Clinical & Radiographic Evaluation Of Maxillofacial Injuries

RADIGRAPHIC EXAMINATION IN MAXILLOFACIAL TRAUMA

Dr ARJUN SHENOYRadiological examinationUseful diagnostic aid.

Radiation cost

Financial cost

Urgency of the treatment.Projections for facial fracturesFor fractures of middle third of the face

Occipitomental viewSubmentovertex viewLateral skullPA view waters position

For zygomatic complex fracture

Occipitomental viewSubmentovertex viewPA view waters position

For mandibular fractures

OPGRight & left lateral oblique view of mandiblePA view of mandible

Radiological interpretation of facial traumaYou see what you look for!!!!Occipitomental projection

Fractures & other signs are commonly found.

Campbells and trapnells linesDolan & Jacobys lineOrbital line. B) Zygomatic line.

C) Maxillary line.

4 S by Delbalso et alSymmetry.

Sharpness Bright sign, Trapdoor sign.

Sinus.

Soft tissues. foreign bodies, emphysema.

HOT sites of fracture on face.

Radiographic signs of fracture.Separation sign.Sutural diastasis.Overlap sign.Abnormal linear densityDisappearing fragment sign.Abnormal angulation.Step deformity

Indirect signs.Soft tissue swelling. localized attention to that part

Paranasal sinus opacification.

Air in the soft tissues.CT scanProvides images in thin slices, avoid superimposition of structures.Increased contrast- foreign bodies.Axial CT scan transverse plane.Coronal CT scan orbital examination

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.

Conclusion.References.Oral & maxillofacial trauma- Fonseca,vol 1

Maxillofacial Injuries- Rowe & Williams

Textbook of oral & maxillofacial surgery by Peter Ward Booth.