Management of Pediatric Facial Trauma by Pyriform Suspension Tahrir N. N. Aldelaimi Anb Med J Vol.10 No.1 Mar. 2012; 8-12 Background: Surgical treatment of pediatric maxillofacial region is a complex and challenging task to maxillofacial surgeons. Incorrect and inappropriate treatment of trauma will end with secondary deformity that is very difficult to correct. Objectives: This study discusses types of pediatric maxillofacial injuries and evaluates the management of child patients with injuries to the maxillofacial region using pyriform suspension in Anbar Province, Iraq. Materials & Methods: Twenty-eight child patients with maxillofacial trauma were seen at Maxillofacial Surgery Department at Ramadi Teaching Hospital during the period from December 2009 till November 2010; including 21(75%) boys and 7(25%) girls. Age, sex, etiology, associated injuries, pattern of fractures and treatments were reviewed. Results: Road traffic accident was the most common cause for pediatric facial trauma, mandibular trauma was found in 13 children while Midfacial trauma was found in 15 children. Conclusions: Significant advances have been made in the management of these injuries, decreasing the incidence of secondary deformities. Key Words: pediatric surgery, maxillofacial trauma, pyriform suspension, mid face trauma, facial fracture. Introduction acial fractures are afflictions of the young persons. Disruption of the facial skeleton distorts the patient's appearance, and may compromise the function of the masticatory system, ocular system, olfactory apparatus and nasal airway 1,2 . Most facial trauma results in complex forces applied to the skeleton. Fractures can be isolated or occur in combinations that blur the division between classifications 3 . Patients with facial fractures may be a victim of multi- trauma, or have isolated facial injury. Multi- trauma patients will usually be evaluated by a trauma team and the facial injuries addressed after the patient is stabilized 4,5 . Trauma is the leading cause of death in children. Some children occasionally sustain severe injuries of the face which requires appropriate therapy. Serious maxillofacial injuries occur less frequently in children compared to adults 2,3,6 . Treatment issues in children compared to adults are also somewhat different owing to the needs of the growing facial skeleton in children. Whereas absolute reduction of fixation of fractures is indicated in adults, minimal manipulation of the facial skeleton in children is mandated to prevent growth abnormalities 1,2 . Furthermore, periosteal stripping can affect bone growth and the treatment required to accomplish a complete reconstruction may adversely affect growth and development of the face 2,4,6 . Facial fractures in the pediatric age group generally account for about 5% of all facial fractures and this percentage drops considerably in those less than the age of five. Some factors that account for the disparity in the incidence of facial fractures between adults and children include the higher cranial to facial skeleton size, F Management of Pediatric Facial Trauma by Pyriform Suspension Tahrir N. N. Aldelaimi Ass. Prof., Department of Oral & Maxillofacial Surgery, College of Dentistry, University of Anbar, Iraq Abstract Corresponding author: Tahrir N. N. Aldelaimi E-mail: TahrirALdelaimi@yahoo.com , Mobile: 07901896381. RTA= road traffic accident, FFH= fall from height