With congested roads in frequent disrepair, Motor vehicle accidents are unfortunately all too common in our lives. Facial fractures are especially important because of the sheer number of important structures in the head. Moreover, some of these bones bear weight, some do not. Some need a long time to rejoin, others do it far quicker. Add each of these together, and the correct treatment paradigm can quickly become confusing. Fortunately Dr. Bhattacharyya has received advanced training in two Level 1 trauma centers in the USA over 3 years so that we can provide you with the perfect treatment outcome, every single time!
Find Out MoreThe jaw bone is one of the hardiest bones in the body, so it takes significant trauma to fracture. The flip side is that repair of the fracture needs to be carefully timed to balance adequate healing with maintenance of function. Many of these fractures can be repaired intraorally with no scars, but some of them may need to be approached through the neck. Variable periods of Maxillomandibular fixation may also be necessary
The upper 2/3 rds of the facial skeleton is made of fine bone which can very easily fracture on impact. These fractures can often be comminuted & require painstaking repositioning.
Our approach to these fractures is always to start from the most stable part & proceed towards the least stable region. The facial buttresses must be reconstructed to prevent future deformities.
Orbit fractures are extremely common, due to weak walls inferiorly and medially. These fractures may sometimes not need active treatment, but wrong judgement can lead to future enophthalmos, shrunken eye and visual disturbances so we prefer to err on the side of caution. Orbital floor fractures can be repaired scarlessly, or we use existing lacerations, if present. Medial wall fractures can often be repaired similarly. Lateral wall fractures usually involve the zygoma or cheek bone, and can again be repaired without visible scars.
In case of any doubt of co-existent intraglobe injuries, it is critical to have an ophthalmologist assessment prior to repair.
Sometimes the optic nerve canal may be fractured and need endoscopic repair if it leads to visual deficits.
Skull base fractures can accompany MVA s and may be asymptomatic or present with CSF leak. While it is true that many of these CSF leaks will stop with conservative measures and Antibiotics, this does open up communication between the sterile brain and the bacteria laden nasal sinus cavity. It is for this reason that many neurosurgeons and trauma surgeons would prefer to close significant leaks when noted.
Another complication of skull base fractures is a possible closure of the frontal sinus (forehead) drainage outflow or the sphenoid sinus (back of the head) injury. Each of these need to be addressed on case by case basis, and require careful assessment of imaging and endoscopic exam.
Temporal bone fractures cannot be fixed, thus surgical treatment is only indicated for specific reasons. Any facial nerve injury with obvious fracture line passing through the facial nerve may need exploration & repair. Similarly Obvious injury to the roof of the T. Bone with CSF leak & dural herniation may need repair. Depending on the situation the approach may vary. Unfortunately hearing loss accompanying these fractures may often be due to damage to the inner ear with low chances of recovery
Panfacial fractures are the most advanced cases handled by a facial trauma surgeon, often following a Gunshot wound or a head on collision. These may be accompanied by significant soft tissue loss & need staged surgery- with local and regional flaps to reconstruct the soft tissue cover followed by staged reconstruction, usage of cartilage or bone grafts or even prostheses.
Dr. Bhattacharyya has the required expertise to provide you with comprehensive care as may be needed. Please understand these are extremely delicate surgeries and may require patience and careful staging to provide optimum final outcome
All good surgeons can give adequate outcomes 85% of the times, however the unending passion and joy of surgery is striving for the last 15%. That means doing all surgeries under magnification to give you the finest scars possible, using surgical adjuncts to promote healing, reducing your downtime.
Dr. Bhattacharyya has trained at many of the premier institutes in India and abroad, including the famed Vanderbilt University, Nashville, TN. Extensive use of endoscopes, tissue glues, stem cell rich substrates to promote healing, usage of nerve monitoring whenever required are all steps we take to ensure we give you the absolute best chance at great outcomes. Do discuss with us in detail about your surgery, and if you would like a complimentary surgical video, where possible.
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