Skin Examination:
Determining whether the individual receives sufficient oxygen and determining the location of the trauma plays a role in detecting cyanosis.
Head and Neck Examination:
If there is a simple laceration or abrasion, a penetrating cranial injury may be encountered below. It should be requested on cervical radiography.
Examination of the Eyes:
While periorbital ecchymoses occur due to local traumas, anterior fossa traumas should also be considered. Rhinorrhea indicates ethmoid fractures and the presence of pupillary edema indicates increased intracranial pressure.
Ears :
Blood and cerebrospinal fluid coming from the ear canal suggest a skull base fracture.
Nose :
If cerebrospinal fluid occurs, an ethmoid fracture should be considered. Different pupillary levels suggest orbital or zygoma fractures.

UPPER JAW, FACE FRACTURES AND TREATMENT

There are great differences in shape, condition and structure between the bones that make up the head skeleton and the trunk and surrounding bones. This morphological privilege arises from the differences in the functions of the bones. Except for the mandible and inner ear bones, all other skull bones are connected to each other with immobile joints. The facial bones are flat and thin and there are sinuses between them.The head skeleton is divided into two parts according to the organs they contain. The part that contains the brain, which consists of a large cavity, is called neurocranium, and the part that borders the mouth and nasal cavities and surrounds the organs that perceive the sense of sight, taste and smell is called splanchnocranium. The splachnocranium, which forms the facial skeleton, is embryologically formed partly from the cartilage drafts in the pharyngeal arches and partly from embryonic connective tissue covering these parts, as in the neurocranium. The facial bones protect the brain against trauma like a shock absorber system. Without this buffer system, the majority of head traumas would result in death. As a result of trauma, the facial bones undertake the protection of important organs even at the cost of fracture themselves. Depending on the severity and direction of the trauma, various facial bone fractures occur. Especially today, various fractures involving the facial bones occur as a result of traffic accidents that increase due to the development of technology and increasing speed. In addition to automobile accidents, other etiological causes include sports accidents, home accidents, work accidents, fights and gunshot wounds. Fractures resulting from these traumas can be listed as follows according to the frequency of occurrence. Nasal fractures, zygomatic bone fractures, mandibular fractures, orbital base fractures, maxilla fractures, dental fractures, sinus injuries, supraorbital fractures, alveolar fractures, nasoethmoid fractures. Therefore, many secondary deformities occur as a result of incorrect or inadequate treatment.

GENERAL RULES FOR FACE FRACTURES

As a general rule, life-threatening causes (bleeding, airway obstruction, etc.) are urgently eliminated in patients with facial injuries. Then, the displaced ends of the fracture are reduced and brought to their normal anatomical position and if necessary, ataxation is applied. Reduction can be performed manually or in cases of failure, fractures are treated by open reduction with surgical interventions. Either extraoral or intraoral route is used to reach the fracture site. The scar that will remain on the face in extraoral interventions and the risk of infection in intraoral interventions should be discussed and evaluated and the most appropriate route should be chosen. Currently, wide open reduction, rigidification with plates and screws and repair with bone grafts when necessary is the most appropriate treatment method for maxillofacial region fractures. During surgical interventions, if the soft tissue relations of the fractured bone fragments are intact, these fragments must be replaced and the fractured bone fragments must be covered with healthy soft tissues. If there is a tooth in the fracture line and the mucosa is torn and the fracture line is opened into the mouth, the tooth must be removed. Simple fractures should be repaired under local anaesthesia, complicated fractures should be repaired under general anaesthesia and in the operating theatre. Time factor is also important in facial bone fractures. Early treatment should be performed within the first 48 hours after the injury.