Trends in The Sequential Approaches For Management Of Panfacial Fracture: A Systematic Review

The patterns of panfacial fracture are complicated and may vary from patient to patient. This makes the management of these fractures extremely challenging. In literature there are various surgical approaches mentioned. There are number of approaches for the management of panfacial fracture, such as, conservative and surgical approaches. The aim for any sequential approaches for management of panfacial fracture is to improve and maintain the patients' functional and aesthetic life style. Ultimately any approach should also aim to reduce confusion and improve patient's quality of life. To evaluate the various sequential surgical approaches for management of panfacial fracture. Authors searched data by the following methods: Electronic searches, Hand searching, Eligibility criteria, Inclusion criteria, 1. Articles with full text available in English, 2. In-vivo studies, retrospective and comparative studies, 3. Studies published between 1st January 1985 and 31st December 2015,4. Study population should be above 18years. Exclusion criteria i. Age group below 18years. ii. Articles in other languages. iii. Review article, case report, letters to editors, editorials, and in-vitro studies are excluded. The electronic search identified a total of 120 publications (records identified through database searching 107 and additional records identified through other sources 13) of which 6 remained after removing duplicates. 6 articles were reviewed by three authors independently and were screened for eligibility. Then 6 full articles were selected for this review. There is a lack of evidence to support or refute the effects of the sequential surgical approaches of management of panfacial fracture. The most preferred approach is "bottomup and outside-in" when the mandible is involved. When midface and upper face is involved, then " outside to inside" approach is employed. However, the sequential approach to be used for panfacial fractures is completely depended on the surgeon's knowledge and preference. There is clearly a need for comparative studies to investigate the effectiveness of sequential surgical approaches for management of panfacial fracture.