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Modern management of maxillofacial trauma in the emergency departmentOA

中文摘要

BACKGROUND:Maxillofacial trauma represents a significant challenge in emergency medicine,requiring both diagnostic accuracy and prompt intervention while balancing immediate life-saving interventions with preservation of function and aesthetics.The complex anatomy of this region,with its proximity to critical structures,demands a thorough understanding of assessment and management principles.This narrative review aims to provide evidence-based guidelines for emergency physicians managing maxillofacial trauma,with particular emphasis on early recognition of critical injuries,airway management strategies,and special population considerations.METHODS:A narrative review was conducted via a comprehensive literature search of the PubMed and Scopus databases,which focused on maxillofacial trauma management in emergency settings.Articles were selected based on relevance to clinical practice,methodological quality,and current management guidelines.The review synthesized evidence from multiple study types,including original research,systematic reviews,and clinical practice guidelines,to provide practical guidance for emergency physicians.RESULTS:Initial assessment following Advanced Trauma Life Support(ATLS)principles is crucial,with airway management being a primary concern due to the risk of dynamic obstruction.Critical time-sensitive emergencies include orbital compartment syndrome,trapdoor fractures(in pediatric patients),and facial nerve injuries.Computed tomography(CT)imaging remains the gold standard for diagnosis.Special considerations are required for pediatric patients,who present unique anatomical challenges and injury patterns,and for elderly patients,who often have complex medical comorbidities and increased complication risks.Management strategies range from conservative treatment to urgent surgical intervention,with decisions based on the injury pattern and associated complications.CONCLUSION:Emergency physicians must maintain a structured yet fl exible approach to maxillofacial trauma,focusing on early recognition of critical injuries,appropriate airway management,and timely specialist consultation.Understanding injury patterns and their potential complications allows for eff ective risk stratifi cation and treatment planning,ultimately improving patient outcomes.

Gaia Bavestrello Piccini;Domenico Sfondrini;Silviu-Andrei Tomulescu;Ciro Esposito;Andrea Piccioni;Giorgia Caputo;Antonio Voza;Christian Zanza;Yaroslava Longhitano;Gabriele Savioli

PhD Program in Clinical and Experimental Medicine and Medical Humanities,University of Insubria,Varese 21100,ItalyDepartment of Emergency,Division of Maxillofacial Surgery,Fondazione IRCCS Policlinico San Matteo,Pavia 27100,ItalyDepartment of Internal Medicine,Groupement Hospitalier de l''Ouest Lémanique,Nyon 1260,SwitzerlandUnit of Nephrology and Dialysis,ICS Maugeri,University of Pavia,Pavia 27100,ItalyEmergency,Anesthesiological and Reanimation Sciences Department,Fondazione Policlinico Universitario A.Gemelli-IRCCS of Rome,00168 Rome,ItalyDepartment of Anesthesia and Intensive Care,University San Luigi Gonzaga Teaching Hospital,University of Turin,Turin 10043,ItalyDepartment of Emergency Medicine,IRCCS Humanitas Research Hospital,Rozzano 20089,Italy Department of Biomedical Sciences,Humanitas University,Pieve Emanuele,Pieve Emanuele 20072,ItalyDepartment of Systems Medicine-Geriatric Medicine Residency Program,University of Rome"Tor Vergata",Rome 00133,ItalyDepartment of Anesthesiology and Perioperative Medicine(UPMC),University of Pittsburgh,Pittsburgh 15216,USADepartment of Emergency Medicine,Fondazione IRCCS Policlinico San Matteo,Pavia 27100,Italy

医药卫生

Maxillofacial traumaOrbital fracturesLeFort fracturesFacial fractures

《World Journal of Emergency Medicine》 2026 (1)

P.15-27,13

10.5847/wjem.j.1920-8642.2026.003

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