Modern Management of Maxillofacial Injuries

Maxillofacial involvement in patients with multiple trauma injuries is usually frequent and noticeable, but it is mainly dangerous for ATLS priorities, meaning that it can compromise airway protection (A) and circulation (C) and it can often be associated with brain and cervical spine injuries. Facial hemorrhages are rarely one of the main causes of hemodynamic instability, but their early detection and prompt local control must be supported by each emergency surgeon. In very few, selected and complex cases, when local measures fail, endovascular treatment is today the best option available to achieve definitive control of refractory bleeding. Once the lifesaving priorities are successfully managed, clinicians have to preserve patients’ eyesight as well as limbs; timely clinical diagnosis and appropriate treatment work-up are essential to preserve visual function. On the other hand, we have a few, easy, damage control surgical procedures to save time, thus managing visual-threatening injuries, for instance, anterior orbitotomy is more effective, having a better aesthetic outcome. Being more confident with facial trauma emergency issues allows clinicians to be better able to deal with the comprehensive care of acutely injured patients.