Facial trauma, also called maxillofacial trauma, is any physical trauma to the face. Commonly injured facial bones include the nasal bone (the nose), the maxilla (the bone that forms the upper jaw), and the mandible (the lower jaw). The mandible may be fractured at its symphysis, body, angle, ramus, and condoyle. The zygoma (cheekbone) and the frontal bone (forehead) are other sites for fractures. Fractures may also occur in the bones of the palate (mouth) and those that come together to form the orbit of the eye. As many as 50–70% of people who survive traffic accidents have facial trauma. In most developed countries, violence from other people has replaced vehicle collisions as the main cause of maxillofacial trauma; however in many developing countries traffic accidents remain the major cause. Rene Le Fort used cadaver studies in 1900 to provide detailed descriptions of 3 basic types of facial fracture, these are now known as Le Fort I, Le Fort II & Le Fort III Fractures. Fractures of the nose, base of the skull, or maxilla may be associated with profuse nosebleeds. Nasal fractures may be associated with deformity of the nose, as well as swelling and bruising. Deformity in the face, for example a sunken cheekbone or teeth which do not align properly, suggests the presence of fractures. Asymmetry can suggest facial fractures or damage to nerves. People with mandibular fractures often have pain and difficulty opening their mouths and may have numbness in the lip and chin. With Le Fort fractures, the midface may move relative to the rest of the face or skull. The 3 goals of therapy in treating facial fractures are (1) to restore functional occlusion; (2) to stabilize the major facial skeletal supports, thereby restoring the pre-morbid 3-dimensional contour (height, width, and projection) to the face (Open Reduction & Internal Fixation); and (3) to provide skeletal support for the proper function and appearance of the overlying facial soft tissue structures. Continue reading
Dr. Debraj Shome, Top Facial Plastic Surgeon India 