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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.

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