Thaller S R, Kawamoto H K
Department of Surgery, University of California Davis, Sacramento.
Plast Reconstr Surg. 1992 Oct;90(4):562-7. doi: 10.1097/00006534-199210000-00003.
The purpose of this survey was to evaluate the current trends in the care of facial trauma. Data were obtained through the responses of a survey mailed to all those members and candidates listed in the 1989 American Society of Plastic and Reconstructive Surgeons Directory. A total of 2777 questionnaires were sent, with 1113 (40 percent) returned by means of a self-addressed envelope. Demographic results show that over 70 percent of the treating plastic surgeons fall within the age range 30 to 50 years. Although significant advances have occurred, treatment goals have remained unchanged. These center around the principles of accurate reduction and precise stabilization of fracture segments. The results of this survey reveal that a number of acceptable techniques were employed in the surgical repair of mandibular and zygomatic complex fractures. In the care of Le Fort III fractures, 59 percent of the respondents preferred the use of miniplates and screws for stabilization. Only 26.8 percent believed that facial fracture repair should be performed within the initial 24 hours. With frontal sinus fractures, the vast majority of plastic surgeons (82.1 percent) obtained a neurosurgical consultation. When the posterior wall was involved, 45.6 percent favored removal of the sinus mucosa, 29.7 percent obliterated the frontal sinus with a variety of autogenous materials, while 20.5 percent preferred cranialization. In summary, this survey shows a wide variation in the practice of facial fracture management within the plastic surgical community.
本次调查的目的是评估面部创伤治疗的当前趋势。数据通过邮寄给1989年美国整形与重建外科医师协会名录中所有会员和候选人的调查问卷回复获得。共发放了2777份问卷，其中1113份（40%）通过回邮信封寄回。人口统计学结果显示，超过70%的主治整形外科医生年龄在30至50岁之间。尽管已取得显著进展，但治疗目标仍未改变。这些目标围绕骨折段精确复位和精准固定的原则。本次调查结果显示，在下颌骨和颧骨复合体骨折的手术修复中采用了多种可接受的技术。在治疗Le Fort III型骨折时，59%的受访者倾向使用微型钢板和螺钉进行固定。只有26.8%的人认为面部骨折修复应在最初24小时内进行。对于额窦骨折，绝大多数整形外科医生（82.1%）会寻求神经外科会诊。当后壁受累时，45.6%的人倾向切除鼻窦黏膜，29.7%的人用各种自体材料闭塞额窦，而20.5%的人倾向采用颅骨化。总之，本次调查显示整形外科界在面部骨折治疗实践中存在很大差异。
