Craniofacial Trauma and Reconstruction

Abstract

The concept of treatment of craniofacial injury has evolved from conservative, delayed, multiple-staged surgery into early, aggressive, and one-stage operation. Adequate exposure, accurate anatomic reduction, rigid fixation, primary bone grafting, and soft tissue suspension remain the gold standard to obtain expected results. A variable plating system applied to specific anatomic areas of the facial skeleton produces three-dimensional (3D) reconstructions, enhances bone healing, and decreases infection. Minimal invasive surgery replaces part of conventional wide incision and achieves competitive results. Microvascular free tissue transplantation makes reconstruction of devastating injury on the face possible, with a more pleasing outcome. Alloplastic implants become more popular especially for orbital reconstruction and produce equivalent results compared with conventional bone grafts. Contemporary computed tomography (CT) scans gradually replace conventional plain films to provide more accurate diagnosis and can be used as a preoperative simulation tool. With the advancement of diagnostic imaging, surgical approaches, and instruments, optimal functional outcome and aesthetic facial appearance can be achieved.