American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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Facial nerve injury can be a complication of which type of fracture?

  1. Zygomatic fracture

  2. Maxillofacial fracture

  3. Mandibular fracture

  4. Nasal fracture

The correct answer is: Maxillofacial fracture

Facial nerve injury is a recognized complication that can occur with maxillofacial fractures. This type of fracture involves the bones of the face, including the zygomatic arch, maxilla, mandible, and nasal bones. The facial nerve (cranial nerve VII) runs close to several of these anatomical structures, particularly the mandible and the region of the zygomatic bone. In maxillofacial trauma, the facial nerve can be directly affected due to its proximity to these bones or indirectly injured as a result of swelling, hematoma formation, or displacement of bone fragments that impinge on the nerve. The risk of injury is higher in complex fractures that disrupt the facial skeleton's continuity and can lead to various degrees of facial motor dysfunction. While other types of fractures, such as zygomatic and mandibular fractures, can also pose a risk for facial nerve injury, maxillofacial fractures encompass a broader range of facial structures, inherently increasing the likelihood of nerve involvement due to more extensive disruption of the facial anatomy. Nasal fractures, on the other hand, typically do not involve significant structures in close proximity to the facial nerve and consequently have a lower risk of nerve injury.