Facial trauma

Definition

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

Alternative Names

Maxillofacial injury; Midface trauma; Facial injury; LeFort injuries

Causes, incidence, and risk factors

Blunt or penetrating trauma can cause injury to the area of the face that includes the upper jaw (maxilla). Common causes of injury to the face include:

• Automobile accidents
• Penetrating injuries
• Violence

Symptoms

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

Signs and tests

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

• Bleeding from the nose, eyes, or mouth, or nasal blockage
• Breaks in the skin (lacerations)
• Bruising around the eyes or widening of the distance between the eyes, which may mean injury to the bones between the eye sockets

• 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

Patients who cannot function normally or who have significant deformity will need surgery.

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.

Expectations (prognosis)

Patients generally do very well with proper treatment. You will probably look different than you did before your injury. You may need to have more surgery 6 - 12 months later.

Complications

General complications include, but are not limited to:

• Bleeding
• Uneven face (asymmetry)
• Infection
• Brain and nervous system (neurologic) complications
• Numbness or weakness

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 violent confrontations with other people.