Full-face craniomaxillofacial procedures entail two or more facial thirds being the object of surgical intervention and virtual planning. Traumatology offers one of the most suitable settings to study the relevance of a comprehensive facial planning, as panfacial trauma can present with a multitude of combinations of fractures distributed across every facial subunit. On the other hand, full-face procedures are rarer in oncologic ablative surgery and limited to the most advanced disease scenarios, which are decreasing owing to the improvement of prevention strategies and neoadjuvant therapies. However, certain severe malformations of the craniofacial skeleton might still benefit from highly extended surgical procedures. In such cases, reconstruction using a combination of free flap must account for an optimal functional and esthetic outcome, and VSP must be conducted accordingly. Last, a highly specialized surgical field applying dynamic facial reanimation techniques might in the future benefit of VSP to define the full facial path of crossface grafts, as well as their length and orientation. This chapter provides a comprehensive overview of panfacial fractures, detailing the correct sequencing of reduction maneuvers both in VSP and surgery, double osseous flap for maxillary and mandibular reconstruction, and facial reanimation procedures.

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Full-Face Cranio-maxillo-facial Surgery Procedures

  • Alessandro Tel,
  • Federico Bolognesi,
  • Federico Biglioli,
  • Silvano Ferrari,
  • Massimo Robiony

摘要

Full-face craniomaxillofacial procedures entail two or more facial thirds being the object of surgical intervention and virtual planning. Traumatology offers one of the most suitable settings to study the relevance of a comprehensive facial planning, as panfacial trauma can present with a multitude of combinations of fractures distributed across every facial subunit. On the other hand, full-face procedures are rarer in oncologic ablative surgery and limited to the most advanced disease scenarios, which are decreasing owing to the improvement of prevention strategies and neoadjuvant therapies. However, certain severe malformations of the craniofacial skeleton might still benefit from highly extended surgical procedures. In such cases, reconstruction using a combination of free flap must account for an optimal functional and esthetic outcome, and VSP must be conducted accordingly. Last, a highly specialized surgical field applying dynamic facial reanimation techniques might in the future benefit of VSP to define the full facial path of crossface grafts, as well as their length and orientation. This chapter provides a comprehensive overview of panfacial fractures, detailing the correct sequencing of reduction maneuvers both in VSP and surgery, double osseous flap for maxillary and mandibular reconstruction, and facial reanimation procedures.