Face and Head (Non-ocular) Injury

Abstract

Combat head and neck trauma arrives in many forms, from blunt to penetrating to blast injuries, and usually accompanies comorbid injuries such as closed head injuries and cervical spine fractures. Fortunately, these head and neck injuries are usually survivable, but every surgeon needs to be prepared for the worst-case scenario such as airway obstruction and hemodynamic instability. Damage control measures may include an emergent surgical airway or a neck exploration with repair of a lacerated carotid artery or fixation of a comminuted laryngeal fracture. After the patient is stabilized, they still need a diagnostic workup looking for occult injuries and a methodical surgical plan for repairing the injuries that may include a combination of complex soft tissue repair, grafts, and maxillofacial skeletal reduction and fixation. While most facial soft tissue and skeletal reconstruction can be delayed, it is challenging nonetheless due to the combined functional and cosmetic goals of reconstruction.