Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Home
  • Home
Chapter
  • Print publication year: 2020
  • Online publication date: April 2020

Chapter 18 - Craniofacial Trauma

Export citation

Summary

The complexity of management of the patient with a severe craniofacial injury demands multidisciplinary care to deal with neurosurgical, maxillofacial, otolaryngological and ophthalmic problems. These teams should be available in all Major Trauma Centres. A dedicated craniofacial service with multiprofessional teamworking ensures that the long-term issues of neurorehabilitation, psychiatric support and support of the family are met as well as the early challenges of airway threat, resuscitation, head injury and fracture management. Inadequate investigation, planning and management results in missed or inadequately treated injuries; and the increased risk of late complications including poor functional and aesthetic results as well as the need for potentially sub-optimal rescue revision procedures.

Related content

Powered by UNSILO
1.American College of Surgeons. Advanced trauma life support manual. Chicago: American College of Surgeons Committee on Trauma; 2004.
2.Hernandez Altemir, F. The submental route for endotracheal intubation: a new technique. J Maxillofac Surg.1986;14(1):64–65.
3.Williams, J, Jehle, D, Cottington, E, Shufflebarger, C. Head, facial, and clavicular trauma as a predictor of cervical-spine injury. Ann Emerg Med 1992;21(6):719–22.
4.Hills, MW, Deane, SA. Head injury and facial injury: is there an increased risk of cervical spine injury? J Trauma 1993;34(4):549–53.
5.Vella, MA. Acute management of traumatic brain injury. Surg Clin N Am 2017;95(5):1015–30.
6.Spaite, DW, Hu, C, Bobrow, BJ, et al. Mortality and prehospital blood pressure in patients with major traumatic brain injury: implications for the hypotension threshold. JAMA Surg 2017;152(4):360–8.
7.Komiyama, M, Nishikawa, M, Kan, M, Shigemoto, T, Kaji, A. Endovascular treatment of intractable oronasal bleeding associated with severe craniofacial injury. J Trauma 1998;44(2):330–4.
8.Le Fort, RL. Etude expérimentale sur les fractures de la mâchoire supérieure. Rev Chir Paris 1901;23:208–27.
9.Wassmund, M. Frakturen und Luxationen des Gesichtsschädels. Meusser; 1927.
10.Manson, PN. Maxillofacial injuries. Emerg Med Clin North Am 1984;2(4):168–78.
11.Manson, PN, Clarke, N, Robertson, B, et al. Subunit principles in midface fractures: the importance of sagittal buttresses, soft tissue reductions and sequencing treatment of segmental fractures. Plastic Reconstruc Surg 1999;103(4):1287–307.
12.Martin, RC, Spain, DA, Richardson, JD. Do facial fractures protect the brain or are they a marker for severe head injury? Am Surg 2002;68(5):477–81.
13.al-Qurainy, IA, Stassen, LF, Dutton, GN, Moos, KF, el-Attar, A. The characteristics of midfacial fractures and the association with ocular injury: a prospective study. Br J Oral Maxillofac Surg 1991;29(5):291–301.
14.al-Qurainy, IA, Titterington, DM, Dutton, GN, Stassen, LF, Moos, KF, el-Attar, A. Midfacial fractures and the eye: the development of a system for detecting patients at risk of eye injury. Br J Oral Maxillofac Surg 1991;29(6):363–7.
15.Lee, HJ, Jilani, M, Frohman, L, Baker, S. CT of orbital trauma. Emerg Radiol 2004;10(4):168–72.
16.McMahon, JD, Koppel, DA, Devlin, M, Moos, KF. Maxillary and panfacial fractures. In: Wardbooth, P, Epply, BL, Schmelzeizen, R, eds. Maxillofacial trauma and esthetic reconstruction. Churchill Livingstone; 2003.
17.Wallis, A, Donald, PJ. Frontal sinus fractures: a review of 72 cases. Laryngoscope 1988;98:593–8.
18.Gruss, JS, Pollock, RA, Phillips, JH, Antonyshyn, O. Combined injuries to the cranium and face. Br J Plastic Surg 1999;42:385–98.
19.Wilson, BC, Davidson, B, Corey, JP, Haydon, RC 3rd. Comparison of complications following frontal sinus fractures managed with or without obliteration over ten years. Laryngoscope 1998;98(5):516–20.
20.Bell, RB, Dierks, EJ, Brar, P, Potter, JK, Potter, BE. A protocol for the management of frontal sinus fractures emphasising sinus preservation. J Oral Maxillofac Surg 2007;65(5):825–39.
21.Friedman, JA, Ebersold, MJ, Quast, LM. Post traumatic cerebrospinal fluid leakage. World J Surg 2001;25(8):1062–6.
22.Eljamel, MS, Foy, PM. Acute traumatic CSF fistulae: the risk of intracranial infection. Br J Neurosurg 1990;4(6):479–83.
23.Donald, PJ, Bernstein, L. Compound frontal sinus injuries with intracranial penetration. Laryngoscope 1978;88:225–32.
24.Warnecke, A, Averbeck, T, Wurster, U, et al. Diagnostic relevance of beta2-transferrin for the detection of cerebrospinal fluid fistulas. Arch Otolaryngol Head Neck Surg 2004;130:1178–84.
25.Phang, SY, Whitehouse, KJ, Lee, L, Khalil, H, McArdle, P, Whitfield, PC. Management of CSF leak in base of skull fractures in adults. Br J Neurosurg 2016;30(6):596–604.
26.Mincy, JE. Posttraumatic cerebrospinal fluid fistula of the frontal fossa. J Trauma 1966;6:618–22.
27.Ratilal, BO, Costa, J, Sampaio, C, Pappamikail, L. Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures. Cochrane Database Syst Rev 2011;8:CD004884.
28.Scholsem, M, Scholtes, F, Collignon, F, et al. Surgical management of anterior cranial base fractures with cerebrospinal fluid fistulae: a single institution experience. Neurosurgery 2008;62:463–9.