The TN Chawla Lecture - The current management of midfacial trauma

The management of mid-facial trauma has changed very little in the last decade with minor modifications related to orbital trauma and minimal access approaches particularly related to secondary reconstruction. In the UK the introduction of major trauma centres has tended to concentrate the management of polytrauma patients to individual regional sites. From a maxillofacial perspective this increases craniofacial cases treated in these units. It also requires a collaborative team approach and a thorough understanding of ATLS principles. Imaging has progressed to include rapid CT scans, individualised CBCT scans and the use of rapid prototyping models to aid in both visualisation, planning and construction of customised implants. Finally the industry has managed to develop smaller implants with equal strength to facilitate low profile fixation which is less likely to be prominent in the midface. These also facilitate the use of endoscopic assisted procedures, which tend to be used in secondary reconstruction of the upper 1/3 and osteotomy surgery.