Maxillofacial traumas take the form of injuries to the face that are often not identifiable to their full extent at first examination. The first step in any assessment, whether after an incident on the athletic field or in a vehicle, is to make sure that there are no major hemorrhages or internal losses of blood. Another essential is checking for compromised vision and airway obstructions.
Nasal fractures are the most common type of facial fracture and make up more than half of such incidents. They are defined by a break in the cartilage or bone over the nose’s bridge or the sidewall or septum, which divides the two nostrils. Oedema, involving a buildup of fluid and swelling in the nose tissue, may mask nasal bone deformations.
This means the nasal base must be manually palpitated and assessed, with nasal bones checked for mobility and asymmetry and the throat checked for posterior nasal bleeding. A nasal speculum is used to identify areas of hematoma (clotted blood) or hemorrhage, which may reduce blood supply to the septal cartilage and cause abscess and cartilage necrosis.
Mandibular fractures involving the jaw are also relatively common in the face. Because the mandible is a mobile bone, intense pain, and malocclusion often, patients and physicians direct attention to the area of the fracture and make diagnosis easier.
Christopher C. Babcock 