Surgical Dilemmas in Multiple Facial Fractures – Coronal Flap Versus Minimally Invasive: Case Report and Literature Review

THE RATIONALE: Pan-facial fracture is a complex trauma that involves the upper, middle, and lower third of the facial bones. The surgical management of such complex cases is either by the posterior approach (coronal flap) or anterior approach through local incisions. PATIENT CONCERNS: This report describes the case of severe pan-facial trauma in a 52-year-old male who sustained a severe pan-facial trauma. DIAGNOSIS: He suffered from multiple facial fractures that included: Frontal bone, skull base, Naso-orbitoethmoid (NOE), zygomatic and sub-condylar fractures. TREATMENT: He was managed by minimally local periorbital and lynch incisions. OUTCOMES: Fractures were properly reduced with resultant symmetrical facial dimensions. No postoperative complications were demonstrated including facial nerve function. TAKE-AWAY LESSONS: We should consider minimally invasive local incisions in pan-facial fractures when there is no need to restore the frontal sinus and the anterior-posterior dimensions of the zygomatic arch.