Mid-facial soft tissue re-suspension following skeletal fixation after maxillofacial trauma-a prospective case series study.

Abstract

Open reduction and internal fixation (ORIF) is used for reduction and stabilization of facial fractures. Despite perfect anatomic skeletal reduction, subtle asymmetries are seen in facial appearance as mid-facial soft tissue often reattaches to the respective facial bones in an aberrant, mostly lower in position. Thus, the present study evaluates the effectiveness of mid-facial soft tissue re-suspension procedure to prevent changes in mid-facial soft tissue profile after ORIF of maxillo-facial fractures. Fifteen patients with maxillo-facial fractures requiring ORIF were included. After ORIF, mid-facial soft tissue resuspension (STRP) was done by suspending the soft tissue and periosteum over cheek region from temporal fascia by polydioxanone suture material. The results were analyzed by patient satisfaction survey and doctor perspective form on photographs by three surgeons 6months postoperatively. All patients were male in the age range of 18-60years. STRP was done unilaterally in 7 cases and bilaterally in 8 cases, with average time ranging from 10.6 to 20.5min. The patient satisfaction survey revealed that 86.6% were pleased with their appearance and 93% said that there was no abnormal change in the esthetics postoperatively. The doctor perception form revealed almost 80% agreement, that there was minimal change in the appearance of cheek mound, nasolabial fold, corner of the mouth, and lateral canthus postoperatively. STRP is a simple technique to perform with fewer complications, and helps in restoring facial esthetics, same as prior to facial trauma; as it prevents soft tissue sagging after degloving incisions for fracture reduction and fixation.