Craniofacial Trauma in Children

Craniofacial trauma in children involves any injury to the face, upper jaw bone, or skull. It can include skeletal injury, skin injuries and injuries to the neck, nose, eye socket, sinuses, teeth and other mouth parts. It is usually identified by a laceration, swelling or bruising of the facial tissue. Signs of fractures include bruising around the eyes, called Raccoon’s eyes or behind the ear, called a battle sign. One can see a widening of the space between the eyes or teeth that are not in alignment. There can be bleeding from the nose, ears or mouth.

There are about 3 million people treated for facial trauma in United States emergency rooms. Of the children involved, 5 percent have suffered facial fractures. In kids under the age of three, most of them suffered their injury due to a fall. In kids over the age of five, motor vehicle accidents are the top cause of craniofacial injuries. This means that seatbelts and proper child restraints can reduce the risk of facial trauma.

Older children have other risks for facial injuries that include cheerleading, gymnastics, contact sports and cycling. Protective gear like helmets helps to reduce the risk of injury to the face. When accidents do occur, there is a great need to recognize and treat maxillofacial trauma in children as soon as possible. The development of their facial bones is greatly affected whenever there is poorly treated care of these types of injuries.

Facial trauma
is different in kids when compared to adults. The facial trauma can be minor or can be disfiguring throughout a child’s life. It is a good idea to get the best possible treatment in kids, because their face hasn’t fully formed and the treatment must be good enough to allow for proper growth and development of the face. Sometimes it takes a team of doctors to manage complicated facial injuries.

The types of facial injuries you’ll see include soft tissue injuries or lacerations that can disfigure the face, especially if it involves nerves or cuts perpendicular to the lines of the facial skin. Bone injuries can involve the skull, the maxillary bone, the mandible, the zygomatic arch and the periorbital bones. Some of these can be left to heal on their own while others need surgery to correct misalignment of bones or open fractures, which need to be cleaned out extensively.

Isolated teeth injuries are common and may need the care of a dental specialist. If the teeth do not line up correctly, there must be a fracture of the maxilla or the mandible and these need to be corrected. A knocked out tooth must be placed in milk or salt water and then taken immediately to the emergency room where it can be replaced and temporarily cemented to keep it in place until it heals.

In one study, 750 children who sustained craniofacial injuries resulting from slips, trips and falls. It was found that the peak incidence of these kinds of falls occurred when a child was a toddler with straight falls happening when a child was under the age of one Most patients were in the preschool age group. These accidents happened at home 73-86 percent of the time. Lacerations occurred more in slips and trips than in straight falls.