© Medical Center - University of Freiburg

Svetlana R. is a professional dancer of Latin American dance styles. In a performance in Japan, the young Russian woman falls down the stairs - she sees double and her cheek is numb. For help, she flies halfway around the world - and lands in Freiburg.

Latin American dances are the passion of Svetlana R.* She is a master, and travels around the world for competitions. But when in Japan's capital Tokyo for a performance, something disasterous happens. In a moment of carelessness, Svetlana R. falls down the stairs. She has painful bruises. But something else is not right. "The young woman had a numbness in her left cheek and saw everything double," says Professor Dr. Rainer Schmelzeisen, Medical Director of the Department of Oral and Maxillofacial Surgery of the Medical Center - University of Freiburg. "It was suspected that a facial bone was broken."

9,000 kilometer journey after falling down stairs

When the symptoms do not improve after a couple of days, Svetlana R. decides to find an expert - and travels on the next plane to Germany and the Medical Center - University of Freiburg. Fortunately, she gets an appointment there at short notice. She undertakes the more than 9,000 kilometer long journey because Professor Schmelzeisen has a high reputation internationally in the reconstruction of facial injuries and the field of aesthetic facial surgery.

Actually a typical men's injury

The experts quickly discover that a bone in the face, the cheekbone, is actually broken. "We treat a cheekbone fracture about once a week, often in young men," says Professor Schmelzeisen. Because a fractured cheekbone is a typical injury resulting from a punch in the face or a fall from a bike.

Sunken eye and compressed nerve

The cheekbone lies on the lateral lower edge of the eye socket and can easily be felt by touch. It holds the eye in position and is an important insertion point for the masticatory (chewing) muscles. The nerves run through a tiny channel in the bone. "A break can sometimes be felt as a small step. Typical are bleeding in the eyelids and a strong swelling around the eye", says Professor Schmelzeisen. "Due to the fracture the patient's eye was sunken slightly in the eye socket, and the nerve was compressed. That caused the discomfort", explains the surgeon.

Scarless surgery thanks to innovative approach

After detailed 3D imaging, the team around Professor Schmelzeisen plans the intervention. During surgery, the positioning of the bone is repeatedly checked and corrected using special computer-aided 3D navigation methods, a procedure that the Freiburg doctors specialize in. The facial bone must be moved to the right place and screwed to a small titanium plate. Instead of getting at the site of the fracture from the outside as is standard, Professor Schmelzeisen has developed a minimally invasive procedure.

"If possible, we perform these procedures through the oral cavity. This allows us to completely avoid visible scars", says Professor Schmelzeisen. "Of course, that was very important for the young woman from an aesthetic point of view." After only one hour, the operation is successfully completed. A short time later, the feeling in the cheek is back and the double images have disappeared. The patient stays in the medical center for another two days before she is allowed to fly home. And soon she and her partner can again compete in dance competitions.

*Name changed by the editor