Zusammenfassung
Mittelgesichtsverletzungen können knöcherne und weichgewebige Aspekte umfassen. Durch die direkte anatomische Nähe treten weiterhin regelhaft begleitende Verletzungen der Schädelbasis, des Neurokraniums, des Unterkiefers und des Auges auf. Neben der Versorgung der allgemein gut zugänglichen Weichteilverletzungen zielt die Erstversorgung bei Mittelgesichtstraumata hauptsächlich auf das Management von posttraumatischen Komplikationen ab. Auch traumabedingt stark gelockerte aspirationsgefährdete Zähne oder Zahnfragmente sollten hierbei umgehend entfernt werden. Je nach vorhandener Compliance lassen sich nahezu alle Maßnahmen im Rahmen der Erstversorgung in Lokalanästhesie durchführen. Ist dennoch eine Intubationsnarkose erforderlich, kann unter Berücksichtigung der jeweils herrschenden Gesamtsituation erwogen werden, die Primärversorgung gleich auf die Gesamtversorgung des verletzten Mittelgesichts auszudehnen.
Abstract
Injuries to the midface can encompass aspects of bone and soft tissue. Due to the anatomic proximity, concomitant injuries of the skull base, the neurocranium, the mandible, and the eye are common. In addition to treatment of the generally easily accessible soft tissue injuries, primary care of midface trauma is primarily directed toward management of posttraumatic complications. Teeth or tooth fragments loosened by the trauma and at risk of aspiration should be immediately extracted. Depending on patient compliance, almost all primary care procedures can be performed under local anesthesia. If, however, intubation is required, based on the overall situation, expansion of primary treatment to also encompass definitive treatment of the injured midface can be considered.
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Lentge, F., Tavassol, F. Primärversorgung von Mittelgesichtsfrakturen. MKG-Chirurgie 17, 10–17 (2024). https://doi.org/10.1007/s12285-023-00458-6
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DOI: https://doi.org/10.1007/s12285-023-00458-6