Brignol L, Ricbourg L, Meyer C, Ricbourg B
Service de Chirurgie Maxillo-faciale, Plastique de la face et Stomatologie, Hôpital Jean Minjoz, Besançon, France.
Rev Stomatol Chir Maxillofac. 2006 Sep;107(4):233-43. doi: 10.1016/s0035-1768(06)77045-0.
Most victims of complex facial trauma will have permanent sequelae. The goal of our work was to evaluate, by means of a retrospective study, the long-term sequelae in these patients.
102 victims of complex facial trauma were treated in our department between 1995 and 2000. Twenty-four could be re-examined in 2006 in order to evaluate their long-term sequelae. All the patients suffered a mild brain injury.
The overall satisfaction rate was good (19/24), but all patients presented either functional or aesthetic sequelae. The major functional sequelae were dental lost (17/24), sensory impairment of the trigeminal nerve (15/24), partial or complete loss of vision (10/24), pain (10/24), hypo- or anosmia (9/24), stenosis of the lacrimal ducts (8/24) and symptomatic deviation of the nasal septum (7/24). The main esthetic sequelae were facial scarring (23/24), facial asymmetry (13/24), dystopia of the eyeball (11/24) and modification of the aspect of the nose (10/24).
The prognosis of severe facial trauma is highly dependent on the quality of the initial pluridisciplinary care. Secondary revision procedures are technically more difficult and only enable partial resolution of persisting sequelae. Thus, primary single-course surgical procedures should be a priority, recognizing that complete recovery is almost always illusory.
大多数复杂面部创伤的受害者会有永久性后遗症。我们这项工作的目的是通过一项回顾性研究来评估这些患者的长期后遗症。
1995年至2000年间，我们科室治疗了102例复杂面部创伤的受害者。2006年对其中24例进行了复查，以评估他们的长期后遗症。所有患者都有轻度脑损伤。
总体满意率良好（24例中的19例），但所有患者都存在功能或美学方面的后遗症。主要的功能后遗症有牙齿缺失（24例中的17例）、三叉神经感觉障碍（24例中的15例）、部分或完全失明（24例中的10例）、疼痛（24例中的10例）、嗅觉减退或丧失（24例中的9例）、泪道狭窄（24例中的8例）和鼻中隔症状性偏曲（24例中的7例）。主要的美学后遗症有面部瘢痕形成（24例中的23例）、面部不对称（24例中的13例）、眼球异位（24例中的11例）和鼻外观改变（24例中的10例）。
严重面部创伤的预后高度依赖于初始多学科治疗的质量。二次修复手术在技术上更困难，只能部分解决持续存在的后遗症。因此，应优先考虑一期单阶段手术，要认识到完全康复几乎总是不切实际的。
