Preoperative management of maxillofacial war injuries

Abstract EN

The complex anatomical structures of the Cervico-Facial area, makes the knowledge of the anatomical extent of the tissue damaged by war injury, and the location of the foreign body or shell, quite difficult.

The terms perforating, penetrating and avulsive wounds used in war injuries are merely superficial description ; they hide the nature and the actual amount of the tissue damage.

The critical nature of some of these wounds and their fatal consequences such as those who had sever bleeding and or sever airway obstruction mandates a quick diagnosis of the injured tissue and a quickly intubated and anesthetized patients.

It usually takes time and effort of imagination by the surgeon to follow the path of travel of the shell or bullet in different anatomical structures of the cervico-facial area in order to anticipate the amount and extent of the damaged tissues.

A simple division of the cervico-facial area into anatomical quadrants by two coronal planes, two transverse planes and two sagittal planes, helps the surgeon to remember and define the injured anatomical area, have a better localization of the foreign body and if these planes are used routinely and in a systematic way, the cervical vertebrae might be defined for any injury, and lastly these anatomical quadrants can be used by the maxillo-facial surgeon to communicate more easily with other specialists whose cooperation is of utmost important for the management of such injuries.