There is localized edema, hematoma or abscess within in the facial or scalp soft tissues, SMAS, infratemporal fossa, masticator space or oral cavity.   [Yes/No]

There is evidence of gas or a foreign body at a possible fracture site, indicative of an open or penetrating injury.   [Yes/No]

There is soft tissue swelling suggesting injury to the parotid or submandibular glands.   [Yes/No]

The upper airway is significantly narrowed or obstructed.   [Yes/No]

There is bony injury or displacement of the body, angle, ramus, parasymphyseal region, alveolar ridge, and condylar and coronoid process of the mandible. [In case of fracture, describe complexity and displacement].   [Yes/No]

There is entrapment of the muscles of mastication or other soft tissues by fractures of the coronoid process and/or zygomatic arch.   [Yes/No]

The condylar head and fossa as well as the temporomandibular joint space are fractured and/or dislocated.   [Yes/No]

There is condylar fracture either within or outside of the joint capsule, or with or without involvement of the articular surface of the condylar head.   [Yes/No]

There is evidence of radiodense intra-articular osteochondral fragments.   [Yes/No]

There is bony injury or displacement of the external auditory canal and/or other evidence of temporal bone injury.   [Yes/No]

There are dental fractures and/or missing or displaced teeth.   [Yes/No]

There is bony injury of the body, alveolar ridge, premaxilla, the infraorbital rim, the palatine or the frontal process of the maxillary bones on either side.   [Yes/No]

More specifically, there is bony injury of the medial wall or orbital floor, orbital - zygomatic complex and/or the fronto- naso-ethmoidal complex.   [Yes/No]

There is subperiosteal, epidural or subdural hematoma and/or pneumocephalus along the boney walls of the anterior or middle cranial fossa or elsewhere.   [Yes/No]

There is subarachnoid bleeding.   [Yes/No]

There is evidence of parenchymal brain injury.   [Yes/No]

The visualized portions of the cervical spine are abnormal for the patient’s age.   [Yes/No]