Learning objectives
To carry out a systematic approach to the imaging findings that are relevant on the craniofacial trauma diagnostic.
To perform a full and rapid radiological report since it´s a matter of emergency / urgency.
To identify the major fracture patterns: upper third,
middle third and lower third.
To describe the main anatomical structures and their corresponding subtype (for example,
in maxillo-malar fractures: LeFort 1,
LeFort 2 and LeFort 3).
Background
INTRODUCTION
Facial skeletal fractures are common and frequently associated with other life-threatening conditions,
such as traumatic brain injuries.
Although they represent serious injuries,
the workup and treatment of facial fractures is often properly delayed until more pressing problems have been addressed,
such as the establishment of an adequate airway,
hemodynamic stabilization,
and the evaluation and treatment of other more serious injuries of the head,
chest and skeleton.
Once these problems have been managed,
it is time to work up facial fractures.
COMMON CAUSES OF FACIAL...
Findings and procedure details
KEYS FOR DIAGNOSE FACIAL TRAUMA
Look at the orbits carefully,
since 60 – 70 % of all facial fractures involve the orbit in some way.
Know the normal anatomy (including buttresses).
Ver Fig. 5 .
Know the most common patterns of facial fractures and look for them.
Bilateral symmetry can be very helpful.
Carefully trace along the lines of Dolan when examining the Waters view in a facial series.
Ver Fig. 8 .
Use CT in working up facial fractures.
KEYS FOR FRONTAL SINUS FRACTURES...
Conclusion
The knowledge of the main anatomical structures involved in craniofacial fractures is essential for the performance of a proper radiological report.
To become familiar with the fracture patterns and anatomical structures more frequently involved.
This will allow us to be more confident when faced with this clinical situation which causes many doubts and stresses in the younger radiologists.
Personal information
Dra.
Mónica Orgaz Álvarez
Neuro-radiology section.
Department of Radiology,
Infanta Cristina University Hospital.
Avenida 9 de Junio,
nº 2.
CP: 28981,
Parla,
Madrid,
Spain.
E-mail:
[email protected]
Dra.
Verónica Gamero Medina
Breast section.
Department of Radiology,
Infanta Cristina University Hospital.
Avenida 9 de Junio,
nº 2.
CP: 28981,
Parla,
Madrid,
Spain.
E-mail:
[email protected]
References
1. Dreizin D,
Nam AJ,
Diaconu SC,
Bernstein MP,
Bodanapally UK,
Munera F.
Multidetector CT of Midfacial Fractures: Classification Systems,
Principles of Reduction,
and Common Complications.
RadioGraphics.
2018; 38:248-274.
2. Dreizin D,
Nam AJ,
Tirada N,
et al.
Multidetector CT of mandibular fractures,
reductions,
and complications: a clinically relevant primer for the radiologist..
RadioGraphics.
2016; 36(5):1539-1564.
3. Winegar BA,
Murillo H,
Tantiwongkosi B.
Spectrum of critical imaging findings in complex facial skeletal trauma.
RadioGraphics.
2013; 33(1):3-19.
4. Hopper RA,
Salemy S,
Sze RW.
Diagnosis of...