title: Cephalic traumas with lacrimal apparatus involvement. Our experience.
abstract: OBJECTIVE
  The involvement of the lacrimal ducts in the extreme cephalic trauma is an infrequent condition. A correct diagnosis and appropriate management of injuries of the lacrimal system are essential to prevent the onset of post-traumatic epiphora.
  
  
  METHODS
  In the last 5 years, 37 patients were treated for lacrimal apparatus injury as a result of cephalic trauma: in 16 there was an isolated lacrimal injury and in 21 were documented fractures combined with lacrimal damage.
  
  
  RESULTS
  In 16 patients who had only deep lesions, was performed a reconstruction after location lesion localization, and only in 4 cases, because of the gravity of the lesion, it was decided to perform a reconstruction in a second time. In the remaining 21 patients the facial fractures were treated before lacrimal injuries, whose reconstruction was carried out on a second time.
  
  
  CONCLUSIONS
  The reconstruction of the cephalic district has to be based on the restoration of morpho-functional component and on the identification and treatment of lacrimal injuries. The reduction of fractures in our view should start from the lateral area (centripetal reconstruction) allowing to have a guide for alignment of the fracture lines. The objectives to be achieved in a facial trauma are therefore three: the maintenance of vital functions, the recovery of the function and the restoration of morphological and functional prior to the event.
authors.affiliation: Division of Plastic, Reconstructive and Aesthetic surgery, University of Perugia, Italy. stefanochiumamariello@gmail.com
authors.forename: Stefano
authors.initials: S
authors.lastname: Chiummariello
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Del Torto
authors.forename: Marcello
authors.initials: M
authors.lastname: Desgro
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pica
authors.forename: Carmine
authors.initials: C
authors.lastname: Alfano
mesh_terms: D000328:Adult; D005151:Facial Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000293:injuries*; D008297:Male