A prospective computed tomography study of maxillofacial injuries in patients with head injury

Road traffic accidents (RTA) are one of the foremost causes of head injuries and its prevalence is more in developing countries owing to its unorganised road utilisation system. Maxillofacial injuries occur in 5-33% of all trauma cases universally and are commonly associated with head injury (HI).

The purpose of this prospective study is to determine the incidence and pattern of facial fractures in head injury patients and to evaluate the relationship between them. Does the midface acts as a cushion to the brain when subjected to trauma?

Hospital records of 500 consecutive patients admitted with head injury in a Tertiary Health Care Centre (National Institute of Mental Health and Neurosciences) in Bangalore between March and June 2015 were included in the study.

Out of the total of 500 patients, the overall incidence of maxillofacial fractures among head injury patients was found to be 8.6%. Out of the 43 cases of maxillofacial involvement, the most commonly fractured facial bone was the maxilla (5.4%). All the cases of maxillofacial fractures due to RTA involved two-wheel vehicles and none of those cases had helmet protection at the time of the incident. 4.4% of study participants had sustained maxillofacial injuries while under the influence of alcohol.

In our study of head injury patients, the most common aetiology of maxillofacial fractures was found to be RTA with drivers being most affected. Alcohol intoxication and lack of helmet protection played a significant role in causing maxillofacial fractures. We concluded that maxillofacial fractures are closely related to head injury especially in cases of RTA.