Update on the management of craniomaxillofacial trauma in low-resource settings. Issue 4 (August 2019)

• Record Type: Journal Article
• Authors: Shah, Irfan; Gadkaree, Shekhar K.; Tollefson, Travis T.; Shaye, David A.
• Is Part Of: Current opinion in otolaryngology & head and neck surgery. Volume 27:Issue 4(2019:Aug.)
• Publication Date: 2019-08
• Subjects: craniomaxillofacial trauma -- facial fractures -- global health -- global surgery -- low and middle-income countries -- low-resource settings; Otolaryngology -- Periodicals; Neck -- Surgery -- Periodicals; Head -- Surgery -- Periodicals; 617.51
• DOI: 10.1097/MOO.0000000000000545
• Languages: English
• ISSNs: 1068-9508

Abstract

Abstract : Purpose of review: Craniomaxillofacial (CMF) trauma is a common cause of global morbidity and mortality. Although in high resource settings the management of CMF trauma has improved substantially over the past several decades with internal rigid fixation technology; these advancements have remained economically unviable and have not yet reached low and middle-income countries (LMICs) en masse. The purpose of this review is to discuss the current management of CMF injuries in low-resource settings. Recent findings: Trauma injuries remain a global epidemic with head and neck injuries among the most common. CMF trauma injuries largely occur in LMICs, with motor vehicle trauma being a common cause. Patients present in a delayed fashion which increases complications. Diagnostic methods are often limited to plain radiographs as computed tomography is not always available. In low-resource settings, CMF trauma continues to be treated primarily by closed reduction, maxillomandibular fixation, and transosseous wiring, yielding acceptable results through affordable methods. With the advent of less expensive plating systems, internal fixation with plates and screws are gradually finding their place in the management of facial trauma in low-resource settings. A shortage of CMF surgeons in LMICs is a recognized problem and is being addressed by targeted curricula. Summary: CMF trauma is a major cause of morbidity and mortality globally that remains poorly addressed. Currently, conventional methods of treating CMF trauma in low-resource settings have evolved to meet resource constraints. The education of CMF surgeons remains a key leverage point in improving CMF trauma care globally.