Etiology and pattern of maxillofacial trauma

Abstract

Introduction Maxillofacial trauma can be limited to superficial lacerations, abrasions, and facial bone fractures. The objective of this study was to determine the etiology, pattern, and predictors of soft tissue and bony injuries. Materials and methods This study was conducted in the department of maxillofacial surgery Lady Reading hospital Pakistan from Jan 2019 to June 2021. The nonprobability consecutive sampling technique was used for the selection of patients. All patients were assessed clinically and radiologically. The neurosensory examination was done for any altered sensation, anesthesia, or paresthesia. Motor nerve function was also assessed clinically. Data were analyzed using SPSS version 26. The etiology and pattern of maxillofacial trauma were stratified among age and genders using the chi-square test to see effect modifiers. Tests for regression analysis were also applied. P≤0.05 was considered significant. Results A total of 253 patients meeting inclusion criteria were included in this study. The majority of these patients were males, 223 (88.1%), while only 30 (11.9%) were females. The mean age for the group was 25.4 ± 12.6 years. RTAs were the most common causes of trauma (63.6%) followed by assault (15.0%), falls (11.5%), FAIs (5.9%), and sports (0.4%). The most vulnerable skeletal part was the mandible (22.9%) followed by Zygoma (7.1%), significantly predicted by RTAs. Soft tissue laceration analysis showed a high frequency of multiple lacerations (38%) significantly predicted by FAIs. The frequency of trigeminal nerve injury was 5.5% (14 patients) and that of the facial nerve was 1.6% (4 patients). The strongest association of nerve injury was with firearm injury (47%), followed by road traffic accidents and sports injuries. Conclusion Road traffic accident was the most common etiological factor and mandible fracture was commonly predicted by RTA. Trigeminal nerve injuries were common, frequency of nerve injuries was highly associated with mandible fracture and was predicted by FAI.

World trends in publication for maxillofacial and dental trauma in the elderly

“…The most cited anatomical structures of the middle third in the articles were the orbit, zygomaticus, nose, and maxilla. The zygomatic bone and the nose are the most prominent bones in the face, and the orbit has a larger area that can receive the most direct impact 21 in the event of falls 14 and car accidents, 10,15 which were the main etiological factors cited in the studies. The complexity of trauma in this region may require a multidisciplinary team involving maxillofacial surgery, plastic surgery, and ophthalmology, 14 especially in elderly patients 44 …”

“…Maxillofacial traumatic injuries are common 8 since the face is one of the most unprotected parts of the body 9 . Maxillofacial traumatic injuries can affect the skeletal, dental, and soft tissue components of the face, and their severity depends on the structures involved and the magnitude of the injury 10 . Further, dentoalveolar trauma is a public health problem 11 because it can affect dental structures and/or their supporting tissues, 12 triggering aesthetic, functional, psychological, and financial damage 13 .…”

“…9 Maxillofacial traumatic injuries can affect the skeletal, dental, and soft tissue components of the face, and their severity depends on the structures involved and the magnitude of the injury. 10 Further, dentoalveolar trauma is a public health problem 11 because it can affect dental structures and/or their supporting tissues, 12 triggering aesthetic, functional, psychological, and financial damage. 13 However, there is little scientific evidence available about dentoalveolar trauma in the elderly.…”

Fraturas e perdas dentárias em adultos vítimas de traumatismo facial e alternativas reabilitadoras: revisão integrativa

“…Lesões físicas na face podem acarretar em trauma facial, o qual engloba danos aos tecidos moles e duros de forma isolada ou combinada (Khan et al, 2022). Esse tipo de trauma ocorre, predominantemente, no sexo masculino, na faixa etária de 21 a 30 anos e apresenta maior incidência na mandíbula, seguida pelo zigoma (Wusiman et al, 2020).…”

The Causes and Prevalence of Maxillofacial Fractures in Iran: A Systematic Review

“…The facial skeleton consists of multiple bones that can be affected by fractures, such as the maxilla, mandible, nasal bones, zygomatic arch, and orbital bones. Of these, the mandible is the most commonly affected bone in maxillofacial fractures 9 .…”