Panfacial Fractures

Abstract

The chances of survival for patients with severe brain injuries have improved considerably in recent years. Brain injuries are often combined with fractures of the facial skeleton which - in contrast to the brain injuries - are life-threatening only in rare cases. Bleeding from the cranial base can be stopped by tamponage, for example, and airway obstruction in cases with mandibular fractures is nonthreatening due to endotracheal intubation. Unfortunately, the correct diagnosis of fractures of the viscerocranium is sometimes delayed, and immediate proper treatment is hindered. Occasionally, minor injuries such as isolated zygomatic fractures or closed fractures of the temporomandibular joint are not recognized at all. For the patient who survives, the sequelae of these fractures are of major importance, not only with respect to esthetics but also to functional disturbances. Due to the complex structure of the viscera-cranium, minor dislocations may cause major disturbances. Whereas secondary soft tissue corrections may yield good results, skeletal deformities are much more difficult to be corrected secondarily and often cause severe defacement.