Maxillofacial trauma with head injuries at a tertiary care hospital in Chitwan, Nepal: clinical, medico-legal, and critical care concerns

Authors: SANTOSH KUMAR YADAV, BIRENDRA KUMAR MANDAL, ABHISHEK KARN, AJIT KUMAR SAH

Abstract: Maxillofacial trauma is commonly associated with other injuries, predominantly head injuries. The present study aimed to evaluate types of injury, management, and outcome of patients sustaining maxillofacial trauma and concomitant cranial injuries. Materials and methods: A retrospective study was carried out in the department of oral and maxillofacial surgery. A case series of 63 patients who were admitted to the intensive care unit with maxillofacial trauma and head injuries was evaluated. The data were then compiled systematically and analyzed using SPSS for Windows and values of P < 0.05 were considered significant and P < 0.0001 as highly significant. Results: Among the 63 patients, the majority of them had had roadside accidents (90%) and there was a predominant sex bias with a male to female ratio of 7:1. Fractured maxilla and nasal bones were the most commonly encountered injuries (49.21%), followed by mandibular fractures (38.09%). Forty-two patients (66.67%) required mechanical ventilation, tracheostomy was needed in 19 (30.16%) patients, and 42 (66.67%) patients were operated on for head injuries. The majority of the victims were aged between 15 and 40 years. Conclusion: Maxillofacial trauma with head injuries demands special attention as airway compromise is invariably present. Equally critical is the surgical intervention as simultaneously cranial and maxillofacial surgeries were performed. Preventive measures and legislation regarding traffic rules require a review also as the higher incidence of accidents among young adults has acquired epidemic status.

Keywords: Maxillofacial injury, craniofacial trauma, road traffic accidents, head injuries, mechanical ventilation, tracheostomy, tracheal intubation

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