Analysis of the effectiveness of minimally invasive methods for facial skeleton reduction

Objective. To optimize and evaluate the effectiveness of minimally invasive orbital bone reposition while providing qualified medical care to the wounded.

Materials and methods. We analyzed the case histories of more than 500 patients with combined and isolated injuries to the zygomatic-nasal-orbital-ethmoidal (ZNOE) complex, admitted to a multidisciplinary hospital over a two-year period. From this cohort, 190 patients were included in the study control group. These patients were divided into groups according to Hooper`s classification (2004). Among them, 94 patients had a fracture with prolapse of soft tissue structures into the maxillary sinus, accompanied by hemosinus, and the presence of foreign bodies of various density and size, 96 patients had type 2 fractures with soft tissue prolapse and hemosinus, but without foreign bodies in the maxillary sinus.

 Results. No inflammatory complications were recorded in 141 patients in the early postoperative period. In 49 patients, nasal congestion, swelling of the middle third of the face, and limited mouth opening persisted for 2 days after catheter removal. Follow-up visual examination revealed the presence of exudate in the maxillary sinus on the injured side. This finding was associated with exacerbations of chronic odontogenic infection, a factor which requires separate and detailed investigation beyond this study.

Conclusions. According to the protocol for the first two stages of evacuation, the primary goals are to eliminate life-threatening conditions and prevent predictable post-traumatic functional impairments. These goals are best achieved using minimally invasive methods. The principles and extent of such gentle surgical techniques are determined by fracture type, the degree of bone fragment displacement, and the risks of predictable functional disorders, particularly those of the visual system. A comparative analysis of the outcomes demonstrates that restoring anatomical integrity – for both isolated and combined injuries – through maximally atraumatic surgical techniques has the best results in terms of functional recovery.