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.