Cervical spine injury in maxillofacial trauma

Objective—To find out the incidence of associated facial injuries and injuries to the cervical spine. Design—Retrospective study. Setting—Teaching hospital, India. Subjects-536 patients treated for maxillofacial injuries between January 1992 and November 1993. Interventions—Review of hospital case notes and radiographs. Main outcome measures—Coexisting facial and cervical spine injuries, morbidity and mortality. Results—16 patients (3%) had sustained both facial and cervical spine injuries. There were 14 men (median age 40, range 21–64) and 2 women (aged 19 and 30). In 10 of the 16 patients the cause of the injury was a road traffic accident. In 11 patients the facial injury was to the soft tissue only, in 4 it was to both hard and soft tissue, and in 1 it was to hard tissue only. Soft tissue damage to the midface was more likely to be associated with injuries in the area of C5–7 and that to the lower third of the face was more likely to be associated with damage to the upper cervical spine. 11 patients had neurological deficits as a result of their injuries and 2 died. Conclusion—If diagnosis and treatment of simultaneous facial and cervical spine injuries are to be improved, further study of the biomechanics of injury is necessary.