Facial trauma is a physical trauma that happened to the face. One can get physical facial trauma through road traffic accidents, industrial accidents, and personal injuries from sports, etc. Some of the most common examples of facial trauma involve injuries to soft tissue like burns, and bruises, laceration, fractures of the jaw, facial bones, & nasal fractures and damage to the eye.
Facial trauma may cause damage or injury to the following regions:
1. Soft tissue – Skin, subcutaneous tissue or any underlying muscle
2. Bones- Maxilla :
• Upper jaw
• Orbit – Eye socket
• Zygoma – Cheekbone
• Mandible – Lower jaw
• Nasoethmoid orbital skeleton – Central face, joint of bones starting from the nose, orbits, maxilla, and cranium
3. Avulsed teeth-it is called ‘knocked-out teeth,' which needs to be given an immediate preference to have successful tooth reimplantation.
4. Special region- This involves injuries to the nerves in the salivary glands, eyes, or face.
Facial Reconstructive Surgery
Facial reconstructive surgery is a surgery required to correct the deformities and misalignments of the structures of the face. It is performed by oral and maxillofacial surgeons. It often becomes necessary for the restoration of the function and appearance of the face and self-confidence of the patient.
Candidates for Reconstructive Surgery
Those who have the following abnormalities are potential candidates for surgery-
• Birth defects and deformities that arise from conditions such as cleft lip or palate, Apert syndrome, craniosynostosis,
• Injuries to the head, face or jaw
• Deformities caused by surgery done to treat tumors
The operation is performed when the patient is deep asleep or under general anesthesia. It may take 4 to 12 hours or more. In this procedure, some parts of the facial bones are cut and moved to attain proper alignment. The pieces of bone grafts taken from the pelvis, ribs, or skull may be used to fill in the gaps. The tissues are moved, and blood vessels and nerves are carefully reconnected using microscopic surgery techniques.
Small screws, implants, and plates material may be used to fix the bones in place. Implants may also be used. The jaws may be joined with wire to keep the new bone in positions. Flaps may be taken from the hand, chest wall, buttocks, or thigh buttocks to use to cover the surgical area. In some cases, the surgery is followed by swelling of the face, mouth, or neck that may end in a few weeks.
It takes around three months for the patients to recover entirely from the craniofacial reconstruction. During this period, patients may experience swelling while the face heals. Some patients need to have regular follow-up procedures during the next 1 to 4 years.
The patients are advised to avoid contact sports for 2 to 6 months after surgery.
The potential complications of facial reconstructive surgery are-
• Problems breathing
• Reactions to medicines
• Bleeding, blood clots, infection
• Nerve injury (cranial nerve dysfunction) or brain damage
• Need for follow-up surgery, especially in growing children
• Partial or total loss of bone grafts
• Permanent scarring