Facial Trauma Among Patients With Head Injuries

This article covers Facial Trauma Among Patients With Head Injuries.

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Facial Trauma among patients with head injuries

ABSTRACT

Introduction:

Facial trauma is without a doubt a most challenging area for any emergency physician. Despite many researches and advances in the understanding of multiple techniques; initial assessment and management of facial injuries in emergency and early stages remained a complex area for patient care.

Objective:

The purpose of this study is to determine the prevalence of facial trauma among patients with head injuries that may help emergency department physicians to deliver accurate and quick diagnosis and decision. Trauma to this region is often associated with mortality and morbidity and varying degree of physical and functional damage.

Study Design:

Prospective Cross-sectional Descriptive Study.

Place and Duration of Study:

Department of Emergency Medicine, Ziauddin University Hospital, Karachi from four months from Feb 2014 to May 2014.

Methodology:

This study was conducted at Ziauddin university hospital emergence medicine department. It is a prospective cross sectional descriptive hospital based study. 115 patients who were diagnosed of having head injuries were included in this study. Information on age, sex and cause of injury was taken for each case. Each patient was then examined for the presence of facial trauma using the CT 3D face. Data was analyzed using the SPSS program.

Result:

Out of 115 patients, 85 (74%) were males and 30 (26%) were females. A total of 59 (51%) patients were between 15 – 30 years of age; 26 (23%) were aged between 31 – 50; and 30 (26%) were above 51 years of age.

76% patients had facial trauma where head injuries were evident. 63% female and 80% male had facial trauma where head injuries were found in patients. Out of these 115 patients majority were involved in road traffic accidents and are from the age group 15 – 30 and predominantly male.

Conclusion:

Based on the study conducted; it is safe to conclude that patients who have facial trauma associate with head injuries are young males and is mainly caused by road traffic accident. The result might vary by governmental, culture or social differences.

Key words: Facial Trauma; Head Injuries; emergency department

_____________________________________________________________________________________________


INTRODUCTION

Trauma is a type of injury where external force is being applied suddenly and violently at the body which causes a serious injury [1]. A head injury in human body is any trauma that can cause injury of scalps, brain or skull. The injury could be a minor bruise or serious injury on the head and brain injury [2]. Some injuries can result in prolonged or unrecoverable brain damage. The injury can cause bleeding inside the brain or forces that damages the brain directly. The most common cause of head injuries are road traffic accidents, fall, physical assault or others. These accidents can occur at home, work, outdoors, sports or many other places.

Head injuries are commonly associated with facial trauma; often result from high energy blunt force injury to facial skeleton. Typical mechanisms of trauma include motor vehicle accidents, altercation and fall [3].

PG Emergency Medicine, Department of Emergency Medicine, Ziauddin University Hospital, North Campus, Karachi

* Correspondence Email:drshazia24@live.com

The face is vital to human appearance and function. Facial injuries can impair a patient’s ability to eat, speak, interact with others, and perform other important functions. Facial injuries may be caused by a direct blow, penetrating injury, or fall. Pain may be sudden and severe. Bruising and swelling may develop soon after the injury [11].

METHODOLOGY

This study was carried out at the department of emergency medicine, Ziauddin University Hospital, Karachi, Pakistan. Patients of either gender with more than 15 years of age presenting to Ziauddin Hospital Karachi who were diagnosed of having head injuries were selected.

Patients who gave the history of previous head trauma were not included in this study, this aimed at avoiding some ambiguity during examination as to whether the encountered trauma was the result of the recent head injury or previous underlying trauma.

Each patient was then examined for the presence of facial trauma, using 3D CT scan. A 3D CT scan, or a three-dimensional computerized tomography scan, is a type of x-ray that allows high quality images of organs, blood vessels, and bones to be recorded in a very short amount of time. The individual CT images are then layered together to form a virtual model of the body. It is able to reveal the functionality of many of the anatomical structures in the body, in addition to structural defects, tumors, and lesions [12].

The obtained data was checked for completeness and clarity then entered into the computer and analysis was performed using Statistical package for social sciences program (SPSS). Chi –square test (X2) will be carried out and significant level p<0.05 will be used to draw out conclusion by the help of the statistician.

RESULT

A Total of 115 patients with head trauma were included in the study. The gender distribution of the study population is as shown in Table 1 below.

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Facial Trauma Among Patients With Head Injuries
Facial Trauma Among Patients With Head Injuries

Table 1:- There were 85 (74%) males and 30 (26%) females.


Gender


Total


%Age

Female

30

26%

Male

85

74%


Total


115

 

The age distribution of the study population is as shown in Table 2 below.

Table 2:- There were 59 (51%) cases between ages 15 – 30, 26 (23%) cases with ages from 31 – 50 years males and 30 (26%) with age over 51 years old.


Age


Total


%Age

15 – 30

59

51%

31 – 50

26

23%

51+

30

26%


Grand Total


115

 

The presence of facial trauma according to gender is shows in table 3. Out of 115 patients monitored, 19 female have facial trauma out of 30 which consist of 63% female, while 68 male patients have facial trauma with head injuries out of 85 which make 80% of male population. The total of 76% patients has facial injuries where head injuries were evident.

Table 3:- Presence of facial trauma according to gender


Presence of facial trauma according to gender


Gender


No


Yes


%Age


Total

F

11

19

63%

30

M

17

68

80%

85


Total


28


87


76%


115

         

The presence of facial trauma according to age is shows in table 4 along with graphical representation. Out of 115 patients monitored, 59 patients were between ages 15 – 30. From these 59 patients 51 have facial trauma where head injuries were evident, this make 86% of the population.

The patients between 31 – 50 years of ages were 26, where only 14 were found to have facial trauma which makes 54% of the population.

The patients over 51 years of age were 30 where 22 were found to have facial trauma which makes 73% of the population.

Table 4:- Presence of facial trauma according to age


Presence of facial trauma according to age


Age


No


Yes


Total


%Age

15 – 30

8

51

59

86%

31 – 50

12

14

26

54%

51+

8

22

30

73%


Total


28


87


115


76%

         

1213490.001

Table 5 shows prevalence of facial trauma by gender according to the causes of injuries. Out of 87 patients where facial trauma was also observed 11% female had it because of road traffic accident comparing to 39% male. Fall in female was 9% comparing to 17% male; no assault in female was observed while 14% male had facial trauma during assault.


Prevalence of facial trauma by gender according to Cause of injury


Gender


RTA


Fall


Assaults


Others


Total

F

10

8

0

1

19

M

34

15

12

7

68


Total


44


23


12


8


87

           

1213490.002

Table 6 below shows the details of prevalence of facial trauma by age according to cause of injury. The detail shows higher number of road traffic accident, followed by fall, assault and other causes of injuries.

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Facial Trauma Among Patients With Head Injuries
Facial Trauma Among Patients With Head Injuries


Prevalence of facial trauma by age according to Cause of injury


Age


RTA


Fall


Assaults


Others


Total

15 – 30

29

12

7

3

51

31 – 50

6

3

5

0

14

51+

9

8

0

5

22


Total


44


23


12


8


87

           

1213490.003


DISCUSSION

Head injuries causes hospitalization of 200 – 300 patients per 100,000 population per year worldwide. A head injury associated with facial trauma comprises a number of complications, such as sequestrum formation, sinusitis, nasolacrimal duct injuries, facial deformity and injury to or entrapment of the globe. Trauma is very well known to be the main cause of death in first forty

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