Contemporary Management of Facial Trauma

Ralph Litschel, MD, and Abel-Jan Tasman, MD

There are few challenges in facial plastic surgery that require as much of a multidisciplinary approach as the treatment of facial trauma. Previous issues of this journal have been dedicated to facial trauma in 1988, 1998, 2000, and 2005, with editorials calling for an update given the substantial developments in treatment concepts and surgical techniques and the increasing number of published articles on facial trauma. A PubMed database search using the keywords “facial trauma epidemiology” yields approximately 200 articles for each year between 2010 and 2014. Causes and patterns of craniofacial trauma appear to have changed over time and new classification systems for facial fractures have emerged.[1] In large European case series, assaults and falls were recently found to be the most important etiologic factor of maxillofacial fractures outnumbering those due to road traffic accidents.[2] Concomitant injuries are frequent calling for a multidisciplinary approach. For example, a substantial number of patients may have intracranial bleeding and require an interdisciplinary management in the trauma room.[3] An overall decreasing severity of facial injuries, an increasing use of sophisticated imaging, and evolution in surgical techniques continue to popularize less invasive or more conservative options that may optimize patient outcomes.[4] [5] These aspects were an important motivation for collating the articles you have in front of you. As this issue is framed by a recent publication on orbital and nasal trauma, we have invited authors to expand our knowledge beyond facial plastic surgery proper and have included articles on psychological aspects of facial trauma, airway management, and the treatment of concomitant craniocerebral injuries. We thank all authors and especially those who are not facial plastic surgeons for their contributions and for further expanding our knowledge. We hope you will appreciate this issue of the journal as much as we did composing it.

• References

• 1 Cornelius CP, Kunz C, Neff A, Kellman RM, Prein J, Audigé L. The comprehensive AOCMF classification system: fracture case collection, diagnostic imaging work up, AOCOIAC iconography and coding. Craniomaxillofac Trauma Reconstr 2014; 7 (Suppl. 01) S131-S135
• 2 Boffano P, Roccia F, Zavattero E , et al. European Maxillofacial Trauma (EURMAT) project: a multicentre and prospective study. J Craniomaxillofac Surg 2015; 43 (1) 62-70
• 3 Scheyerer MJ, Döring R, Fuchs N , et al. Maxillofacial injuries in severely injured patients. J Trauma Manag Outcomes 2015; 9: 4
• 4 Pawar SS, Rhee JS. Frontal sinus and naso-orbital-ethmoid fractures. JAMA Facial Plast Surg 2014; 16 (4) 284-289
• 5 VandeGriend ZP, Hashemi A, Shkoukani M. Changing trends in adult facial trauma epidemiology. J Craniofac Surg 2015; 26 (1) 108-112