• James Chan, Michelle A Putnam, Paul J Feustel, and Peter J Koltai.
• Department of Otolaryngology and Communicative Disorders, The Cleveland Clinic Foundation, A71, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
• Int. J. Pediatr. Otorhinolaryngol. 2004 Jul 1; 68 (7): 877-81.

ObjectiveTo provide clinical evidence to support the age dependent relationship between facial fractures and skull fractures.DesignRetrospective chart review of all children and adults admitted with combined facial fractures and skull fractures and skull fractures alone between January 1991 and November 1997.SettingThe Albany Medical Center Hospital, a tertiary level-one trauma center.PatientsTwo hundred and one children, ages 1 month to 17 years, with skull fractures (frontal, parietal, or temporal), and 41 children with concurrent facial fractures were included in this study. One hundred and thirty-nine adults, ages 18-90 years, with skull fractures, and 70 adults with concurrent facial fractures were also studied.Outcome MeasuresThe gender, age, skull fracture, facial fracture, Glasgow coma score (GCS), mechanism of injury, and outcome of all patients admitted with frontal, parietal, or temporal fractures with or without facial fractures.ResultsThere are a significantly greater (P < 0.001) number of facial fractures associated with skull fractures among adults as compared to children. Moreover, there is an exponential rise in facial fractures associated with skull fractures between infancy and adolescence. The GCS of children with combined facial and skull fractures is significantly lower than in those with skull fractures only (P < 0.001).ConclusionThe spectrum of craniofacial injuries is related to the specific developmental stage of the craniofacial skeleton. This is demonstrated by the variable pattern of combined facial and skull fractures observed clinically in children and adults.

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