Facial trauma management : a nationwide data collection on practice patterns and patient care in oral and maxillofacial surgery in Germany

Abstract

This study aims to analyze facial trauma management, practice patterns, and patient care in Oral and Maxillofacial Surgery (OMFS) in Germany by using a dynamic online questionnaire with up to 54 questions. The survey, comprising single/multiple-choice and open-ended questions, was implemented via SurveyMonkey® and distributed to OMFS departments and surgeons in Germany. Data was analyzed anonymously and descriptively. Eighty-four OMFS departments and surgeons participated, revealing diverse facial trauma management. Monthly facial trauma patient volumes ranged from 0 to 10 (37.8 %) to more than 75 (4.88 %). Computed tomography (CT) was the primary imaging modality (82.05 %), supplemented by cone-beam CT and panoramic radiographs (56.41 % each). Orbital floor reconstruction primarily involved transconjunctival access (42.86 %) and prefabricated titanium meshes (69.01 %). Champy mini-plate osteosynthesis mainly managed mandibular angle fractures (51.47 %). Variability persists in the management of mandibular condylar process fractures in Germany. While a significant number of participants favor conservative treatment for condylar process fractures overall (26.87 %), the rate of surgical intervention for condylar head fractures is notably higher than international standards (59.42 %). Endoscopic techniques were rare (18.84 %). The management of standard thrombosis prophylaxis and perioperative antibiotic administration varied. Differences in specific facial trauma management were identified and assumed to be based on internal experiences and structural and personnel resources.