eMedicine Specialties > Plastic Surgery > Facial Fractures

Facial Trauma, Management of Panfacial Fractures: Multimedia

Author: Kris S Moe, MD, FACS, Chief, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine; Clinical Associate Professor of Surgery, Division of Head and Neck Surgery, University of California, San Diego
Contributor Information and Disclosures

Updated: Sep 9, 2009

Multimedia

Coronal view of patient with panfacial fractures ...Media file 1: Coronal view of patient with panfacial fractures from facial trauma.
Coronal view of patient with panfacial fractures ...

Coronal view of patient with panfacial fractures from facial trauma.

Close-up view of left zygomatic comminution.Media file 2: Close-up view of left zygomatic comminution.
Close-up view of left zygomatic comminution.

Close-up view of left zygomatic comminution.

Coronal view demonstrating cant of maxilla and ma...Media file 3: Coronal view demonstrating cant of maxilla and mandible.
Coronal view demonstrating cant of maxilla and ma...

Coronal view demonstrating cant of maxilla and mandible.

Axial view demonstrating increased zygomatic widt...Media file 4: Axial view demonstrating increased zygomatic width.
Axial view demonstrating increased zygomatic widt...

Axial view demonstrating increased zygomatic width.

Three-dimensional reconstruction aids in treatmen...Media file 5: Three-dimensional reconstruction aids in treatment planning of these complex panfacial fractures.
Three-dimensional reconstruction aids in treatmen...

Three-dimensional reconstruction aids in treatment planning of these complex panfacial fractures.

Initial clinical presentation of a patient with p...Media file 6: Initial clinical presentation of a patient with panfacial fracture.
Initial clinical presentation of a patient with p...

Initial clinical presentation of a patient with panfacial fracture.

Large stellate upper lip laceration demonstrating...Media file 7: Large stellate upper lip laceration demonstrating comminution of anterior maxilla.
Large stellate upper lip laceration demonstrating...

Large stellate upper lip laceration demonstrating comminution of anterior maxilla.

Traumatic telecanthus secondary to nasoorbitoethm...Media file 8: Traumatic telecanthus secondary to nasoorbitoethmoid fracture. Intercanthal distance is 39 mm.
Traumatic telecanthus secondary to nasoorbitoethm...

Traumatic telecanthus secondary to nasoorbitoethmoid fracture. Intercanthal distance is 39 mm.

Intermaxillary fixation in place. Note comminutio...Media file 9: Intermaxillary fixation in place. Note comminution of mandible.
Intermaxillary fixation in place. Note comminutio...

Intermaxillary fixation in place. Note comminution of mandible.

Coronal approach used to access mid face.Media file 10: Coronal approach used to access mid face.
Coronal approach used to access mid face.

Coronal approach used to access mid face.

Comminuted zygomatic arch.Media file 11: Comminuted zygomatic arch.
Comminuted zygomatic arch.

Comminuted zygomatic arch.

Coronal access to nasal and medial orbital compon...Media file 12: Coronal access to nasal and medial orbital components.
Coronal access to nasal and medial orbital compon...

Coronal access to nasal and medial orbital components.

Mandible stabilized with plate-and-screw fixation.Media file 13: Mandible stabilized with plate-and-screw fixation.
Mandible stabilized with plate-and-screw fixation.

Mandible stabilized with plate-and-screw fixation.

Fixation of zygoma and zygomatic arch.Media file 14: Fixation of zygoma and zygomatic arch.
Fixation of zygoma and zygomatic arch.

Fixation of zygoma and zygomatic arch.

Fixation of nasoorbitoethmoid component.Media file 15: Fixation of nasoorbitoethmoid component.
Fixation of nasoorbitoethmoid component.

Fixation of nasoorbitoethmoid component.

Maxillary fixation at the level of the zygomatico...Media file 16: Maxillary fixation at the level of the zygomaticomaxillary buttress and the piriform rim.
Maxillary fixation at the level of the zygomatico...

Maxillary fixation at the level of the zygomaticomaxillary buttress and the piriform rim.

Postoperative coronal CT scan image.Media file 17: Postoperative coronal CT scan image.
Postoperative coronal CT scan image.

Postoperative coronal CT scan image.

Postoperative axial CT scan image.Media file 18: Postoperative axial CT scan image.
Postoperative axial CT scan image.

Postoperative axial CT scan image.

Postoperative view of patient.Media file 19: Postoperative view of patient.
Postoperative view of patient.

Postoperative view of patient.

Postoperative frontal view of patient, demonstrat...Media file 20: Postoperative frontal view of patient, demonstrating good facial symmetry.
Postoperative frontal view of patient, demonstrat...

Postoperative frontal view of patient, demonstrating good facial symmetry.

Postoperative profile view of patient, demonstrat...Media file 21: Postoperative profile view of patient, demonstrating good nasal dorsal and zygomatic anterior-posterior projection.
Postoperative profile view of patient, demonstrat...

Postoperative profile view of patient, demonstrating good nasal dorsal and zygomatic anterior-posterior projection.

Postoperative view of patient, demonstrating norm...Media file 22: Postoperative view of patient, demonstrating normal intercanthal distance (33 mm) after resuspension of the medial canthal ligament and fixation of the nasoorbitoethmoid component.
Postoperative view of patient, demonstrating norm...

Postoperative view of patient, demonstrating normal intercanthal distance (33 mm) after resuspension of the medial canthal ligament and fixation of the nasoorbitoethmoid component.

More on Facial Trauma, Management of Panfacial Fractures

Overview: Facial Trauma, Management of Panfacial Fractures
Workup: Facial Trauma, Management of Panfacial Fractures
Treatment: Facial Trauma, Management of Panfacial Fractures
Follow-up: Facial Trauma, Management of Panfacial Fractures
Multimedia: Facial Trauma, Management of Panfacial Fractures
References

References

  1. Wenig BL. Management of panfacial fractures. Otolaryngol Clin North Am. Feb 1991;24(1):93-101. [Medline].

  2. Follmar KE, Debruijn M, Baccarani A, et al. Concomitant injuries in patients with panfacial fractures. J Trauma. Oct 2007;63(4):831-5. [Medline].

  3. Erdmann D, Follmar KE, Debruijn M, et al. A retrospective analysis of facial fracture etiologies. Ann Plast Surg. Apr 2008;60(4):398-403. [Medline].

  4. Caron G, Paquin R, Lessard MR, et al. Submental endotracheal intubation: an alternative to tracheotomy in patients with midfacial and panfacial fractures. J Trauma. Feb 2000;48(2):235-40. [Medline].

  5. Stoll P, Galli C, Wachter R, Bahr W. Submandibular endotracheal intubation in panfacial fractures. J Clin Anesth. Jan-Feb 1994;6(1):83-6. [Medline].

  6. Babu I, Sagtani A, Jain N, Bawa SN. Submental tracheal intubation in a case of panfacial trauma. Kathmandu Univ Med J (KUMJ). Jan-Mar 2008;6(1):102-4. [Medline].

  7. Berardo N, Leban SG, Williams FA. A comparison of radiographic treatment methods for evaluation of the orbit. J Oral Maxillofac Surg. Oct 1988;46(10):844-9. [Medline].

  8. DeMarino DP, Steiner E, Poster RB, et al. Three-dimensional computed tomography in maxillofacial trauma. Arch Otolaryngol Head Neck Surg. Feb 1986;112(2):146-50. [Medline].

  9. Gillespie JE, Quayle AA, Barker G, Isherwood I. Three-dimensional CT reformations in the assessment of congenital and traumatic cranio-facial deformities. Br J Oral Maxillofac Surg. Apr 1987;25(2):171-7. [Medline].

  10. Zide MF, Kent JN. Indications for open reduction of mandibular condyle fractures. J Oral Maxillofac Surg. Feb 1983;41(2):89-98. [Medline].

  11. Kelly KJ, Manson PN, Vander Kolk CA, et al. Sequencing LeFort fracture treatment (Organization of treatment for a panfacial fracture). J Craniofac Surg. Oct 1990;1(4):168-78. [Medline].

  12. Tang W, Feng F, Long J, et al. Sequential surgical treatment for panfacial fractures and significance of biological osteosynthesis. Dent Traumatol. Apr 2009;25(2):171-5. [Medline].

  13. Irby WB. Facial Trauma and Concomitant Problems: Evaluation and Treatment. 2nd ed. St. Louis, Mo: CV Mosby; 1979.

  14. Tullio A, Sesenna E. Role of surgical reduction of condylar fractures in the management of panfacial fractures. Br J Oral Maxillofac Surg. Oct 2000;38(5):472-6. [Medline].

Further Reading

Keywords

facial trauma, panfacial fractures, facial fracture, plate and screw fixation, plate-and-screw fixation, facial trauma pictures, facial fracture pictures, facial fracture treatment, facial fracture repair, rigid fixation, midface injury, mid-face injury, midface reconstruction, mid-face reconstruction, panfacial injury, complex maxillofacial injury, panfacial trauma, facial fracture, face fracture, maxillofacial surgery, maxillofacial reconstruction, maxillofacial repair, maxillofacial injury, maxillomandibular fixation, MMF, panfacial fracture, facial trauma, facial fracture management

Contributor Information and Disclosures

Author

Kris S Moe, MD, FACS, Chief, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine; Clinical Associate Professor of Surgery, Division of Head and Neck Surgery, University of California, San Diego
Kris S Moe, MD, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Society for Head and Neck Surgery, and North American Skull Base Society
Disclosure: Nothing to disclose.

Medical Editor

James F Thornton, MD, Assistant Professor, Department of Plastic and Reconstructive Surgery, University of Texas Southwestern
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Jaime R Garza, MD, DDS, FACS, Consulting Staff, Private Practice
Jaime R Garza, MD, DDS, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society of Maxillofacial Surgeons, Texas Medical Association, and Texas Society of Plastic Surgeons
Disclosure: Allergan Honoraria Consulting

CME Editor

Nicolas (Nick) G Slenkovich, MD, Director, Colorado Plastic Surgery Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Deepak Narayan, MD, FRCS, Associate Professor of Surgery (Plastic), Yale University School of Medicine; Chief of Plastic Surgery, West Haven Veterans Affairs Medical Center
Deepak Narayan, MD, FRCS is a member of the following medical societies: American Association for the Advancement of Science, American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Indian Medical Association, Plastic Surgery Research Council, Royal College of Surgeons of Edinburgh, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

 
 
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