Facial trauma

Definition

Facial trauma is any injury of the face and upper jaw bone.

Alternative Names

Maxillofacial injury; Midface trauma; Facial injury; LeFort injuries

Causes, incidence, and risk factors

Blunt or penetrating trauma can cause injury to the midface region, which includes the upper jaw (maxilla). Common causes of facial injury include:

• Automobile accidents
• Violence
• Penetrating injuries

Symptoms

• Difficulty breathing through the nose due to swelling and bleeding
• Changes in sensation and feeling over the face
• Swelling around the eyes may cause vision problems
• Double vision
• Missing teeth

Signs and tests

The doctor will perform a physical exam, which may show:

• Lacerations (breaks in the skin)
• Bruising around the eyes or widening of the distance between the eyes, which may mean injury to the bones between the eye sockets

The following may suggest bone fractures:

• An upper jaw that moves when the head is still
• Abnormal sensations on the cheek and irregularities that can be felt

A CT scan of the head may be done.

Treatment

Surgery is needed if the person can not function normally or if a substantial deformity is present.

The goal of treatment is to:

• Create a clear airway
• Control bleeding
• Treat the fracture
• Rule out other injuries
• Fix broken bone segments with titanium plates and screws
• Leave the fewest amount of scars possible

Treatment should be immediate, as long as the patient is stable and there are no neck fractures or life-threatening injuries.

Expectations (prognosis)

Patients generally do very well with proper treatment. The patient should gently told that they will probably look different than they did before their injury, and that additional surgeries may be needed 6-12 months later.

Complications

General complications include, but are not limited to:

• Bleeding
• Infection
• Neurologic complications
• Facial asymmetry

Calling your health care provider

Go to the emergency room or call the local emergency number (such as 911) if you have a severe injury to your face.

Prevention

Wear seat belts and use protective head gear when appropriate. Avoid triggering potentially violent confrontations with other people.