title: Investigation of the relationship between facial injuries and traumatic brain injuries using a realistic subject-specific finite element head model.
abstract: In spite of anatomic proximity of the facial skeleton and cranium, there is lack of information in the literature regarding the relationship between facial and brain injuries. This study aims to correlate brain injuries with facial injuries using finite element method (FEM). Nine common impact scenarios of facial injuries are simulated with their individual stress wave propagation paths in the facial skeleton and the intracranial brain. Fractures of cranio-facial bones and intracranial injuries are evaluated based on the tolerance limits of the biomechanical parameters. General trend of maximum intracranial biomechanical parameters found in nasal bone and zygomaticomaxillary impacts indicates that severity of brain injury is highly associated with the proximity of location of impact to the brain. It is hypothesized that the midface is capable of absorbing considerable energy and protecting the brain from impact. The nasal cartilages dissipate the impact energy in the form of large scale deformation and fracture, with the vomer-ethmoid diverging stress to the "crumpling zone" of air-filled sphenoid and ethmoidal sinuses; in its most natural manner, the face protects the brain. This numerical study hopes to provide surgeons some insight in what possible brain injuries to be expected in various scenarios of facial trauma and to help in better diagnosis of unsuspected brain injury, thereby resulting in decreasing the morbidity and mortality associated with facial trauma.
authors: Department of Mechanical Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore 117576. Electronic address: tsekm.research@yahoo.com.
authors: Kwong Ming
authors: KM
authors: Tse
authors: Department of Mechanical Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore 117576.
authors: Long Bin
authors: LB
authors: Tan
authors: Division of Plastic, Reconstructive and Aesthetic Surgery, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074.
authors: Shu Jin
authors: SJ
authors: Lee
authors: Department of Mechanical Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore 117576.
authors: Siak Piang
authors: SP
authors: Lim
authors: Department of Mechanical Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore 117576; National University of Singapore (Suzhou) Research Institute, 377 Lin Quan Street, Suzhou Industrial Park, Jiangsu 215123, People's Republic of China. Electronic address: mpeleehp@nus.edu.sg.
authors: Heow Pueh
authors: HP
authors: Lee
mesh_terms: D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000209:etiology* / Q000503:physiopathology*; D003198:Computer Simulation; D005147:Facial Bones / Q000293:injuries*; D005151:Facial Injuries / Q000150:complications*; D020342:Finite Element Analysis; D006801:Humans; D008954:Models, Biological
keywords: Blunt impacts; Concomitant injury; Facial trauma; Finite element; Traumatic brain injury (TBI)