Results of treatment of midfacial fractures. Indications for exploration and drainage of the maxillary sinuses.

The results of late follow-up of 45 patients with midfacial fractures are reported. The intervals between accident and follow-up ranged from 6 months to 6 years. Methods of treatment are discussed, with emphasis on frontomaxillary or zygomaticomaxillary wire suspension and external fixation. The late results and complications in this series are compared with those previously described in the literature. Since opinions differ as to the basic necessity for surgical exploration and drainage of the sinuses following midfacial fracture, the influence of the latter procedure was investigated statistically. In the group of Le Fort II and III fractures the results following revision were compared with those in sinuses which were not revised: the radiographs (chi2 0.415) and sensory testing (chi2 1.668) showed no significant differences. This supports our opinion that surgical exploration and drainage of the sinuses should continue to be limited to cases which fulfill the strict criteria described in this paper.