title: Maxillofacial Fractures: Midface and Internal Orbit-Part II: Principles and Surgical Treatment.
abstract: 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.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Gerson
authors.initials: G
authors.lastname: Mast
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Ehrenfeld
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Carl-Peter
authors.initials: CP
authors.lastname: Cornelius
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Cantonal Hospital, St. Gallen, Switzerland.
authors.forename: Abel-Jan
authors.initials: AJ
authors.lastname: Tasman
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Cantonal Hospital, St. Gallen, Switzerland.
authors.forename: Ralph
authors.initials: R
authors.lastname: Litschel
mesh_terms: D000359:Aftercare; D001860:Bone Plates; D001863:Bone Screws; D006801:Humans; D008446:Maxillofacial Injuries / Q000601:surgery*; D009295:Nasal Bone / Q000293:injuries; D009917:Orbital Fractures / Q000601:surgery; D010347:Patient Care Planning; D011182:Postoperative Care; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D020205:Skull Fracture, Basilar / Q000601:surgery; D012887:Skull Fractures / Q000601:surgery*; D013515:Surgery, Oral / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D015051:Zygomatic Fractures / Q000601:surgery