Membaca Radiologi Fraktur WajahSandy S.S.

Pemeriksaan fisik = deteksi paling sensitif

Rodriguez ED, Dorafshar AH, Manson PN. Facial fractures. In: Neligan PC, editor. Plastic surgery. 3rd ed. New York: Elsevier-Saunders, 2013. p. 51.

Anatomi

Anatomi

Anatomi

Foto Roentgen

AP, lateral, Waters, panoramik C-spine clear?

Hollier Jr L. Kelley P. Soft tissue and skeletal injuries of the face. In: Thorne CH, Beasley RW, Aston SJ, Bartlett SP, Gurtner GC, Spear SL, editor. Grabb & Smith’s plastic surgery, 6th ed. Philadelphia: Lippincott Williams & Wilkins, 2007. p. 317.

Foto Roentgen

Identitas Intensitas Scope Simetri

Fraktur vs sutura vs lekuk pembuluh darah

Dislokasi Opasitas abnormal

AP

Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2nd ed. Philadelphia: Elsevier-Saunders, 2005. p. 13-42.

Lateral

Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2nd ed. Philadelphia: Elsevier-Saunders, 2005. p. 13-42.

Proyeksi Towne

Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2nd ed. Philadelphia: Elsevier-Saunders, 2005. p. 13-42.

Waters

Head and soft tissues of face and neck. In: Mettler FA, editor. Essentials of radiology, 2nd ed. Philadelphia: Elsevier-Saunders, 2005. p. 13-42.

Panoramik

1. Zygomatic arch2. Maxillary sinus3. Pterygoid plate4. Nasal septum5. Articular eminence6. Glenoid fossa7. Mandibular condyle

8. Sigmoid notch9. Coronoid process10. Mandibular ramus11. Mandibular angle12. Mandibular body13. Mandibular canal14. Mental foramen

15. Mandibular symphysis16. Antegonial notch17. Hyoid bone18. Edentulous maxilla19. Edentulous mandible

Fraktur nasal

Foto waters(1) Fr nasal dg lateral displacement(2) Medial displacement dari proc.frontalis maxilla sin(3) Lateral displacement dari proc.frontalis maxilla dext(4) Septum deviasi

Fraktur zygoma

Foto Waters:(1)Fr zygomaticofrontal(2)Fr infraorbital(3)Fr proc.zygomaticus

dari os temporal(4)Gambaran radioopak

pd sinus maksilaris

Foto Waters: (1)Fr rima orbita inferior(2)Fr basis orbita(3)Air-fluid level pd sinus maksilaris.

Fraktur maksila

LeFort I: garis fraktur transversal sedikit di atas akar gigi dan melingkar sehingga memisahkan maxilla menjadi 2 fragmen

Fraktur maksila LeFort II (pyramidal

fracture): mirip Le Fort I pd bagian lateral kiri dan kanan makin ke medial seperti piramid melewati bagian medial orbita dan bertemu dg sisi sebelahnya

Maxillary Fracture LeFort III (craniofacial

dysjunction): melepaskan hub antara zygomaticofrontal junction, nasofrontal junction dan berlanjut kedasar orbita kesisi yang lain

(1)Fr horizontal dari midface (2)Fr dinding medial dari sinus

maksilaris (1)Garis fraktur yg menembus ddg anterior dari sinus maksilaris, (2) ddg posterior sinus maksilaris, dan (3) maloklusi

(1)Fr zygomaticofrontal bilateral(2)Fr pros.frontalis(3)Fr septum nasal(4)Fr infraorbital bilateral(5)Fr basis infraorbita dext

Garis fraktur yang melewati (1) sinus frontalis, (2) ethmoid, (3) sinus maksilaris dan (4) pterygoid

Fraktur mandibula

1. Condylar head or intracapsular fracture

2. Subcondylar fracture

3. Coronoid fracture4. Ramus fracture5. Angle fracture6. Body fracture7. Symphysis

fracture

(1)Fr ramus mandibularis komplit

(2)Fr angulus mandibularis komplit

Fraktur mandibularis komplit

Fraktur proc.coronoideus komplit Dislokasi TMJ

Foto Towne’s yang memperlihatkan fraktur ramus mandibularis bilateral

Fraktur proc.condylaris

(1) fraktur parasymphisis mandibula dan (2) fraktur ramus mandibula

Kasus

http://www.stritch.luc.edu/lumen/MedEd/Radio/curriculum/Neurology/Head_trauma2.htm

http://images.radiopaedia.org/images/25042/e3f99d2b616c9e4c6b8920b6f2ff10.jpg

Fraktur linear dan fraktur depresi

Dislokasi TMJ

Kasus

http://www.abstractsonline.com/EPosterViewer/MediaPreView.aspx?Ckey=%7B88399FA8-DBD5-4C24-A400-AB053E4E6946%7D&Mkey=%7B22FDF1E0-BB98-47D9-B084-94213A1B7D4D%7D

Fraktur blow out orbita dg fraktur dasar orbita

CT scan

Fraktur Jaringan lunak Hematoma Air fluid level Dinding orbita, otot ekstraokuler

3D: orientasi keseluruhan

Rodriguez ED, Dorafshar AH, Manson PN. Facial fractures. In: Neligan PC, editor. Plastic surgery. 3rd ed. New York: Elsevier-Saunders, 2013. p. 51.Hollier Jr L. Kelley P. Soft tissue and skeletal injuries of the face. In: Thorne CH, Beasley RW, Aston SJ, Bartlett SP, Gurtner GC, Spear SL, editor. Grabb & Smith’s plastic surgery, 6th ed. Philadelphia: Lippincott Williams & Wilkins, 2007. p. 317.

CT Scan

Densitas fokal ↑(perdarahan, ca, logam)/↓ (edema, stroke)

Simetri pola gyrus Midline shift Ukuran dan posisi ventrikel Sinus: cairan, massa Pembengkakan jaringan lunak Fraktur

http://w-radiology.com/skull-ct-anatomy.php

http://www.drstretch.net/graphics/reconstructive/ws_zygoma_Z_F_b.gifhttp://img.medscape.com/pi/emed/ckb/otolaryngology/834279-1048674-867687-1674168.jpg

Hematoma sinus maksilaris dxDiskontinuitas os maksilaris dx, sphenoid dx

CT scan 3D

3D reconstructionFraktur panfasial

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