多发性面部骨折的手术困境——冠状皮瓣与微创手术：病例报告及文献综述
Surgical Dilemmas in Multiple Facial Fractures - Coronal Flap Versus Minimally Invasive: Case Report and Literature Review.
作者信息
Nseir Saleh, Abu Shqara Fadi, Krasovsky Andrei, Rachmiel Adi
机构信息
Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Institution of Technion, Haifa, Israel.
出版信息
Ann Maxillofac Surg. 2021 Jan-Jun;11(1):191-194. doi: 10.4103/ams.ams_452_20. Epub 2021 Jul 24.
THE RATIONALE
Pan-facial fracture is a complex trauma that involves the upper, middle, and lower third of the facial bones. The surgical management of such complex cases is either by the posterior approach (coronal flap) or anterior approach through local incisions.
PATIENT CONCERNS
This report describes the case of severe pan-facial trauma in a 52-year-old male who sustained a severe pan-facial trauma.
DIAGNOSIS
He suffered from multiple facial fractures that included: Frontal bone, skull base, Naso-orbitoethmoid (NOE), zygomatic and sub-condylar fractures.
TREATMENT
He was managed by minimally local periorbital and lynch incisions.
OUTCOMES
Fractures were properly reduced with resultant symmetrical facial dimensions. No postoperative complications were demonstrated including facial nerve function.
TAKE-AWAY LESSONS: We should consider minimally invasive local incisions in pan-facial fractures when there is no need to restore the frontal sinus and the anterior-posterior dimensions of the zygomatic arch.
理论依据
全面部骨折是一种涉及面骨上、中、下三部分的复杂创伤。此类复杂病例的手术治疗可采用后路（冠状皮瓣）或通过局部切口的前路。
患者情况
本报告描述了一名52岁男性严重全面部创伤的病例。
诊断
他患有多处面部骨折，包括：额骨、颅底、鼻眶筛（NOE）、颧骨和髁突下骨折。
治疗
通过最小限度的局部眶周和林奇切口进行治疗。
结果
骨折得到妥善复位，面部尺寸对称。未出现术后并发症，包括面神经功能。
经验教训
当无需恢复额窦和颧弓的前后尺寸时，对于全面部骨折应考虑采用微创局部切口。
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