A scarless approach to mitigate external wound complications in Nasomaxillary fracture patients: Case report
Abstract
Nasomaxillary fractures, which involve the nasal bone, maxillary frontal process, and anterior maxilla, present both cosmetic and functional difficulties due to their central anatomical location and vulnerability to injury. Conventional method, subciliary incisions, may lead to negative outcomes including scarring, changes in pigmentation, and ectropion. To mitigate these issues, we utilize closed endonasal reduction with fixation of the nasal bone to the maxilla employing a straight instrument through the gingivobuccal approach, ensuring proper anatomical alignment while safeguarding the infraorbital nerve, thus enhancing results for patients who have risk factors like poor wound healing or Fitzpatrick skin type V. Postoperative evaluations revealed a successful restoration of nasal shape, airflow, and patient satisfaction without any visible external scarring. This method underscores the importance of customized surgical planning, particularly for patients with a higher risk of scarring, and demonstrates the effectiveness of the straight instrument gingivobuccal approach as an alternative to traditional technique.
References
Burke E., Sherard A. (2020). Nasal fractures. In Flint, P. W., Haughey, B. H., Lund, V. J., Robbins, K. T., Thomas, J. R., Lesperance, M. M., & Francis, H. W.(Ed.), Cummings Otolaryngology: Head and Neck Surgery, 3-Volume Set (6thed., pp. 457-469). Elsevier Health Sciences.
Alvi, A., Doherty, T., & Lewén, G. (2003). Facial fractures and concomitant injuries in trauma patients. The Laryngoscope, 113(1), 102–106.
Shepherd, J., Shapland, M., Pearce, N., & Scully, C. (1990). Pattern, severity and aetiology of injuries in victims of assault. Journal of the Royal Society of Medicine, 83(2), 75–78.
Kim, S. H., Lee, S. H., & Cho, P. D. (2012). Analysis of 809 facial bone fractures in a pediatric and adolescent population. Archives of Plastic Surgery, 39(06), 606–611.
Jin, K., Lee, H., Sohn, J., Han, Y., Jung, D., Sim, H., & Kim, H. (2018). Fracture patterns and causes in the craniofacial region: an 8-year review of 2076 patients. Maxillofacial Plastic and Reconstructive Surgery, 40(1).
Adnot, J., Desbarats, C., Joly, L., & Trost, O. (2019). Nasomaxillary fracture: Retrospective review of 11 consecutive patients and literature review. Journal of Stomatology, Oral and Maxillofacial Surgery, 120(6), 534–539.
Shariati, S. M. M. A., Dahmardehei, M., & Ravari, H. (2014). Subciliary Approach for inferior orbital rim fractures; case series and literature review. DOAJ (DOAJ: Directory of Open Access Journals), 2(3), 121–124.
Kelahmetoğlu, O., Kuzu, İ. M., Ünal, M., Yağmur, Ç., Yıldız, K., & Güneren, E. (2016). The comparison of complication rates of subtype subciliary approaches: The review of literature. Journal of Experimental & Clinical Medicine, 33(4).
Trost, O., & Péron, J. (2014). Regarding unilateral nasomaxillary buttress fractures. Journal of Plastic, Reconstructive & Aesthetic Surgery, 67(11), e278–e279.
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