISMA) guidelines. Two independent authors performed a comprehensive search of the PUBMED, EBSCO, J-Gate, SCOPUS and NDH for articles published up until December 2018. Sequence of fixation, timing of intervention, outcome, follow-up period and complications were evaluated for patients with panfacial fracture. Results In total, 202 articles were identified from the databases. After screening and full text analysis, 25 studies were included in this systematic review. Nineteen studies reported bottom-to-top sequence and two studies reported top-to-bottom approach. However, four studies reported both the approaches. The follow-up period ranges from 3 weeks to 4 years. Conclusion Based on the literature support and evidence, good and satisfactory outcome achieved in ''Bottom-top and outside-in'' sequence when compared with other sequence pattern. Early repair of panfacial fracture is advised for proper reduction and fixation, but can be delayed in accompanying life-threatening injuries.Complications are perceptible in all the sequences; it can be avoided by definitive treatment planning and stepwise management.

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Section: Sequencing In Fixationmentioning

confidence: 99%

“…In addition, the radiological outcome with proper reduction and fixation was reported in four articles [15,27,32,37]. Improved soft tissue scar healing with satisfactory extraoral and intraoral wound healing were reported in three articles [18,19,29].…”

Section: Outcomementioning

confidence: 99%

Sequencing of Fixation in Panfacial Fracture: A Systematic Review

Rajendran

Palanivel

Narayanan

et al. 2020

J. Maxillofac. Oral Surg.

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“…Updating diagnostic imaging is imperative, and 3D reconstruction of CT scans are especially useful in this situation for VSP and general planning purposes. 29,31 Some surgeons also Fig. 6 (A-C) Lateral canthopexy technique.…”

Section: Virtual Surgical Planningmentioning

confidence: 99%

“…29 Khader et al recommended complete subperiosteal dissection in the orbit when attempting secondary reconstruction to ensure there is no tethering of scar tissue. 31 A patient-specific implant can be helpful in these challenging orbital trauma cases. Mirroring the unaffected side in cases of severely comminuted orbits can offer symmetric reconstruction.…”

Section: Virtual Surgical Planningmentioning

confidence: 99%

Surgical Management of Panfacial Fractures

et al. 2019

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The evaluation and management of a patient with panfacial fractures are multifaceted. Herein, we describe basic facial skeletal anatomy, considerations for airway securing, and common concurrent injuries. Finally, we discuss primary and secondary reconstructions of facial trauma including sequencing of repair, available landmarks, and the utility of intraoperative computed tomography imaging and virtual surgical planning with custom implants.

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“…Fractures involving the naso-orbital ethmoid (NOE) region can be especially difficult to correct later and the patient will rarely achieve as good an outcome as when the injuries are treated primarily. 1 Most of these patients have associated fractures that must be addressed as well. Occasionally, other factors such as severe brain or ocular injury render the patient too unstable to undergo repair in the primary setting and secondary reconstruction is unavoidable.…”

mentioning

confidence: 99%

Secondary Treatment of Naso-orbital Ethmoid Injuries

Herford

2017

Facial plast Surg

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Central midface fractures should be treated early due to their propensity for secondary devastating and disfiguring consequences. For example, the expected sequelae to inadequately repaired naso-orbital ethmoid (NOE) injuries include shortened retruded nose, altered palpebral fissures, telecanthus, enophthalmos, and ocular dystopia, to name a few. Secondary repair of NOE fractures is indicated when primary surgical repair is not possible and for any of the aforementioned sequelae. When secondary repair of NOE fractures is necessary, these should be planned carefully while focusing on restoring facial function and aesthetics. Specific attention should focus on midface projection and intercanthal relationship. Virtual surgical planning as intraoperative navigation can be helpful for complex secondary reconstructions.

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Secondary reconstruction of panfacial fractures

Abstract: In this paper, we present three cases of secondary reconstruction of the maxillofacial skeleton following complicated panfacial fractures. We also discuss the challenges that exist in treatment planning and executing treatment in these complex cases.

Cited by 12 publications

References 12 publications

Sequencing of Fixation in Panfacial Fracture: A Systematic Review

Sequencing of Fixation in Panfacial Fracture: A Systematic Review

Surgical Management of Panfacial Fractures

Secondary Treatment of Naso-orbital Ethmoid Injuries

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