Maxillofacial Injury
Write a short note on maxillofacial injuries.
Answer. Maxillofacial injuries are due to road traffic accidents, assaults, bullet injuries, or sports injuries.
“Surgical Approaches For Maxillofacial Injuries”
Maxillofacial injuries Classification
- Fracture of the lower third, which comprises of mandible
- Fracture of the middle third, which comprises of maxilla, zygoma, and nose
- Fracture of the upper third of the face involving part of the orbit and frontal bones.
Read And Learn More: Maxillofacial Fractures, Disorders, and Treatments
“Zygomatic Arch Fracture Types”
Maxillofacial injuries, Soft tissue injuries
- Lacerations, contusions, cut wounds, etc.
- Eyelid injuries with black eyes
- Facial nerve injury: Primary repair is required
- Parotid duct injury: Primary Anastomosis of the injured duct is done, with fie polyethylene cannula kept as a stent inside the duct, which is removed in 14 days.
- Lacrimal apparatus injuries: Here, the duct is sutured with fine nylon thread in the canaliculus, which is kept for three months.
“3d Imaging In Maxillofacial Fracture Classification“
Injuries To Facial Bones
- Fracture nose: Nasal bones are the most commonly injured bones in the face.
- The patient presents with pain and swelling in the nose, with deviation and displacement.
- Here reduction of the fractured nasal bones and nasal septum under general anesthesia is done.
- Later position is maintained by nasal packs from inside (which are removed in 7 days) and by a nasal plaster from outside (which will be kept for 14 days).
- The procedure is done using Walsham and Asch forceps.
- Injuries to the maxilla
- Zygomatic bone injuries.
- Mandibular bone fracture and mandibular dislocation.
- Orbital bone fracture: Presents with diplopia, enophthalmos, and sensory loss in the area of the infraorbital nerve.
- Infraorbital ecchymosis of the orbit is called the Panda sign.
“Most Common Facial Fractures In Trauma Patients”
Maxillofacial Injuries: Clinical Features
- Localized swelling due to hematoma
- Facial edema
- Bleeding with open wounds
- Asymmetry, which is clinically confirmed by observing the supraorbital ridges, the nasal bridge
- Localized tenderness
- Step deformity
- Trismus
- Diplopia
- Features of associated injuries such as intracranial, abdominal, or thoracic injuries.
“Virtual Reality For Maxillofacial Surgery Planning”
Maxillofacial injuries Investigations
- X-ray face
- CT scan of the head and jaw
“Comparison Of Facial Fracture Classifications“
Maxillofacial injuries Management
- As the initial assessment, evaluation, and management of life-threatening injury get completed compound fracture should be treated in the following manner, i.e.
“Role Of CBCT in Facial Trauma”
- Hemostasis should be achieved.
- For Type I and Type II compound fractures, cefazolin or clindamycin is the choice of drugs, while for Type III compound fractures, an aminoglycoside is given.
- Tetanus vaccination should be given.
- Irrigation, as well as debridement of the wound, should be carried out immediately.
- In cases with Type II and Type III compound fractures, serial irrigation and debridement are recommended every 24 to 48 hours till a clean surgical wound is confirmed. Close the wound when it gets fully clean.
- Management of open fractures depends on their type and site. Later on wound is stabilized temporarily or definitively.
- If coverage of soft tissue after injury is not proper,r soft tissue transfer or free flap is given to the patient when the fracture is treated.
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