Extended Access/Internal Approaches for the Management of Facial Trauma

The article “Extended Access/Internal Approaches for the Management of Facial Trauma” in this issue of the Archives provides an important discussion describing the "the state-of-the-art" management of fractures of the facial skeleton. The article is well written and focuses on the advantages and disadvantages of concealed, yet extended, incisions. The reader is provided with details of the procedures and methods to prevent complications. Many of the surgical approaches that are described in the article have been known for years; only recently have they been applied to maxillofacial injuries. Extended access was needed because the surgeon wanted to evaluate the entire fracture while he or she reduced and fixed the fragments. Moreover, surgeons found it advantageous to use plates (and bone grafts), and these techniques required more than the traditional exposure that was used with wire fixation. To obtain extended exposure for the frontal and ethmoid.