Bagheri et al reported a Facial Injury Severity Scale (FISS) for patients who have had craniomaxillofacial trauma. The authors are from Legacy Emanuel Hospital in Portland, Mayo Clinic, and Oregon Health & Sciences University in Portland.
Parameters:
(1) facial laceration
(2) upper facial injuries (fracture orbital roof/rim, fracture into frontal sinus)
(3) injuries to the mid-face (dento-alveolar, fractures)
(4) injuries to the mandible (dento-alveolar, fractures)
Parameter |
Finding |
Points |
facial laceration |
<= 10 cm |
0 |
|
> 10 cm |
1 |
fracture of the orbital roof or rim |
absent |
0 |
|
present |
1 |
fracture into frontal sinus or bone |
absent |
0 |
|
nondisplaced |
1 |
|
displaced |
5 |
dento-alveolar injury of the maxilla |
absent |
0 |
|
present |
1 |
Le Fort fracture |
none |
0 |
|
unilateral type I |
1 |
|
bilateral type II |
2 |
|
unilateral type II |
2 |
|
bilateral type II |
4 |
|
unilateral type III |
3 |
|
bilateral type III |
6 |
naso-orbital-ethmoid (NOE) fractures |
none |
0 |
|
present |
3 |
zygomatico-maxillary complex (ZMC) fracture |
absent |
0 |
|
present |
1 |
nasal fracture (alone) |
absent |
0 |
|
present |
1 |
dento-alveolar injury of mandible |
absent |
0 |
|
present |
1 |
fracture of mandibular body, ramus and/or symphysis |
absent |
0 |
|
present |
2 * <number> |
fracture of mandibular subcondyle, condyle or coronoid process |
absent |
0 |
|
present |
<number> |
where:
• It is unclear facial laceration is based on any over 10 cm or the absolute number.
• Subcondylar fractures of the mandible are graded with the condyle in the text on page 410.
total score =
= SUM(points for all of the injuries present)
Interpretation:
• minimum: 0
• maximum: probably over 25 (influenced by the total number of fractures)
• The maximum FISS reported by Bagheri et al was 13.
Purpose: To evaluate a patient with craniomaxillofacial injuries using the Facial Injury Severity Scale (FISS) of Bagheri et al.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Otolaryngology
Objective: severity, prognosis, stage
ICD-10: S00-S09,