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​Craniofacial Fracture Types, Symptoms, and Treatment Options

Craniofacial fractures (broken bones in your face) can be minor or complex and can happen in many ways.

Learn about the treatment options for Craniofacial Fractures at the UPMC Pituitary Center of Excellence.

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What Is a Craniofacial Fracture?

A craniofacial fracture is a fracture to the face, orbits, and/or skull. Often, it is a consequence of direct trauma to the head and face region.

Depending on the extent of your fracture and your other injuries, you may need care from many UPMC specialists.

Common types of craniofacial fractures (facial fractures)

The most common craniofacial fractures we see are:

  1. Nasal bone: The most common type of craniofacial fracture, nasal bone fractures happen when the nose moves out of place from an impact.
  2. Cranial bone: This is a skull fracture to one or more of the eight cranial bones (frontal, parietal, temporal, occipital, sphenoid, and ethmoid).
  3. Mandible (lower jaw): A fracture of the lower jaw may make it hard to move the jawbone up and down to talk, chew, and breathe.
  4. Zygoma (cheekbone): A fracture to the arch of bones in the cheek may cause swelling to the face and tingling around the mouth.
  5. Orbital bones (around the eye): An orbital fracture is a fracture in a bone around the eye, including:
    • An orbital rim fracture affects the outer edges of the eye socket.
    • A blowout fracture affects the inner wall of the eye socket, pinching the nerve and keeping the eyeball from moving properly.
    • An orbital floor fracture pushes the bones around the eye socket downward and affects eye movement.
  6. Maxilla (upper jaw): There are three types of fractures to the upper fixed bones of the jaw:
    • LeFort I — a crack separates the upper jawbone and teeth from the other facial bones.
    • LeFort II — includes the upper jaw as well as the nasal bones.
    • LeFort III — includes the eye sockets and the bridge of the nose, and is known as craniofacial separation.

Complications from Craniofacial Fractures

Some craniofacial fractures have complications that need neurosurgical treatment:

  • A dislodged bone in the skull may compress the optic nerve and cause vision issues.
  • A fractured bone may tear the dura — the membrane that protects the brain — and cause a cerebrospinal fluid (CSF) leak.

UPMC experts treat both optic nerve compression and CSF leaks with the Endoscopic Endonasal Approach (EEA). This minimally invasive technique uses the nose and nasal cavities as natural access points for hard-to-reach areas or inoperable tumors.

Pros of EEA include:

  • No incision to heal.
  • No disfigurement.
  • Faster recovery time.

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Craniofacial Fracture Symptoms and Diagnosis

Craniofacial fracture symptoms

Symptoms of a craniofacial fractures include:

  • Concussion.
  • Dizziness.
  • Trouble concentrating.
  • Pain.
  • Vomiting.
  • Changes in vision.
  • Feeling faint or tired.

Diagnosing craniofacial fractures

Craniofacial fractures occur from direct trauma to the head and face. To diagnose a craniofacial fracture, your doctor my order imaging studies, such as:

  • CT scan.
  • X-rays.
  • MRI scan.

Your doctor may also do a neurological exam or exams of your ear or nose to check for cerebrospinal fluid (CSF) leaks.

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Craniofacial Fracture Treatments

At UPMC, we look at craniofacial fractures from every angle to find a treatment that will least disrupt your:

  • Brain.
  • Critical nerves.
  • Ability to return to normal functioning.

Minimally invasive surgery for craniofacial fractures

UPMC surgeons may use the Endoscopic Endonasal Approach (EEA) to repair CSF leaks or to decompress the optic nerve.

EEA lets surgeons see and fix your injury without making an incision. They do this technique through the nose and nasal cavities, and recovery is faster than with a traditional method.

Our neurosurgical team may suggest both surgery and non-surgical treatments for the best returns.

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