Facial and Cervical Injuries

A review of cervical spine injury associated with maxillofacial trauma at a UK tertiary referral centre

“…This is consistent with the majority of studies in the literature, which report incidences ranging from 0% to 8%. [1][2][3][4][7][8][9][10][11][12][13][14][15][16][22][23][24][25] Additionally, in our study, trauma patients with maxillofacial fractures had a twofold higher incidence of concomitant CSI compared with trauma patients without maxillofacial injury. This finding has been replicated in several studies [23][24][25][26] but not all.…”

“…The differences in these factors between studies have led to inconsistent observations of injury patterns. [1][2][3][4][7][8][9][10][11][12][13][14][15][16] In our study at a single tertiary centre for trauma, we observed several trends in CSI as described above, for which we have provided biomechanical explanations.…”

“…Maxillofacial fractures are accepted as injuries at high risk for concomitant cervical spine or spinal cord injury. 1,2 The presence or absence of a cervical spine injury (CSI) has important implications in trauma patients, influencing airway management techniques, choice of diagnostic imaging studies, surgical approach and timing for repair of concomitant facial fractures. Most injuries of the cervical spine associated with facial fractures are attributed to forces transmitted directly or indirectly from the facial skeleton to the cervical bony and connective tissue structures.…”

“…[5][6][7][8] The majority of cohort studies have reported wide variations in the incidence of CSI in maxillofacial trauma patients, ranging between 0% and 8%, in part owing to differences in the mechanism of injury, anatomical location of impact, location of trauma centre, and patient demographics including age and sex. [1][2][3][4][7][8][9][10][11][12][13][14][15][16] In specific subgroups of patients such as RTA fatalities, the incidence of CSI has been cited as high as 24%. 9 Trauma protocols including the Advanced Trauma Life Support ® manual stress the importance of the association between maxillofacial injury and CSI, and the catastrophic consequences that can ensue if the diagnosis is missed or its presence or absence ignored.…”

Pearls of Mandibular Trauma Management

“…Studies have reported that the incidence of C-spine injuries in patients presenting with facial fractures ranges from 2 to 10% (whereas there is an inverse relationship between mandibular fractures and intracranial pathology). [8][9][10][11][12] Additionally, 32% of mandibular fractures are associated with abrasions or lacerations, 24% with neurologic injury, 20% with additional orthopedic injuries, and 12% with pulmonary, abdominal, or cardiac injury. Once again, though, the overall incidence of these accompanying injuries will differ based on the initial mechanism of injury.…”