the same results [Hill et al. 1984 (83%); Probst and Tomaschett 1990; Neidhardt 2002 (92%)]. Within our own trauma victims, the ratio of men to women was 11: 1 (Neidhardt 2002).

5.7  Associated Injuries

Of the patients with facial trauma, 50–70% show associated injuries (Gwyn 1970; Dufresne et al. 1992; Serletti and Manson 1992; Lehmann et al. 2001).

5.7.1  Thoracic, Abdominal, and Cervical

Spine Injuries

Complicated polytrauma occurs in approximately 25% of all panfacial fractures. Nine percent of the cases concern abdominal and thoracic trauma (Smith and Bradley 1986; Schilli and Joss 1991; Shockley 1993). Twenty percent of the polytraumatic cases have additional injuries of the extremities (Joos et al. 2001). Approximately 10% have additional fractures in the cervical spine (Fig. 5.3).

Fig. 5.3  Extended cervico-thoracic emphysema after tearing of the trachea in a mandibular and midface fracture. (a) Lateral cephalogram: comminuted and displaced fracture of the mandible and prevertebral collection of air (arrow). (b) CT scan:

emphysema spreading through the neck and into the spinal canal (arrow). (c) CT scan: cervical emphysema and asymmetry of thyreoid cartilage and air collection within the parapharyngeal soft tissues (arrow). (d) CT scan: Mediastinal air collectionl (arrow)