Does the Facial Construct Protect the Brain from the Impact of Traumatic Injuries? A Retrospective study

Aim: To evaluate the prevalence and association of traumatic brain injuries in patients sustaining maxillofacial trauma, and correlate with the proposed role of the facial skeleton to protect the brain. Background: Maxillofacial skeletal architecture has been considered to sustain the impact during trauma and protect the brain from injury. Whether or not, this has an important clinical implication as it will help the surgeon to assess and rule out during the preliminary evaluation thereby reducing the risk of potential delayed complications. Materials: A retrospective analysis of trauma patients reported to the emergency department of a tertiary care center in Tamil Nadu during March 2015- March 2020 was done. A detailed review of the maxillofacial trauma cases was done. Details related to the demography, trauma, injury sustained, primary and secondary survey, records pertaining to the diagnosis of traumatic brain injuries, their pattern, severity, and spectrum were studied, recorded, and subjected to statistical analysis. Results: 888 out of 6350 patients sustained maxillofacial injuries. The Mean age was 31.4 years and the population was predominantly male. 61% sustained soft tissue injuries. Among the hard tissue injuries, mandibular fractures were highest followed by isolated zygomaticomaxillary complex fractures. 42.4% sustained TBI of which concussion was predominant followed by diffuse axonal injury, contusion, hemorrhage, and skull fractures. A significant association was found between the incidence of TBI and various types of maxillofacial injuries. Conclusion: The incidence of TBI is strongly associated with maxillofacial injuries. Thus traumatic maxillofacial injuries can be used as predictors of the TBI.