Radigraphic Imaging in Maxillofacial Trauma
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Transcript of Radigraphic Imaging in Maxillofacial Trauma
RADIGRAPHIC EXAMINATION IN MAXILLOFACIAL TRAUMA
Radiological examination
Useful diagnostic aid.
Radiation cost
Financial cost
Urgency of the treatment.
Projections for facial fractures
For fractures of middle third of the face
- Occipitomental view
- Submentovertex view
- Lateral skull
- PA view – water’s position
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
Radiological interpretation of
facial trauma
You see what you look for…!!!!
Occipitomental projection
Fractures & other signs are
commonly found.
Campbell’s and trapnell’s lines
Dolan & Jacoby’s line
A) Orbital line.
B) Zygomatic line.
C) Maxillary line.
4 ‘S’ by Delbalso et al
Symmetry.
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 density
Disappearing 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 scan
Provides 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.
Surgical outcome
Treatment planning
Accurate diagnosis
Careful clinical examination
References.
Oral & maxillofacial trauma- Fonseca,vol 1
Maxillofacial Injuries- Rowe & Williams
Textbook of oral & maxillofacial surgery by Peter
Ward Booth.