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What is Facial Trauma?

Facial trauma, also called maxillofacial trauma, is any physical trauma to the face. Facial trauma can involve soft tissue injuries such as burns, lacerations and bruises, or fractures of the facial bones such as nasal fractures and fractures of the jaw, as well as trauma such as eye injuries. While home treatment is usually all that is needed for mild bumps or bruises, more serious facial trauma requires treatment by a specialist.

What are the Causes?

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

Common causes of injury to the face include:

  • Car and motorcycle crashes
  • Wounds
  • Sports injuries
  • Violence
  • Falls
  • Work-related tasks or projects around the home

Acute facial injuries also include:

  • A cut or puncture to your face or inside your mouth. This often occurs with even a minor injury. But a cut or puncture is likely to occur when a jaw or facial bone is broken. The bone may come through the skin or poke into the mouth.
  • Bruises from a tear or rupture of small blood vessels under the skin.
  • Broken bones, such as a fractured cheekbone.
  • A dislocated jaw, which may occur when the lower jawbone (mandible) is pulled apart from one or both of the joints connecting it to the base of the skull at the temporomandibular (TM) joints. This can cause problems even if the jaw pops back into place.

What are the 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

Evaluation

Your doctor 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.

Treatment depends on:

  • The location, type, and severity of the injury.
  • How long ago the injury occurred.
  • Your age, health condition, and other activities, such as work, sports, or hobbies.

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.