Facial fracture repair is part of any ENT's residency training. Fortunately, with seatbelt use and protective headgear for athletes, severe facial fractures are no longer very common. Typically, most facial fractures are minor and usually do not require any surgical repair. But, such fractures still do occur and are performed at tertiary care trauma centers where facial fracture repairs are commonly performed by ENT, plastic surgery, and/or oral-maxillary facial (OMF) surgeons. Although I (and most community ENTs) have been trained in such fracture repairs, given we so rarely see severe fractures in a small community hospital, surgical skills can not be maintained to perform these procedures well, especially given cosmetic appearance is an important outcome factor.
But, we can certainly evaluate and determine whether such fractures require surgical repair... or can be left to heal on its own without any invasive intervention.
As a general rule of thumb, all mandible fractures require surgical repair as so do facial fractures that cause double vision or inability to fully open/close the mouth.
Check out the videos showing how such fractures are repaired!
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