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Invited Commentary
Jan/Feb 2016

Mandibular Fractures—Are We Asking the Right Questions?

Author Affiliations
  • 1Department of Otolaryngology, Medical College of Wisconsin, Milwaukee
JAMA Facial Plast Surg. 2016;18(1):19. doi:10.1001/jamafacial.2015.1549

“How is your occlusion?” “Where is your jaw pain?” These are the common questions we ask when evaluating a patient with mandibular trauma. But maybe what we should also be asking is “Do you have a headache?” “Have you been dizzy?” “How is your mentation?”

In this issue of JAMA Facial Plastic Surgery, Sobin et al1 raise the importance of concussion in isolated mandible fractures. In their prospective study of 16 adults with isolated mandibular fractures, 75% met the criteria for high risk for concussion, based on the Military Acute Concussion Evaluation (MACE). Sobin et al raise the concern that without associated life-threatening injuries, the possibility of concussion may be overlooked in cases of isolated mandible fractures. In their search of the Nationwide Inpatient Sample database, they found that only 5.6% of mandible fractures had a concurrent diagnosis of concussion. However, their prospective study shows that 75% of patients with isolated mandible fractures are at high risk of concussion.