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Official Journal of the Italian Society of Maxillofacial Surgery
Frequency: 3 issues
Online ISSN 1827-1901
Faccioli G. 1, Fraccari E. 1, Cristofori L. 2, Baldin C. 1
1 Maxillofacial Surgery Division General Hospital, Verona, Italy
2 Division of Emergency Neurosurgery and Neurological Intensive Care General Hospital, Verona, Italy
Craniofacial trauma has traditionally been treated through sequential surgery. The first step was neurosurgical and consisted of intracranial haematoma evacuation, repair of dural lacerations, reduction of dislocated fractures of the skull and if necessary soft tissue debridement in the maxillo-facial region. Facial fractures were usually treated after 10-14 days, while frontal contour defects were repaired after 6-12 months. The intent was to reduce the risk of nervous system infection and of long-term neurological damage due to prolonged anaesthesia. However, it is now considered preferable to treat complex craniofacial trauma with a combined neurosurgical and maxillo-facial approach, in order to obtain functional and aesthetic results in a single step. The advantage of decreasing the number of surgical operations is dual: it reduces biological cost and medical expenses. In our series of 16 patients there were no cases of infection or of neurological or cardiovascular damage due to general anaesthesia. On the basis of our surgical results, we believe that the combined neurosurgical and maxillo-facial approach can provide adequate and definitive surgical treatment for severe craniofacial trauma, both from the aesthetic and from the functional standpoint.