Assessment of the Patient With Traumatic Facial Injury

Patients with facial injuries often have multisystem involvement, and the initial assessment of the trauma patient should be consistent with the ATLS (Advanced Trauma Life Support) protocol. Although traumatic facial injuries are rarely life-threatening, the examiner must pay close attention to facial injuries that may cause airway compromise, severe hemorrhage, cervical spine injuries or central nervous system injuries. After the patient is determined to be hemodynamically stable, the secondary survey will focus on any facial lacerations, avulsions, contusions, bony disruptions, vision changes, malocclusion, and trismus. The goals of this chapter are to highlight (1) the common patterns of facial trauma and relevant soft tissue and skeletal anatomy, (2) the importance of organized, systematic approach to physical examination with the aid of radiological imaging, (3) the various considerations in the setting of concomitant multisystem injuries, and (4) the various surgical exposures of the craniofacial skeleton for definitive surgical treatment.