[Long-term functional and aesthetic sequelae after complex facial trauma associated with a mild brain injury].
BACKGROUND
Most victims of complex facial trauma will have permanent sequelae. The goal of our work was to evaluate, by means of a retrospective study, the long-term sequelae in these patients.


METHODS
102 victims of complex facial trauma were treated in our department between 1995 and 2000. Twenty-four could be re-examined in 2006 in order to evaluate their long-term sequelae. All the patients suffered a mild brain injury.


RESULTS
The overall satisfaction rate was good (19/24), but all patients presented either functional or aesthetic sequelae. The major functional sequelae were dental lost (17/24), sensory impairment of the trigeminal nerve (15/24), partial or complete loss of vision (10/24), pain (10/24), hypo- or anosmia (9/24), stenosis of the lacrimal ducts (8/24) and symptomatic deviation of the nasal septum (7/24). The main esthetic sequelae were facial scarring (23/24), facial asymmetry (13/24), dystopia of the eyeball (11/24) and modification of the aspect of the nose (10/24).


CONCLUSIONS
The prognosis of severe facial trauma is highly dependent on the quality of the initial pluridisciplinary care. Secondary revision procedures are technically more difficult and only enable partial resolution of persisting sequelae. Thus, primary single-course surgical procedures should be a priority, recognizing that complete recovery is almost always illusory.
Brignol
L
L
Service de Chirurgie Maxillo-faciale, Plastique de la face et Stomatologie, Hôpital Jean Minjoz, Besançon, France. l.brignol@caramail.com
Ricbourg
L
L
Meyer
C
C
Ricbourg
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications*; D002921:Cicatrix / Q000209:etiology; D003251:Constriction, Pathologic / Q000209:etiology; D004954:Esthetics; D005128:Eye Diseases / Q000209:etiology; D005146:Facial Asymmetry / Q000209:etiology; D005151:Facial Injuries / Q000150:complications* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009668:Nose Diseases / Q000209:etiology; D000857:Olfaction Disorders / Q000209:etiology; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016388:Tooth Loss / Q000209:etiology; D020433:Trigeminal Nerve Diseases / Q000209:etiology; D014786:Vision Disorders / Q000209:etiology