Recent trend and surgical management for panfacial fracture

Kim,  Jin-Wook

J Korean Dent Assoc > Volume 54(10); 2016 > Article

The Journal of The Korean Dental Association 2016;54(10):811-819.
Published online October 31, 2016.

범안면골 골절의 최근 경향 및 수술개념

김진욱

경북대학교 치의학전문대학원 구강악안면외과학교실

Recent trend and surgical management for panfacial fracture

Jin-Wook Kim

Department of oral and maxillofacial surgery, School of dentistry, Kyungpook National University

Abstract

Panfacial fracture is extremely difficult to manage facial injuries but concomitant injuries and severe complications including facial esthetic and functional problems can make it harder. Thorough evaluation and closed co-work with other specialists is needed when reduction and fixation cannot be achieved quickly. Emergency bony support and soft tissue key suture provide the patients with airway integrity, hard and soft tissue vitality. A systemic treatment plan must be made by 3D CT image. This plan include airway management for surgery, sequence of reduction and fixation, approach method, soft tissue resuspension and reconstruction of lost tissue like inferior orbital wall, zygomaic buttress and soft tissue. From known to unknown structures, accurate reduction and fixation will provide proper occlusion, facial projection, width, hight and function. Consideration about facial retaining ligaments must be given to prevent soft tissue sagging.

Key Words: Panfacial fractuer;Surgical management;Bottom up and inside out;Top down and outside in;