Nineteen-year Operative Audit of Faciomaxillary Trauma: Epidemiology, Operative Workload and a Risk-stratified Airway-Management Algorithm - A retrospective study
Parthapratim Dutta, Utpal Kumar Bordoloi, Partha Sarathi Barooah, Dhruba Jyoti Deka, Dhruba Jyoti Borgohain, Pollov BoraAbstract
Introduction:
Faciomaxillary trauma represents a major surgical workload in tertiary referral centres and poses significant airway challenges due to fracture complexity, oedema, haemorrhage and trismus. Long-term data integrating epidemiology, operative workload and airway strategies remain limited.
Materials and Methods:
A retrospective audit of operative faciomaxillary trauma cases managed over 19 years was conducted. Demographic variables, fracture patterns, operative procedures, airway techniques and operative workload distribution were analysed. A risk-stratified airway management algorithm was derived.
Results:
A total of 1266 operative trauma cases were included. Mandibular fractures constituted the largest subgroup, followed by zygomaticomaxillary complex and midface fractures. Nasotracheal intubation was the most frequently employed airway technique, while submental intubation was selectively utilised for complex injuries. The proposed algorithm stratified patients into low-, moderate- and high-risk airway categories.
Discussion:
This long-term audit highlights evolving trauma patterns, operative burden and airway management strategies. The proposed airway-risk algorithm offers a practical approach for airway planning in resource-variable tertiary-care settings.