![]() ![]() Certain concomitant injuries might require attention because they may delay early treatment of pan facial fractures. And the treatment or surgery is individualized for each patient. The pan facial fractures usually present many remarkable challenges for both experienced and inexperienced surgeons because every segment of bone has a precise function in the repair. Gross loss of teeth may affect the ability to relate the maxilla to the mandible. The presence of any dentoalveolar injury must also be analysed before surgery. Surgeons must also note the amount of soft tissue loss (including the skin, mucosa and nerve tissue), and the bone loss. The structures that are involved in the fracture site and are directly or indirectly injured must be identified and noted for individual treatment to prevent complications. Information regarding the location and extent of all fractures must be obtained by surgeons prior to treatment. Surgeons must take care to follow certain careful procedures before the surgery to effectively treat pan facial fractures. Preoperative (before surgery) analysis for pan facial factures But with rigid fixation method, midface reconstruction might precede fixation of the mandible to ensure proper maxillary positioning. The ‘inside-out, bottom-to-top’ approach has been widely accepted as the guiding principle for managing pan facial trauma. Pan facial injuries and fractures are now managed with the plate and screw fixation technique that has revolutionised the sequence. With growing advances, treating pan facial fractures has undergone many changes. Plain radiographs provided limited information about bone involvement. The extent of injuries caused by the trauma was analysed with surgical exploration. Pan facial trauma treatment before technological advancements, was done differently. The general principles for treating maxillofacial trauma can be used here. The surgeon performing the surgery must adhere to the treatment protocol and treat each fracture as a unit to obtain best results. Pan facial fractures are complex to treat because of lack of reliable landmarks. The treatment of pan facial fractures can appear a bit complex because it involves a host of other smaller procedure that are used in maxillofacial injuries. Pan facial injuries and treatment might also need extra care about soft tissue injuries associated with pan facial fractures and other intracranial, cervical or vascular injuries. If the pan facial fractures are severe, it can lead to complex facial deformities, decreased facial movements and malocclusion. Since almost the whole of the face is involved, pan facial fractures might also involve many skeletal structures like the mandible, maxilla, zygomatic complex, frontal bone and the NOE complex. These affect the upper, middle and lower thirds of the face. When there are many simultaneous facial fractures, this is called pan facial fractures. The Le Fort III Osteotomy is typically used in the treatment of mid-face problems and deficiencies.Pan facial trauma – is the trauma that covers a lot of facial area. The Le Fort III Osteotomy is designed the move the entire face forward - including portions of the eye sockets - for the purpose of achieving a more harmonious and symmetrical appearance in those in whom facial disharmony results from pan-facial hypoplasia. This osteotomy allows for lengthening of the nose along with movement of the upper jaw in select cases where this effect is required. One of the rarer osteotomies because it isn’t required as often (only in 2-5% of cases such as Treacher Collins or other very unique cases). The Le Fort II Osteotomy involves the movement of the nose and upper jaw together. This second edition covers the advances in facial feminization as well as helpful patient stories and is a great resource for FFS patients and their loved ones. ![]() Deschamps-Braly’s new book “Facial Feminization Surgery: The Journey to Gender Affirmation” is back and available now. Chin Contouring (Genioplasty/Mentoplasty).Forehead Reshaping (Contouring & Reduction).Ethno-Specific Facial Feminization Surgery.Adam’s Apple Reduction (Tracheal Shave).Cheek Enhancement (Augmentation & Reduction). ![]()
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