When to Seek Medical Care
A doctor should check all people with facial trauma. In the event of massive trauma, call 911.
For any other significant facial injury, you can either go to a hospital emergency department or see your own doctor.
Any of the the following symptoms need to be evaluated by a doctor:
- Clear nasal discharge
- Loss of consciousness
- Any visual disturbance such as double or blurry vision
- Any hearing problem
- Inability to bring teeth together
- Pain with jaw movement
- Altered sensation on the face
- Face uneven (asymmetrical)
- Open wounds with visible bone
Exams and Tests
The exam and the types of tests that are used depend on the type of injury you have.
Even if you have an injury to your nose, it is rare that X-rays will be needed to guide the treatment. A nasal fracture is usually diagnosed by physical exam. The initial care for a nasal injury does not change even if you have a fracture.
If a fracture of the bones high up inside the nose (ethmoid bones) is suspected, the doctor may order a CT scan.
Jaw (mandibular) fracture
If you have a possible jaw fracture, your doctor may order an X-ray. Sometimes a special dental X-ray machine may be used to help in the diagnosis. Not all hospitals have this equipment.
Midface (maxillary) fracture
Because they are most often caused in car accidents, fractures of your midface are often associated with other significant, potentially life-threatening injuries. So diagnosing a facial fracture is often not the most important part of your early treatment.
After you are stabilized, a CT scan of the face is the most useful imaging test for checking for a midface fracture.
Cheekbone (zygomatic) fracture
If you are evaluated right away, the doctor can usually diagnose a cheekbone fracture by physical exam. This becomes more difficult with time because of swelling.
Special X-ray views of the zygomatic bone are often helpful. If you have a severe fracture involving other bones of the face, your doctor may also order a CT scan to get more information.