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Facial Trauma
Symptoms are specific to the type of injury; for example, fractures may involve pain, swelling, loss of function, or changes in
the shape of facial structures.


Facial injuries have the potential to cause facial disfigurement and loss of function; for example, blindness or difficulty moving
the jaw can result. Although it is seldom life-threatening, facial trauma has the potential to be fatal as it can cause severe
bleeding or interference with the airway; thus a primary concern in treatment is ensuring that the airway is kept open and not
threatened so that the patient can breathe.

Depending on the type of facial injury, treatment may include sewing up (
suturing) of open wounds, administration of ice (to
reduce swelling and bruising), antibiotics and pain killers, moving bones back into their correct position (
manipulation) and
surgery (
reduction and fixation).

Where facial fractures are suspected, X-rays & CT scans are used for and to aid diagnosis.

Treatment may also be necessary for other injuries such as traumatic brain injury which commonly accompany facial trauma.

In developed countries, the leading cause of facial trauma is
inter-personal violence; car accidents predominate as the main
cause in developing countries and are still a major cause elsewhere.  Other causes of facial trauma include falls, industrial
accidents and sports injuries.


Epidemiology

Facial fractures are distributed in a fairly 'normal' curve by age, with a peak incidence occurring between ages 20 and 40 and
children under 12 suffering only 5 – 10% of all facial fractures.


Most facial trauma in children involves
lacerations and soft tissue injuries.

There are several reasons for the lower incidence of facial fractures in children:

  • the face is smaller in relation to the rest of the head
  • children are less often in those situations associated with facial fractures such as occupational and motor vehicle hazards
  • the bone is differently proportioned in children making them more resistant to fracture
  • poorly developed sinuses make the bones stronger, and
  • fat pads provide protection for the facial bones.


Useful Articles & Website:

J Cranio-Maxillofac Surg 2003.  Cranio-Maxillofacial Trauma - A 10 Year Review of 9543 Cases with 21067 Injuries

Dental Update 2006.  Common Facial Fractures. 1. Aetiology and Presentation

Dental Update 2006.  Common Facial Fractures. 2. Management

Dental Update 2006.  Common Facial Fractures. 3. Complications

American Academy of Otolaryngology - Head & Neck Surgery Foundation 2012.  Resident Manual of Trauma to the Face,
Head & Neck.  1st Edition

Emergency Medicine Australasia 2014.  Review - Maxillofacial Emergencies + Maxillofacial Trauma

World J Emerg Surg 2014.  Assessment of Maxillofacial Trauma in Emergency Department

BioMed Res Intl 2015.  Airway Management of the Patient with Maxillofacial Trauma - Review of the Literature & Suggested
Clinical Approach

BDJ 2017.  Oral Surgery II.  Part 6.  Oral & Maxillofacial Trauma

Saudi J Oral Dent Res 2018.  Mortality in Maxillofacial Trauma - A Review

A Textbook of Advanced Oral and Maxillofacial Surgery Volume 3.  Chapter 23.  Concepts in Management of Advanced
Craniomaxillofacial Injuries

Trauma Surgery.  Chapter 4.  Maxillofacial Fractures - From Diagnosis to Treatment


AO Surgery Reference
Last Updated 4th January 2020
Facial trauma (Maxillo-facial trauma) is any physical trauma to the face.  Facial trauma can involve soft tissue injuries such as
burns,
lacerations (cuts) and bruises or fractures (breaks) of the facial bones such as nasal fractures and fractures of the jaw,
as well as trauma such as eye injuries.
Pan Oro-Facial Trauma
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