Abstract
Concomitant traumatic brain injury (TBI) and maxillofacial fractures carry the risk
of significant morbidity and mortality. The aim of this review was to explore the
demographics, types of injury, and complications of traumatic maxillofacial and brain
injuries, in order to contribute to comprehensive health strategies. The PubMed and
Scopus databases were systematically searched. Inclusion criteria were clinical studies
investigating combined traumatic maxillofacial and brain injuries. Exclusion criteria
were duplicates, non-English publications, non-full-text publications, publication
date before 1990, and studies with insufficient data. Of the 754 articles identified,
15 eligible articles representing 1421 cases were included. The mean age was 38.3
years. Most cases were male (79%). The most common mechanism of injury was traffic
accidents (53.4%). The most common fracture pattern was middle third fractures (52.4%).
Seven studies had an explicit definition for TBI, using the Glasgow Coma Score (GCS),
radiological evidence, and/or specific symptoms. There were 147 complications reported
in 62 of 253 cases (24.5%), with the most common being infection (n = 54, 36.7%). Significant risk factors for complications included delayed surgical repair,
low GCS, and upper third fractures. Robust longitudinal evaluations with clear definitions
of TBI are required. Gaps in knowledge include risk factors for complications and
fracture pattern–GCS correlations.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to International Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Facial fracture repair in the traumatic brain injury patient.J Oral Maxillofac Surg. 2007; 65: 1693-1699
- A ten year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam: complications and treatment.J Craniomaxillofac Surg. 2014; 42: 1717-1722
- A ten-year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam: incidence and aetiology.J Craniomaxillofac Surg. 2014; 42: 705-710
- Epidemiology and incidence of traumatic head injury associated with maxillofacial fractures: a global perspective.J Int Oral Health. 2018; 10: 63-70
- Efficacy of the motor component of the Glasgow Coma Scale in trauma triage.J Trauma Acute Care Surg. 1998; 45: 42-44
- A review of 100 closed head injuries associated with facial fractures.J Oral Maxillofac Surg. 1992; 50: 218-222
- Increased risk of dementia in patients with craniofacial trauma: a nationwide population-based cohort study.World Neurosurg. 2019; 125: e563-e574
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.Ann Intern Med. 2009; 151: 264-269
- Methodological index for non‐randomized studies (MINORS): development and validation of a new instrument.ANZ J Surg. 2003; 73: 712-716
- Prevalence and patterns of maxillofacial trauma: a retrospective descriptive study.Eur J Trauma Emerg Surg. 2019; : 1-7
- Patterns of brain injuries associated with maxillofacial fractures and its fate in emergency Egyptian polytrauma patients.Chin J Traumatol. 2018; 21: 287-292
- Incidence of major and minor brain injuries in facial fractures.J Craniofac Surg. 2012; 23: 1324-1328
- Does the face protect the brain? A case–control study of traumatic brain injury and facial fractures.Arch Surg. 1999; 134: 14-17
- The facial skeleton: armor to the brain?.Indian J Dent. 2016; 7: 116
- Maxillofacial injuries and traumatic brain injury—a pilot study.Dent Traumatol. 2014; 30: 128-132
- Interrelation of maxillofacial fractures and cranial injury—a prospective study.Int J Appl Dent Sci. 2017; 3: 162-164
- Occurrence and types of associated injuries in patients with fractures of the facial bones.J Oral Maxillofac Surg. 2010; 68: 805-810
- Associated injuries are frequent and severe among geriatric patients with zygomatico-orbital fractures.J Oral Maxillofac Surg. 2019; 77: 565-570
- Frontal sinus fractures in children.Laryngoscope. 2005; 115: 1741-1745
- Severe facial fracture is related to severe traumatic brain injury.World Neurosurg. 2018; 111: e47-e52
- Maxillofacial trauma in the emergency department: a review.Surgeon. 2014; 12: 106-114
- Selective cervical spine radiography in blunt trauma: methodology of the National Emergency X-Radiography Utilization Study (NEXUS).Ann Emerg Med. 1998; 32: 461-469
- The Canadian C-spine rule for radiography in alert and stable trauma patients.JAMA. 2001; 286: 1841-1848
- Traumatic fractures of the cervical spine: analysis of changes in incidence, cause, concurrent injuries, and complications among 488,262 patients from 2005 to 2013.World Neurosurg. 2018; 110: e427-e437
Article info
Publication history
Published online: December 30, 2020
Accepted:
December 4,
2020
Identification
Copyright
© 2020 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.