Principles of surgical treatment in the midface trauma - theory and practice.

INTRODUCTION Facial trauma is a common injury in the urban setting. Many studies have been published on the epidemiology and treatment of facial fractures, but few of them conducted in emergencies hospital as ours. The purpose of this study was to present theory and practice in surgical treatment of midface trauma. MATERIALS AND METHOD We will present a retrospective study and a cases series report with our personal experience in diagnosis and treatment of middle floor facial trauma. Craniofacial trauma in context of polytrauma involves a screening condition assessment of the patient to prioritize lesions and frequently require a multidisciplinary approach: neurosurgeon, ENT surgeon, maxillo-facial surgeon, ophthalmologist, plastic surgeon and so on. Axial and coronal CT are mandatory and three-dimensional CT reconstruction can be extremely useful. Surgical indication in middle floor facial trauma is given by functional and aesthetic deficits. RESULTS We will present the surgical principles we use in treatment of fractured nose, in fractures of maxilla, in fractures of the zygomatic arch with or without zygoma body fractures and fractures of the floor of orbit. DISCUSSIONS The surgical technique was imposed by coexisting lesions of neuro and viscerocranium, by the complexity of the fracture, by functional or aesthetic deficits and by our surgical experience. CONCLUSIONS The main principles in middle face trauma are an accurate and complete lesions evaluation; mixed surgery team with maxillofacial surgeon and neurosurgeon.