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Oral and Maxillofacial Surgery

Published in:

01-09-2013 | Original Article

The relationship between head injury and facial trauma: a case–control study

Authors: Mohammad Zandi, Seyed Rohallah Seyed Hoseini

Published in: Oral and Maxillofacial Surgery | Issue 3/2013

Abstract

Introduction

In spite of anatomic proximity of the facial skeleton and cranium, there is paucity of information in the literature regarding the relationship between head injuries and facial trauma. The objective of our investigation was to evaluate the pattern of head injuries in patients with maxillofacial trauma, and to study their relationship.

Material and methods

We evaluated 2,692 patients with maxillofacial trauma admitted to the Besat hospital, Hamedan, Iran between 2007 and 2010. Patients with associated head injury (302 cases; study group) were compared with those without head injury (2,390 cases; control group).

Results

In our cohort, the rate of head injuries associated with facial bone fractures was 23.3 %. The most common associated head injury was concussion, followed by cerebral contusion and skull fractures. In the unadjusted analysis, motorcycle and car accidents were significantly more frequent in the study group, while stumbling, sports injuries, and work-related injuries were significantly more common in the control group (p < 0.001). Except for Lefort III fractures which was not significantly different between groups, all facial fractures occurred more frequently in the study group (p < 0.001). Logistic regression analysis demonstrated that motorcycle accidents (211-fold), car accidents (139-fold), violence (69-fold), falls (66-fold), frontal sinus fractures (84.5-fold), and Lefort II fractures (27-fold) were the strongest predictors of head injuries.

Discussion

Present study revealed that fracture of facial bones, especially bones that are in anatomic proximity to the cranium and need a high magnitude of trauma energy to be fractured, was marker for an increased risk of head injuries.

Hayter JP, Ward AJ, Smith EJ (1991) Maxillofacial trauma in severely injured patients. Br J Oral Maxillofac Surg 29:370–373PubMedCrossRef

Pappachan B, Alexander M (2006) Correlating facial fractures and cranial injuries. J Oral Maxillofac Surg 64:1023–1029PubMedCrossRef

Lee KF, Wagner LK, Lee YE et al (1987) The impact-absorbing effects of facial fractures in closed-head injuries. An analysis of 210 patients. J Neurosurg 66:542–547PubMedCrossRef

Chang CJ, Chen YR, Noordhoff MS et al (1994) Maxillary involvement in central craniofacial fractures with associated head injuries. J Trauma 37:807–811PubMedCrossRef

Davidoff G, Jakubowski M, Thomas D et al (1998) The spectrum of closed-head injuries in facial trauma victims: incidence and impact. Ann Emerg Med 17:6–9CrossRef

Keenan HT, Brundage SI, Thompson DC (1999) Does the face protect the brain? A case–control study of traumatic brain injury and facial fractures. Arch Surg 134:14–17PubMedCrossRef

Martin RC 2nd, Spain DA, Richardson JD (2002) Do facial fractures protect the brain or are they a marker for severe head injury? Am Surg 68:477–481PubMed

Gassner R, Tuli T, Hachl O et al (2003) Cranio-maxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries. J Craniomaxillofac Surg 31:51–61PubMedCrossRef

Al Ahmed HE, Jaber MA, Abu Fanas SH et al (1999) The pattern of maxillofacial fractures in Sharjah, United Arab Emirates: a review of 230 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:166–170

10.

Erol B, Tanrikulu R, Görgün B (2004) Maxillofacial fractures. Analysis of demographic distribution and treatment in 2901 patients (25-year experience). J Craniomaxillofac Surg 32:308–313PubMedCrossRef

11.

Moncrieff NJ, Qureshi C, Deva AK (2004) A comparative cost analysis of maxillofacial trauma in Australia. J Craniofac Surg 15:686–691PubMedCrossRef

12.

Brasileiro BF, Passeri LA (2006) Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102:28–34PubMedCrossRef

13.

Al-Khateeb T, Abdullah FM (2007) Craniomaxillofacial injuries in the United Arab Emirates: a retrospective study. J Oral Maxillofac Surg 65:1094–1101PubMedCrossRef

14.

Bakardjiev A, Pechalova P (2007) Maxillofacial fractures in Southern Bulgaria—a retrospective study of 1706 cases. J Craniomaxillofac Surg 35:147–150PubMedCrossRef

15.

Lee JH, Cho BK, Park WJ (2010) A 4-year retrospective study of facial fractures on Jeju, Korea. J Craniomaxillofac Surg 38:192–196PubMedCrossRef

16.

Haug RH, Prather J, Indresano AT (1990) An epidemiologic survey of facial fractures and concomitant injuries. J Oral Maxillofacial Surg 48:926–932CrossRef

17.

Haug RH, Adams JM, Conforti PJ et al (1994) Cranial fractures associated with facial fractures: a review of mechanism, type, and severity of injury. J Oral Maxillofac Surg 52:729–733PubMedCrossRef

18.

Lim LH, Lam LK, Moore MH et al (1993) Associated injuries in facial fractures: review of 839 patients. Br J Plast Surg 46:635–638PubMedCrossRef

19.

Haug RH, Savage JD, Likavec MJ et al (1992) A review of 100 closed head injuries associated with facial fractures. J Oral Maxillofac Surg 50:218–222PubMedCrossRef

20.

Rajendra PB, Mathew TP, Agrawal A et al (2009) Characteristics of associated craniofacial trauma in patients with head injuries: an experience with 100 cases. J Emerg Trauma Shock 2:89–94PubMedCrossRef

21.

Hohlrieder M, Hinterhoelzl J, Ulmer H et al (2004) Maxillofacial fractures masking traumatic intracranial hemorrhages. Int J Oral Maxillofac Surg 33:389–395PubMedCrossRef

22.

Kloss F, Laimer K, Hohlrieder M et al (2008) Traumatic intracranial haemorrhage in conscious patients with facial fractures—a review of 1959 cases. J Craniomaxillofac Surg 36:372–377PubMedCrossRef

23.

Hung YC, Montazem A, Costello MA (2004) The correlation between mandible fractures and loss of consciousness. J Oral Maxillofac Surg 62:938–942PubMedCrossRef

24.

Hackl W, Hausberger K, Sailer R et al (2001) Prevalence of cervical spine injuries in patients with facial trauma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 92:370–376PubMedCrossRef

25.

Clayton JL, Harris MB, Weintraub SL et al (2012) Risk factors for cervical spine injury. Injury 43:431–435PubMedCrossRef

Title: The relationship between head injury and facial trauma: a case–control study
Authors: Mohammad Zandi
Seyed Rohallah Seyed Hoseini
Publication date: 01-09-2013
Publisher: Springer Berlin Heidelberg
Published in: Oral and Maxillofacial Surgery / Issue 3/2013
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-012-0368-z

At a glance: The STEP trials

Springer Medicine

The relationship between head injury and facial trauma: a case–control study

Abstract

Introduction

Material and methods

Results

Discussion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Material and methods

Results

Discussion

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