Facial plast Surg 2015; 31(04): 357-367
DOI: 10.1055/s-0035-1563693
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Maxillofacial Fractures: Midface and Internal Orbit—Part II: Principles and Surgical Treatment

Gerson Mast1, Michael Ehrenfeld1, Carl-Peter Cornelius1, Abel-Jan Tasman2, Ralph Litschel2
  • 1Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany
  • 2Department of Otorhinolaryngology-Head and Neck Surgery, Cantonal Hospital, St. Gallen, Switzerland
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Publication History

Publication Date:
15 September 2015 (online)


Current clinical assessment and imaging techniques were described in part 1, and this article presents a systematic review of the surgical treatment principles in the management of midface and internal orbit fractures from initial care to definitive treatment, including illustrative case examples. New developments enabled limited surgical approaches by standardization of osteosynthesis principles regarding three-dimensional buttress reconstruction, by newly developed individualized implants such as titanium meshes and, especially for complex fracture patterns, by critical assessment of anatomical reconstruction through intraoperative endoscopy, as well as intra- and postoperative imaging. Resorbable soft tissue anchors can be used both for ligament and soft tissue resuspension to reduce ptosis effects in the cheeks and nasolabial area and to achieve facial aesthetics similar to those prior to the injury.