Facial trauma is the medical term to call physical trauma that happens in the face. Also called as maxillofacial trauma, this can involve soft tissue injuries as in burns, lacerations and bruises, or fractures in the bones of the facial area such as nasal fracture and jaw fracture. Eye injuries are also counted under facial trauma.
The symptoms for each type of facial injury will vary. Burns might cause irritations based on their severity while fractures might involve pain, swelling and sometimes even change the shape of the facial structures.
Why is facial trauma serious?
- Facial injuries might cause disfigurement and loss of functions – like difficulty moving the jaw and blindness.
- Facial trauma is not usually life threatening but it can turn deadly due to other secondary complications.
- Based on the nature, facial trauma can cause severe bleeding that might cause an interference with the airway. This is why while treating facial trauma, surgeons should ensure that the airway is open for the patient to breathe.
Treatment options for facial trauma
Depending on the type of injury, bandaging and suturing of open wounds might be necessary. Moving bones back into place during surgery and post operative care using antibiotics and pain killers might be required for fracture treatments. Traumatic brain injury can also be a result of severe facial trauma and needs special care to ensure the functionality is restored.
Causes of facial trauma
Accidents and sports injuries are the primary cases of facial trauma. Other wounds can also happen in the full facial region due to violence. Usually women form a huge part of facial trauma victims due to domestic violence.
Symptoms of facial trauma
Deformed or uneven face due to displaced facial bones, swelling or bruising around the eyes that affect vision, difficulty in breathing caused by internal swelling and bleeding, double vision, missing teeth, changes in feeling over the face.
Identifying and treating facial injuries
Facial injuries can be identified by basic physical examination and once any other problems are found, other serious diagnosis methods like CT scan can be used. The goal of a facial trauma treatment is to control bleeding, clear the airway, treat fracture by fixing bone segments, prevent scarring, prevent long term double vision, sunken eyes or cheekbones, rule out other injuries. Treatment should be done in an emergency basis if the person is stable without neck injuries.
Facial fractures in the frontal bones and the maxillofacial, zygomatic regions are also a part of orbital trauma. Fractures in the nasal, zygomatic region, mandibular, frontal, maxillary regions and the superorbital rim fractures come under orbital trauma in surgeon terms.
The maxilla region represents the bridge between the cranial base and the dental occlusal plane. The association with the oral cavity, nasal cavity, orbits and multitude of structures make the maxilla a cosmetically, functionally important structure. The injuries in the upper face, frontal bone and frontal sinus, the middle face, the nasal ethmoid, zygomatic and maxillary bones and the lower face where the mandible is present are classified under maxillofacial trauma. The maxillofacial region includes the important sensory systems like vision, auditory, somatic sensation, gustatory, olfaction and vestibular. The vital structures in the head and neck are also in the maxillofacial region with the airway, blood vessels, nerves and gastrointestinal tracts. Psychological impact of trauma in the maxillofacial and frontal regions and the disfigurement they cause can be devastating.
Mandibular fractures that occur in the jaw region are the break in the mandibular bone. The break occurs in two places and might cause difficulties in opening of the mouth. Mandibular fractures are caused due to trauma that might be caused by a fall onto the chin and hit from the side. Mandibular fractures in the dentate portions might cause difficulty in jaw movement and permanent disfigurement if treated wrongly. The mandible’s prominence and lack of support makes mandible fractures a frequent injury.
Le Fort fracture
The Le Fort fracture of the skull is a classic transfacial fracture of the midface with the maxillary bone and surrounding structures. The Le Fort fractures cause traumatic pterygomaxillary separation that starts from the inferior maxillary margin and sinuses. The Le Fort fractures are named after the French surgeon Rene Le Fort (1869-1951) who examined crush injuries in cadavers and discovered the fracture patterns in the frontal orbital region.
The Le Fort I fracture causes swelling in upper lip and zygomatic arch. The fractures can be immobile if it catches the maxillary teeth. Le Fort II and Le Fort III are symptomised by gross edema of soft tissue over the middle third of the face, with deformity in the infraorbital margin, mid face region or separation at the frontozygomatic suture lengthening face.
Panfacial fractures are the fractures involving the lower, middle and upper face. Panfacial fractures can be treated by understanding the treatment principles of each individual fractures. Panfacial fractures are caused by impact from high energy mechanisms and are different from facial fractures. The high energy forces in the craniofacial region might cause panfacial fractures.
Dr. Debraj Shome treats facial trauma with a deeper understanding of the facial region and the various injuries based on their cause, severity, and secondary and tertiary impacts. He has a great repertoire of testimonials for surgeries that have a cosmetic, medical success.