Radigraphic Imaging in Maxillofacial Trauma

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RADIGRAPHIC EXAMINATION IN MAXILLOFACIAL TRAUMA

Transcript of Radigraphic Imaging in Maxillofacial Trauma

Page 1: Radigraphic Imaging in Maxillofacial Trauma

RADIGRAPHIC EXAMINATION IN MAXILLOFACIAL TRAUMA

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Radiological examination

Useful diagnostic aid.

Radiation cost

Financial cost

Urgency of the treatment.

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Projections for facial fractures

For fractures of middle third of the face

- Occipitomental view

- Submentovertex view

- Lateral skull

- PA view – water’s position

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For zygomatic complex fracture

- Occipitomental view

- Submentovertex view

- PA view – water’s position

For mandibular fractures

- OPG

- Right & left lateral oblique view of

mandible

- PA view of mandible

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Radiological interpretation of

facial trauma

You see what you look for…!!!!

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Occipitomental projection

Fractures & other signs are

commonly found.

Campbell’s and trapnell’s lines

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Dolan & Jacoby’s line

A) Orbital line.

B) Zygomatic line.

C) Maxillary line.

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4 ‘S’ by Delbalso et al

Symmetry.

Sharpness – Bright sign, Trapdoor sign.

Sinus.

Soft tissues.

foreign bodies, emphysema.

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HOT sites of fracture on

face.

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Radiographic signs of fracture.

Separation sign.

Sutural diastasis.

Overlap sign.

Abnormal linear density

Disappearing fragment sign.

Abnormal angulation.

Step deformity

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Indirect signs.

Soft tissue swelling.

localized – attention to that part

Paranasal sinus opacification.

Air in the soft tissues.

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CT scan

Provides images in thin slices,

avoid superimposition of

structures.

Increased contrast- foreign

bodies.

Axial CT scan – transverse

plane.

Coronal CT scan – orbital

examination

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MRI- soft tissue injury, CSF leak.

Recent advances

Spiral & Multislice CT

- Much faster & can provide 9 times larger image.

- High quality reconstruction.

3D CT scan.

Angiography, arthrography.

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Conclusion.

Surgical outcome

Treatment planning

Accurate diagnosis

Careful clinical examination

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References.

Oral & maxillofacial trauma- Fonseca,vol 1

Maxillofacial Injuries- Rowe & Williams

Textbook of oral & maxillofacial surgery by Peter

Ward Booth.

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