Maxillofacial trauma refers to any injury to the face or jaw caused by physical force, foreign objects, or burns. 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 trauma may also prevent the passage of air or be severe enough to cause a concussion or more serious brain injury.
Athletes are particularly at risk of maxillofacial injuries. 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. There are an estimated 300,000 cases every year. Overall, there are one million new traumatic brain injuries every year, causing 50,000 deaths. Of the rest, 7-9% are left with long-term disability.
Burns to the face are also categorized as maxillofacial trauma.
Causes and symptoms
There are no reliable statistics on the incidence of maxillofacial trauma because there are so many types and many are not reported. Automobile accidents are a major cause, as well as participation in sports, fights, and other violent acts, and being hit by an object accidentally, for instance being hit by a baseball while watching a game. People most at risk are athletes, anyone who drives a vehicle or rides in one, and those who do dangerous work or engage in aggressive types of behavior.
One study reported in August 2000 that 42% of all facial fractures resulted from sports activity.
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, and symptoms of a fractured nose also 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 are pain, redness, and possibly blisters, fever, and headache. Extensive burns can cause the victim to go into shock. In that situation, he will have low blood pressure and a rapid pulse.
Symptoms of traumatic brain injury include problems with thinking, memory, and judgement as well as mood swings, and difficulty with coordination and balance. These symptoms linger for weeks or months, and in severe cases can be permanent. Double vision for months after the injury is not uncommon.
Trauma is usually diagnosed in an emergency room or physician’s office by physical examination and/or x ray. Some injuries require diagnosis by a specialist. A detailed report of how the injury occurred is also taken. In some cases, diagnosis cannot be made until swelling subsides.