Chapter 8:
Post-Traumatic Facial Deformities


Craniomaxillofacial Trauma

Zygomatic Fractures

Maxillary Fractures

Nasoethmoid Orbital Fractures

Internal Orbital Fractures

Mandibular Fractures

Post-Traumatic Facial Deformities

Soft Tissue Deformities

Facial Bone Contouring

 

CHAPTERS 

Introduction

Clefts of the Lip and Palate

Ear Reconstruction

Craniosynostosis

Orbital Reconstruction

Treacher Collins Syndrome

Nasal Reconstruction

Orthognathic Surgery

Trauma Reconstruction

Hemifacial Microsomia

Summary

 

The best way to prevent post-traumatic facial deformities is to obtain the appropriate treatment at the time of the injury. Applying the latest craniofacial techniques can in many cases make major secondary revisions unnecessary. However, despite the many advances that have come from the field of craniofacial surgery, there are still patients that end up with significant deformities. These are patients that for whatever reason are treated inadequately or because of life-threatening other injuries, do not receive any treatment of their facial injuries.

Post-Traumatic Facial Deformities

This patient has longstanding post-traumatic right enophthalmos and ectropion.

Preoperative

Postoperative

Unrepaired or inadequately reduced facial fractures can result in a wide range of severe cosmetic and functional deformities. Unrepaired fractures around the orbits can cause a sunken-in appearance of the eyes, nasal deformities, as well as functional problems with vision (double vision). Unrepaired injuries of the middle and lower face can cause contour deformities, flattening of the cheeks, or malocclusion of the teeth with difficulty chewing. These are but a few of the many problems associated with post-traumatic facial deformities.

Post-traumatic facial deformity with displaced nasoethmoid complex.

Preoperative

Postoperative

Late repair or reconstruction after the soft tissue and bones have healed is much more difficult than repair at the time of initial injury. Reconstruction requires wide exposure which enables the surgeon to have direct visualization of the bony deformities. Bone cuts are then made to reposition the displaced bone and reattach the soft tissue back into its normal position. Missing or severely deformed bone may require replacement with bone grafts. These operative procedures all use the standard techniques of craniofacial surgery.

A seventeen year old patient with inadequately treated nasoethmoid orbital fractures.

Preoperative

Postoperative

Preoperative

Postoperative 

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The Tennessee Craniofacial Center, part of the Erlanger Health System, is located in Chattanooga, Tennessee. The Center, led Larry A. Sargent, M.D., specializes in the evaluation and treatment of patients of all ages with craniofacial deformities. Location: 975 East Third Street. Chattanooga, Tennessee 37403
Phone: 423-778-9192 or 800-418-3223 Fax: 423-778-8172
Internet: www.craniofacialcenter.com Copyright ©1997, 2000, Erlanger Health Systems