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
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
- Penetrating injuries
- Violence
Symptoms
- Changes in sensation and feeling over the face
- Difficulty breathing through the nose due to swelling and bleeding
- Double vision
- Missing teeth
- Swelling around the eyes may cause vision problems
Exams and Tests
The doctor will perform a physical exam, which may show:
- Bleeding from the nose, eyes, or mouth, or nasal obstruction
- Bruising around the eyes or widening of the distance between the eyes, which may mean injury to the bones between the eye sockets
- Lacerations (breaks in the skin)
The following may suggest bone fractures:
- Abnormal sensations on the cheek and irregularities that can be felt
- An upper jaw that moves when the head is still
A CT scan of the head may be done.
Treatment
Surgery is needed if the person cannot function normally or if there is significant deformity.
The goal of treatment is to:
- Control bleeding
- Create a clear airway
- Fix broken bone segments with titanium plates and screws
- Leave the fewest scars possible
- Rule out other injuries
- Treat the fracture
Treatment should be immediate, as long as the person is stable and there are no neck fractures or life-threatening injuries.
Outlook (Prognosis)
Patients generally do very well with proper treatment. The patient should gently be told that they will probably look different than they did before their injury, and that additional surgeries may be needed 6-12 months later.
Possible Complications
General complications include, but are not limited to:
- Bleeding
- Facial asymmetry
- Infection
- Neurologic complications
When to Contact a Medical Professional
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.
Reviewed By: Alan Lipkin, MD, Otolargyngologist, private practice, Denver, CO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
