Nastri Alf L, Gurney Ben
Maxillofacial Surgery, Royal Melbourne Hospital, Melbourne, Australia.
Curr Opin Otolaryngol Head Neck Surg. 2016 Aug;24(4):368-75. doi: 10.1097/MOO.0000000000000267.
Management of midface trauma is complex and challenging and requires a clear understanding of the facial buttress system, subunit anatomy and inter-relationships. Too often clinicians attempt surgical repair without adequate knowledge of the common complications associated with poor reduction and improper sequencing of fracture repair. This review outlines a working approach to the identification and management of such injuries, and the definitive management of common injury patterns.
Midface trauma, with or without life-threatening and sight-threatening complications, may arise following isolated injury, or be associated with significant injuries elsewhere. Assessment needs to be both systematic and repeated, with the establishment of clearly stated priorities in overall care.
Accurate and precise relocation of bony subunits and resuspension of soft tissues is vital in achieving acceptable functional and aesthetic outcomes.
面中部创伤的管理复杂且具有挑战性，需要对面部支撑系统、亚单位解剖结构及相互关系有清晰的认识。临床医生常常在对骨折复位不佳和修复顺序不当相关的常见并发症缺乏足够了解的情况下就尝试进行手术修复。本综述概述了识别和处理此类损伤的实用方法以及常见损伤模式的确定性处理。
面中部创伤无论有无危及生命和视力的并发症，都可能单独发生，也可能与其他部位的严重损伤相关。评估需要系统且反复进行，并在整体护理中明确设定优先事项。
准确精确地复位骨亚单位并重新悬吊软组织对于实现可接受的功能和美学效果至关重要。
