The Joint Facial and Invasive Neck Trauma (J-FAINT) Project, Iraq and Afghanistan 2003-2011

Alexandria, VA — With over 37,000 face and neck injuries in more than 7,000 military personnel during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF), a new study in Otolaryngology–Head and Neck Surgery concludes additional training in the management of these injuries and improvements in body armor could be beneficial.

The authors note that OIF and OEF have changed the way military surgeons approach facial and penetrating neck trauma. "This study highlights the need for a trained head and neck surgeon in the deployed environment to address these changes and manage the high number of injuries," according to the authors.

The increased use of improvised explosive devices (IEDs) and improvements in body armor have led to an increase in facial injuries in proportion to other parts of the body, the authors state.

"Exposed body areas not covered by modern body armor are especially susceptible to multiple injuries from IEDS. Despite the technological advancements in body armor, a lightweight, comfortable yet effective face and neck shield has not yet been developed."

Data were collected from the Joint Theater Trauma Registry (JTTR) database, which contains information on all U.S. service members who were injured during OIF and OEF. Service member demographics, types and causes of injuries, intubations, surgical procedures, and other data were reviewed. The majority of those injured were in the Army (75%), with the Marine Corps, Navy, and Air Force at 20.5%, 2.5%, and 2.0%, respectively. Seventy-three percent of the injuries were incurred during OIF.

While males made up 97.5 percent of injured service members and the most common type of injury was penetrating, those least likely to survive their injuries were female and had blast injuries. Other risk factors were treatment at a level IIa facility and intubation before entering the hospital. Most face and neck injuries ranged from mild to moderate.

The authors also provide suggestions for training, treatment, and prevention of face and neck injuries. Tailoring the amount and kinds of training to the most commonly seen types of injuries and making sure surgeons are comfortable performing these surgeries, as well as designing body armor that better protects the face and neck, are important factors of survival.

This particular study "highlights the need for a trained head and neck surgeon in the deployed environment to address changes and manage the high number of injuries." The authors hope "that this study can help guide predeployment training for U.S. medical personnel who contribute to the management of patients with facial and penetrating neck trauma."

Otolaryngology–Head and Neck Surgery is the official scientific journal of the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNSF). The study's authors are Brent A. Feldt, MD; Nathan L. Salinas, MD; Todd E. Rasmussen, MD and Joseph Brennan, MD. Reporters who wish to obtain a copy of the study "The Joint Facial and Invasive Neck Trauma (J-FAINT) Project Iraq and Afghanistan 2003-2011" should contact Mary Stewart at 1-703-535-3762, or newsroom@entnet.org.

About the AAO-HNS

The American Academy of Otolaryngology—Head and Neck Surgery, one of the oldest medical associations in the nation, represents approximately 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The organization's vision: "Empowering otolaryngologist-head and neck surgeons to deliver the best patient care."