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How To Evaluate a Facial Trauma CT
How To Evaluate a Facial Trauma CT
Axial
Frontal
Nasal
Lamina Paprycea
Zygomatic Arches
Pterygoid Plates
Mandibular Bodies
Sagittal
Zygomatic Arch
Mandibular Ramus/Angle
Orbital Roof/Floor
Odontoid
Coronal
Mandibular Ramus/Condyles Pterygoids Orbital Rims
Nasal
Facial fractures- classification and highlights for a useful report.pdfFacial fractures- classification and highlights for a useful report
Facial fractures- classification and highlights for a useful report
Images for a quick review. Please visit the site for a more thorough evaluation
Images for a quick review. Please visit the site for a more thorough evaluation
Other Review Areas & Anatomy
Other Review Areas & Anatomy
If there is a nasal/ FPM fracture, check the anterior nasal spine.
If there is a nasal/ FPM fracture, check the anterior nasal spine.
12 lamina papyracea, 28 nasal bone , 53 nasal process of the maxilla, 46 zygomatic arch, 90 body of mandible, 87 ramus of mandible
12 lamina papyracea, 28 nasal bone , 53 nasal process of the maxilla, 46 zygomatic arch, 90 body of mandible, 87 ramus of mandible
1 nasal bone of the xxx
1 nasal bone of the xxx
5 nasal process of the maxilla
5 nasal process of the maxilla
90 condylar neck of the mandible
90 condylar neck of the mandible
85 ramus of the mandible
85 ramus of the mandible
81 angle of the mandible
81 angle of the mandible
73 mandibular canal
73 mandibular canal
Inferior alveolar canal (mandibular canal): May be damaged in mandible fractures
Inferior alveolar canal (mandibular canal): May be damaged in mandible fractures
The mandibular canal, also known as the inferior alveolar canal (IAC), is located within the internal aspect of the mandible and contains the inferior alveolar nerve, artery and vein.
Example of a classic fracture and description. Unsure of reference.
Orbital Wall Fractures
Orbital Wall Fractures
Medial orbital wall and orbital floor blow-out fracture
Medial orbital wall and orbital floor blow-out fracture
Blow-out fractures in right orbit medial wall extended within related right side ethmoid roof and orbit floor with orbital fat and medial rectus muscle entrapment with intraconal and extraconal and eyelids preseptal emphysema are seen. Note also submucosal hemorrhage in right side maxillary and ethmoid sinuses.
Lateral orbital wall blow-in fracture and concomitant orbital floor and maxillary sinus wall fracture
Lateral orbital wall blow-in fracture and concomitant orbital floor and maxillary sinus wall fracture
The lateral orbital wall fracture is usually comminuted and associated with maxillary sinus wall fracture which leads to deformity of the face in turn. The shortening of the lateral orbital wall and inwardly displaced fractured bone can lead to dysfunctional eyelids and lateral rectus muscledysfunction respectively
Inferior orbital wall blowout fracture with inferior rectus muscle displacement
Inferior orbital wall blowout fracture with inferior rectus muscle displacement
Orbital floor fracture with displacement of orbital fat and inferior rectus muscle into the maxillary sinus. The globe is intact.
Although the inferior rectus muscle is displaced into the maxillary sinus "entrapment" of the muscle is assessed clinically.
Superior orbital roof blowout fracture with intact orbital rim
Superior orbital roof blowout fracture with intact orbital rim
Isolated superior orbital roof blowout fracture with an intact orbital rim. The superior orbital roof is elevated with an acute conal/extraconal hematoma involving the superior rectus/levator palpebrae superioris muscles and contusion of the orbital gyrus of the right frontal lobe. Marked periorbital soft tissue hematoma and a minimally displaced right nasal bone is also noted.
Nasal Bone Fracture
• Cause: Blunt trauma to the nose
• Associated Fractures:
• Nasal Septal
• Orbital Blowout
• Frontal Process of Maxilla
• Complications to Look For:
• Nasal Septal Hematoma
Naso-Orbitoethmoid (NOE) Fracture
• Definition: Facial fracture involving the nasal bones, medial orbit, nasal septum, and nasofrontal junction.
• Key Feature:
• Fracture at the medial orbital rim where the medial canthal tendon inserts.
• Inferomedial orbital rim fracture at the lacrimal fossa implies disruption of this tendon.
Isolated Zygomatic Arch Fracture
• Management: No operative intervention unless:
• Severe depression
• Depressed arch impinging upon the mandible
• Complications to Look For:
• Fragment impingement upon the coronoid process of the mandible
Zygomaticomaxillary Complex (ZMC) Fracture
• Cause: Anterolateral impact to the cheek, separating the zygoma along its sutural attachments.
• Three Components:
• Zygomatic arch ± diastasis of the temporozygomatic suture
• Fracture of the inferior orbital rim, anterior and posterior maxillary sinus walls
• Lateral orbital rim ± diastasis of the frontozygomatic suture
Orbital Blowout Fracture
• Mechanism: The orbital walls “blow out” from their anatomic position.
• Types:
• Inferior (Floor) – Most common
• Medial Wall (Lamina Papyracea)
• Superior (Roof)
• Lateral Wall
• Complications:
• Inferior (Floor): Inferior rectus entrapment
• Superior (Roof): CSF leak, meningitis
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