Abstract

Introduction  : Maxillofacial trauma is a special trauma because it can cause impairment of a number of important functions on the face. Patients with maxillofacial trauma are highly at risk for head and neck injury. Facial Injury Severity Scale (FISS) is a clinical assessment system to look at the severity of maxillofacial trauma, predict the prognostic value of maxillofacial trauma patients and as a research tool. The purpose of this study was to determine the relationship between Facial Injury Severity Scale (FISS) with head injury and neck injury at RSUP H. Adam Malik Medan.

Methods         : This design of this study is an analytical study with cross sectional design. 31 patients who were diagnosed of having concomitant maxillofacial and head injury by appropriate skull X-Ray and CT Scan of brain were included in this study. Maxillofacial trauma patients who were experienced with hematoma, excoriation and had normal investigative results did not participate in the study. Information’s based on age, sex, mode of injury, pattern of facial and head injury, GCS score and type of head injury was  taken for each case. The variables in this study were FISS and head injury. Variable head injuries are divided into intracranial lesions and GCS. The data between FISS and GCS were analyzed with Spearman correlation test and to assess the relationship of FISS with intracranial lesions using ANOVA test.

Results           : 31 maxillofacial trauma patients which consist of 23 (74.2%) males participated in this study. Mean ± SD of patient’s age was 25.84 ± 11.45.  The FISS scores was calculated for each patient (average FISS: 3.00 ± 1.43, range 1 to 6. Mandible was the most commonly fractured facial bone (38,7%). Majority of the patients had mild head injury (87,1%) and there was no cervical injury was present in all patients (100%). The most frequent etiology was due to traffic accidents, especially motorcyclists as many as 30 (96.7%) patients and did not wear helmet in 26 (83.9%) patients. The highest mean FISS patients based on the type of head injury was in mild head injury group (3.07 ± 1.46). The highest mean FISS was in the EDH group (4.00 ± 1.00) and open depressed fracture with pneumocephalus (4.00 ± 1.45). Spearman correlation test between FISS and GCS didn’t give statistically significant result and showed low correlation (r = 0,276, p = 0,133). The relation between FISS and intracranial lesions did not show significant result (p = 0,501).

Conclusion     : Of 31 subjects with maxillofacial injury, 31 (100%) patients had head injury and none of the patients had cervical injury with a mean FISS score of 3.00 ± 1.43. From the statistical analysis using ANOVA test, it is found that there is no relationship between FISS and intracranial lesion with p> 0,05 (p = 0,501) and there is no relationship between FISS and GCS with p> 0,05 (p = 0,713).

Keyword        : Maxillofacial injury, FISS, facial fracture, head injury, cervical injury