Primary treatment of craniofacial injuries

This presentation offers analysis of findings and treatment of 15 patients who suffered cranio-facial injury. 4 of them sustained isolated fractures of the glabella and supra-orbital margin; the remainder suffered disruption of the facial and cranial skeleton. In all cases, the possibility of dural tear with C. S. F. leak, should be considered. The advantages of primary treatment of cranio-facial injuries by a joint neuro- and maxillo-facial team are as follows:--The risk of meningitis is greatly reduced.--The precise diagnosis of injury and maximum conservation of tissue is possible.--Most of the dissection necessary for repair is carried out by the force of impact and no fibrous tissue is present to hinder reconstruction.--Finally, primary surgery gives the best possible cosmetic results. Secondary skeletal surgery, even on the scale proposed by Tessier, often falls short of the results possible with adequate primary treatment.