MULTIREGIONAL CRANIOFACIAL TRAUMA INVOLVING SKULL BASE AND ORBITAL STRUCTURES: A CASE REPORT IN HEAD AND NECK SURGERY

Background:Craniofacial trauma is a major global health concern, most commonly resulting from high-energy impacts such as road traffic accidents. These injuries often involve complex maxillofacial and cranial fractures, leading to functional, neurological, and aesthetic challenges.
Objectives:To present a complex case of panfacial trauma with intracranial and ocular involvement, highlighting the
staged surgical approach and importance of multidisciplinary management.
Results:A 26-year-old male sustained severe craniofacial injuries following a motorcycle accident. Imaging revealed
multiple fractures including Le Fort II maxillary fracture, bilateral orbital rim and blow-out fractures, zygomatic tripod fracture, mandibular symphysis fracture, comminuted frontal sinus fractures, and anterior cranial base fracture, along with intracerebral hemorrhage, brain edema, and vitreous hemorrhage. Initial stabilization was achieved with interdental wiring and mandibular arch bar fixation. Definitive management included craniotomy with frontal sinus reconstruction, orbital exploration with scleral repair and hyphema evacuation, and orthopedic procedures for associated toe dislocations. The staged “bottom-to-top and outside-in” approach facilitated restoration of occlusion prior to cranial and orbital reconstruction.
Conclusion: This case illustrates the complexity of managing multiregional craniofacial trauma involving the skull base and orbit. Optimal outcomes depend on early imaging, a staged surgical strategy, and close multidisciplinary
collaboration between maxillofacial, neurosurgical, ophthalmologic, and orthopedic teams.