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Facial trauma

  • Definition
    • Facial trauma is an injury of the face. It may include the facial bones such as the upper jaw bone (maxilla).

  • Alternative Names
    • Maxillofacial injury; Midface trauma; Facial injury; LeFort injuries

  • Causes
    • Facial injuries can affect the upper jaw, lower jaw, cheek, nose, eye socket, or forehead. They may be caused by blunt force or be the result of a wound.

      Common causes of injury to the face include:

      • Car and motorcycle crashes
      • Wounds
      • Sports injuries
      • Violence
  • Symptoms
    • Symptoms may include:

      • Changes in 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 or bruising around the eyes that may cause vision problems
  • Exams and Tests
    • The health care provider will perform a physical exam, which may show:

      • Bleeding from the nose, eyes, or mouth
      • 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
      • Changes in vision or the movement of the eyes
      • Improperly aligned upper and lower teeth

      The following may suggest bone fractures:

      • Abnormal feelings on the cheek
      • Irregularities of the face that can be felt by touching
      • Movement of the upper jaw when the head is still

      A CT scan of the head and bones of the face may be done.

  • Treatment
    • Surgery is done if the injury prevents normal functioning or causes a major deformity.

      The goal of treatment is to:

      • Control bleeding
      • Create a clear airway
      • Treat the fracture and fix broken bone segments
      • Prevent scars, if possible
      • Prevent long-term double vision or sunken eyes or cheek bones
      • Rule out other injuries

      Treatment should be done as soon as possible if the person is stable and does not have a neck fracture.

  • Outlook (Prognosis)
    • Most people do very well with proper treatment. More surgery may be needed in 6 to 12 months to correct changes in appearance.

  • Possible Complications
    • Complications may include:

      • Bleeding
      • Uneven face
      • Infection
      • Brain and nervous system problems
      • Numbness or weakness
      • Loss of vision or double vision
  • 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 while driving.

      Use protective head gear when doing work or activities that could injure the face.

  • References
    • Kellman RM. Maxillofacial trauma. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 23.

      Mayersak RJ. Facial trauma. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 42.