Facial trauma

• 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

  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

  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.

Review Date: 8/6/2009

Reviewed By: Alan Lipkin, MD, Otolargyngologist, private practice, Denver, CO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.