Endoscopic Facial Fracture Surgery
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Endoscopic Facial Fracture Surgery
The bones of the skull and face form one of the most complex skeletal regions in the body. Proper analysis of facial fractures requires a deep understanding of both normal anatomy and common fracture patterns.
Facial fractures refer to broken bones anywhere on the face, including the nose, cheekbones, areas around the eyes, and the upper and lower jaw.
Most facial fractures occur due to trauma such as motor vehicle accidents, sports injuries, falls, or physical assaults.
Types of Facial Fractures
Nasal Bone Fractures (Broken Nose):
These are the most common type of facial fractures. The nasal bones are fragile and easily injured during trauma.Frontal Bone (Forehead) Fractures:
The frontal bone forms the forehead area. High-impact head injuries can fracture this bone and the floor of the sinuses.Zygomaticomaxillary Fractures (Broken Cheekbone / Upper Jaw):
These involve the cheekbones and surrounding structures, often caused by direct facial trauma.Orbital Rim Fracture:
The outer rim of the eye socket is the thickest part, and breaking it requires significant force.Blowout Fractures:
In these cases, the orbital rim remains intact, but a crack forms in the thin bone at the lower part of the eye socket.Direct Orbital Floor Fracture:
A rim fracture that extends into the lower portion of the eye socket, often resulting in eye movement problems.Mid-face (Le Fort) Fractures:
Caused by blunt force trauma, these fractures occur along three major lines of weakness in the mid-face — Le Fort I, II, and III.Mandible (Lower Jaw) Fractures:
The most common lower facial fracture, involving breaks in the jawbone, often from falls, fights, or accidents.
Treatment of Facial Fractures
The treatment approach depends on the location and severity of the injury. The main goal is to restore the normal appearance and function of the affected facial structures.
In severe cases, life-threatening conditions such as airway blockage, cardiovascular issues, or brain and nervous system injuries are addressed immediately before facial repair.
1. Closed Reduction
This approach does not require incisions.
The surgeon manipulates the fractured segments externally to reposition them correctly.
Movement restriction techniques are used to maintain the alignment.
In facial fractures, Intermaxillary Fixation (IMF) — wiring the upper and lower jaws together — is often applied to keep the bones stable during healing.
2. Open Reduction
This method involves making incisions in the mouth or facial skin to directly access the fracture site.
The fractured bone segments are repositioned accurately, guided by dental occlusion (teeth alignment) or anatomical landmarks.
The bones are then stabilized using miniplates and screws, ensuring proper healing and restoration of facial contour.
