Facial Injuries

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Facial Injuries and Disorders Introduction Facial injuries and disorders can cause pain and affect how you look. In severe cases, they can affect sight, speech, breathing and your ability to swallow. There are many injuries and disorders that can affect the face. Treatment for facial injuries and disorders depends on the cause. In some cases, treatment may not be needed. If treatment is needed, it may include medicines, surgery or other therapies. This reference summary explains facial injuries and disorders. It covers common facial injuries and disorders, including trigeminal neuralgia, Bell’s palsy, cleft lip and cleft palate and facial sports injuries. It also covers treatment options. Trigeminal Neuralgia The trigeminal nerve is the nerve responsible for most of the sensation in the face. There is a nerve on the right side of the face and another one on the left side. Trigeminal neuralgia is characterized by severe pain in the face. The pain lasts for few seconds and can spread to the rest of the face. But it is usually limited to one division of the trigeminal nerve. Between bouts of severe pain, the patient is usually pain free. Specific sites in the patient’s face, such as the corner of the mouth, gum or lip, can act as a trigger point. The pain can be set off when one of these sites is touched. The pain can be so severe that the patient may refrain from eating or speaking. It is still not clear what Trigeminal Nerve causes this pain. Trigeminal neuralgia is most often thought to be caused by abnormal compression of the ganglion of the trigeminal nerve by a normal blood vessel that has become more rigid because of advanced age. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/13/2014 fmf40101 1 Other reasons for trigeminal neuralgia include: • Abnormal blood vessels. • Multiple sclerosis. • Tumors. But these are very rare. Multiple sclerosis, or MS, is a nervous system disease that affects the brain and spinal cord. It causes trouble with coordination and balance, muscle weakness and memory problems. Medicines taken by mouth usually take care of the symptoms of trigeminal neuralgia. If these medicines fail to reduce pain or are not tolerated by the patient because of their side effects, an operation may be needed. There are many surgical options to treat trigeminal neuralgia. The best option depends on the patient’s age, medical condition and expectations. Bell’s Palsy Bell’s palsy is a temporary paralysis of one side of the face. It affects thousands of people every year. In patients with Bell’s palsy, the facial nerve suddenly quits working. The weakness reaches its worst point within 48 hours. The facial muscles are also paralyzed by Bell’s palsy. With the facial muscles paralyzed, the eye is not able to close and the mouth droops. Bell’s palsy usually improves on its own in a matter of weeks to months. Along with paralysis, Bell’s palsy patients may experience sounds being louder than usual. They may have some pain in the ear area. Patients with Bell’s palsy may experience loss of taste sensations on the affected side of the mouth. Lack of taste is sometimes not even noticed since the other side of the tongue’s taste sensation still works. The cause of Bell’s palsy is thought to be a viral infection of the facial nerve. Infection causes the nerve to swell. Swelling may cause the nerve to injure itself in the thin bony tunnel on its way to the face. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/13/2014 fmf40101 2 Herpes simplex, the common cold sore virus, is thought to cause the viral infection that leads to Bell’s palsy. Bell’s palsy is also more common in: • Patients suffering from the flu or a cold. • Patients with diabetes. • Pregnant women. Other diseases that can cause symptoms similar to Bell’s palsy include: • Infections. • Strokes. • Tumors. 75% of patients with Bell’s palsy improve without treatment. But recent studies have shown that treatment with steroids and an antiviral medicine are probably effective in improving facial function. Face massage can keep facial muscles from contracting, keeping them flexible and elastic for when the nerve heals. Patients may also be given an eye patch and eye drops to protect the eye from injury and from drying up. In rare cases of Bell’s palsy, surgery may be recommended. A surgery to take the pressure off the nerve in the narrow canal in the base of the skull is rarely done. Plastic surgery may help improve a patient’s appearance if Bell’s palsy does not improve. Cleft Lip and Palate Cleft lip and cleft palate are birth defects that happen when a baby's lip or mouth do not form properly. They happen early during pregnancy. A baby can have a cleft lip, a cleft palate or both. Cleft lip is more common than cleft palate. A cleft lip happens if the tissue that makes up the lip does not join completely before birth. This causes an opening in the upper lip. The opening can be a small slit. Sometimes the opening is large and goes through the lip into the nose. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/13/2014 fmf40101 3 A cleft lip can be on one or both sides of the lip. Rarely, it can happen in the middle of the lip. Children with a cleft lip also can have a cleft palate. The roof of the mouth is called the "palate." With a cleft palate, the tissue that makes up the roof of the mouth does not join correctly. Among some babies, both the front and back parts of the palate are open. Among other babies, only part of the palate is open. The causes of cleft lip and cleft palate are unknown. Cleft lip and cleft palate are thought to be caused by a combination of genes and other factors, such as environmental exposures. If you smoke or have diabetes, you have an increased risk of having a baby with a cleft lip or cleft palate. Children with a cleft lip or a cleft palate may have: • Dental problems. • Frequent ear infections. • Hearing loss. • Problems with feeding and talking. Often, surgery can close the lip and palate. Cleft lip surgery is usually done before age 12 months, and cleft palate surgery is done before 18 months. Many children will need additional surgeries as they get older. Although surgical repair can improve the look and appearance of a child’s face, it may also improve breathing, hearing, speech and language. Many children may need dental and orthodontic care and speech therapy as they get older. Facial Sports Injuries Sports can result in a variety of different injuries to the face. But many sports injuries can be prevented by wearing the proper safety gear. When the face is injured due to sports, it can result in fractures. Fractures are also known as broken bones. Facial fractures can be serious. They require medical attention. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/13/2014 fmf40101 4 Facial fractures can cause swelling or bruising of the face, such as a black eye. Other common symptoms are: • Changes in teeth structure. • Double or blurred vision. • Nosebleeds. • Not being able to close the mouth properly. • Pain or numbness in the face, cheeks or lips. When you are hit in the upper face, it can fracture the delicate bones around the sinuses, eye sockets, bridge of the nose or cheek bones. A direct blow to the eye may cause a fracture, as well as serious eye injuries. When you are hit in the jaw or lower face, it may change the way your teeth fit together. It may also affect your ability to close your mouth. Besides fractures, sports facial injuries can also include injury to the soft tissues of the face. Soft tissue injuries include bruises, cuts and scrapes. Soft tissue injuries can happen due to high speed or contact sports, such as boxing, football or ice hockey. Most of these injuries can be treated at home. Some soft tissue injuries require medical care. Seek medical attention right away if you have: • Deep skin cuts or scrapes. • Difficulty breathing or swallowing. • Loss of facial movement. • Obvious facial deformity. • Persistent bleeding. • Vision changes. The nose is one of the most injured areas on the face. Nasal injuries should be examined by a health care provider if they cause: • A deformity of the nose. • Breathing difficulties. • Persistent bleeding. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/13/2014 fmf40101 5 Treatment for facial sports injuries depends on the injury. Applying pressure and using an ice pack for the first 24 to 48 hours can reduce bruising and swelling. Scrapes and cuts should be washed with soap and water to remove any foreign material. This also helps prevent infection. For deeper scrapes and cuts, stitches may be necessary. If the teeth alignment is changed, surgery may be needed. Broken jaws can also be repaired with surgery. Your health care provider will explain your treatment options. Sometimes fractured bones are set right away before swelling develops. Fractures may also be repaired after the swelling is gone. These fractures can be repaired under local or general anesthesia, even weeks after the injury. Surgery may also be needed to restore proper function of the nasal air passages and normal appearance of the nose. Swelling and bruising of the nose may last for 10 days or longer. Summary Facial injuries and disorders can cause pain and affect how you look. In severe cases, they can affect sight, speech, breathing and your ability to swallow. There are many injuries and disorders that can affect the face, including: • Trigeminal neuralgia. • Bell’s palsy. • Cleft lip and cleft palate. • Facial sports injuries. Treatment for facial injuries and disorders depends on the cause. In some cases, treatment may not be needed. If treatment is needed, it may include medicines, surgery or other therapies. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2014, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/13/2014 fmf40101 6