Facial trauma, also called maxillofacial trauma is physical trauma to the face. Facial trauma may involve soft tissue injuries such as burns, lacerations and contusions and fractures of facial bones, and nasal fractures and fractures of the jaw, and trauma, such as eye injuries. The symptoms are specific to the type of injury, for example, fractures may involve pain, swelling, loss of function, or changes in the shape of the facial structures.
In developed countries, the main cause of facial trauma used to be the motor vehicle accidents, but this mechanism has been replaced by interpersonal violence, but car accidents still predominate as the cause in developing countries and remain a major cause elsewhere. Therefore prevention efforts include awareness campaigns to educate the public about safety measures such as seat belts and motorcycle helmets, and laws to prevent drunk driving and insecure. Other causes of facial trauma include falls, industrial accidents and sports injuries.
The facial bones are injured or broken, including the nasal bone (nose), the maxilla (the bone that forms the upper jaw) and mandible (lower jaw). The zygomatic bone (cheekbone) and the frontal bone (forehead) are other sites for fractures. Fractures may also occur in the bones of the palate and coming together to form the eye socket.
Signs and symptoms:
Fractures of facial bones, like other fractures may be associated with pain, bruising and swelling of surrounding tissue (these symptoms may occur in the absence of fractures as well). Fractures of the nose, the base of the skull or the jaw may be associated with heavy nosebleeds. Nasal fractures may be associated with deformity of the nose and swelling and bruising. The deformity of the face, for example, a sunken cheek or teeth that do not align correctly suggests the presence of fractures. The asymmetry may suggest facial fractures and damage to nerves. People with mandibular fractures often have pain and difficulty opening the mouth and may have numbness in the lips and chin. With maxilla fractures, midface is movable relative to the rest of the face or skull.
A bandage may be placed on wounds to keep them clean and to facilitate healing, and antibiotics can be used in cases where infection is likely. People with contaminated wounds that have not been immunized against tetanus within ten years must receive an injection of tetanus vaccine. The wounds may require stitches to stop bleeding and facilitate wound healing with minimal scarring as possible. Although not common as bleeding from the maxillofacial region, it remains necessary to control the problem. The Nasal packing can be used to control bleeding from the nose and bruising that can be formed in the septum between the nostrils.
Treatment aims to repair the face of natural bone architecture and leave little trace apparent injury as possible. Fractures can be repaired with metal plates and screws. The bone graft is another option to repair the bone architecture to fill the remaining sections, and to provide structural support. The medical literature suggests that early repair of facial injuries in a matter of hours or days, resulting in better results for the function and appearance.
Plastic surgeons that usually address specific aspects of facial trauma are trained in the comprehensive management of trauma to the lower, middle and upper face.
Prognosis and complications:
By itself, facial trauma rarely presents a threat to life, though often associated with severe injuries and life-threatening complications.
Even when facial injuries are not life threatening, they have the potential to cause disfigurement and disability, with long-term results physically and emotionally. Facial injuries can cause eye problems, the function of the nose or jaw and can endanger sight. The nerves and muscles can be trapped by the broken bones in these cases; the bones need to be put back into their proper places. In facial wounds, tear ducts and nerves of the face may be damaged. Fractures of the frontal bone, it can interfere with drainage of the sinuses and cause sinusitis.
Infection is another potential complication.