Maxillofacial Trauma Health Article

Definition

Maxillofacial trauma refers to any injury to the face or jaw caused by physical force, the presence of foreign objects, animal or human bites, or burns.

Description

Maxillofacial trauma includes injuries to any of the bony or fleshy structures of the face. Any part of the face may be affected. Teeth may be knocked out or loosened. The eyes and their muscles, nerves, and blood vessels may be injured as well as the eye socket (orbit), which can be fractured by a forceful blow. The lower jaw (mandible) may be dislocated by force. Although anchored by strong muscles for chewing, the jaw is unstable in comparison with other bones and is easily dislocated from the temporomandibular joints that attach it to the skull. A fractured nose or jaw may affect the ability to breathe or eat. Any maxillofacial injury may also prevent the passage of air or be severe enough to cause a concussion or more serious brain damage.

Athletes are particularly at risk of maxillofacial injuries; one researcher estimates that 10.4 percent of all fractures of the facial bones are related to sports. Boxers suffer repeated blows to the face and occasional knockouts (traumatic brain injury). Football, basketball, hockey, and soccer players, and many other athletes are at risk for milder forms of brain injury called concussions. Burns to the face are also categorized as  .

Demographics

About 3 million injuries to the face and jaw occur in the United States each year. Falls account for 78 percent of facial injuries in preschoolers and 47 percent of such injuries in children between the ages of six and 15. In older adolescents and adults, violent crime or other personal assaults account for almost 50 percent of facial injuries, with automobile accidents accounting for 29 percent and sports-related accidents for another 11 percent. One researcher estimates that about 2 percent of all children or adolescents who participate in sports eventually suffer a facial injury severe enough to require medical attention. Patients between the ages of 17 and 30 are more likely to suffer facial injuries from gunshot wounds, while older adults are more likely to be injured by attacks with blunt objects. About 10 percent of facial injuries in young children are caused by parental abuse.

Children who grow up on farms are at significant risk for injury by animals. Of one group of 96 children who required inpatient treatment for head or facial injuries, 39 had been kicked or bitten by horses or other farm animals. Another 37 children had been injured by farm machinery, most commonly a tractor.

Causes

Automobile accidents are a major cause of maxillofacial trauma, as well as participation in sports, fights, and other violent acts. Athletes may sustain facial injuries from colliding with other players (as in football or rugby), from direct contact with equipment (baseball bats, hockey sticks, goal posts, parallel bars, etc.), or from contact with other objects related to the sport (baseballs, hockey pucks, lacrosse balls, skis, etc.) People most at risk are athletes, anyone who drives a vehicle or rides in one, and those who live on farms, do dangerous work, or engage in aggressive types of behavior.

Animals are a common cause of maxillofacial trauma. Horses and other large farm animals can cause severe injury to the face and jaw from kicks or bites. In addition, some large pet dogs can bite hard enough to fracture a small child's facial bones.

Domestic violence and abuse is also a common cause of facial injuries in children and adolescents.

Symptoms

The major symptoms of most facial injuries are pain, swelling, bleeding, and bruising, although a fractured jaw also prevents the person from working his jaw properly. Symptoms of a fractured nose include black eyes and possible blockage of the airway due to swelling and bleeding.

Symptoms of eye injury or orbital fracture can include blurred or double vision, decreased mobility of the eye, and numbness in the area of the eye. In severe injuries there can be temporary or permanent loss of vision.

Burn symptoms include pain, redness, and possibly blisters, fever, and headache. Extensive burns can cause the victim to go into shock. In that situation, the person will have low blood pressure and a rapid pulse.

Symptoms of traumatic brain injury include problems with thinking, memory, and judgment as well as mood swings and difficulty with coordination and balance. These symptoms may linger for weeks or months and in severe cases can be permanent. Double vision for months after the injury is not uncommon.