maxillo'

    Cards (18)

    • Maxillofacial fractures

      Physical trauma to the face resulting in laceration, bruises, and fractures of the facial bones
    • Types of maxillofacial fractures

      • Nasal fracture
      • Zygoma & Malar fracture
      • Frontobasal fracture
      • Orbital fracture
      • Mandibular fracture
    • Facial buttresses

      • Maintain the height, width and projection of the face
    • Nasal bone fracture

      Fracture of the nasal bones
    • Diagnosis of nasal bone fracture

      • Radiograph (lateral and sinus projection)
      • CT-scan (severe trauma & evidence of other facial fractures)
    • Nasal bone fracture

      • Normal
      • Plain radiograph
      • CT-scan
    • Management of nasal bone fracture

      1. Assessment of ABC
      2. Topical decongestants
      3. Cold packs
      4. Anterior bleeding (cauterization using silver nitrate)
      5. Anterior nasal packing
    • Timing of reduction

      • Re-examine the patient 2-3 days later after swelling has decreased
      • Ideally, reduction is done before 10 days after trauma
      • After 10 days (development of fibrous connective tissue within the fracture line)
    • Reduction techniques

      • Observation (for non displaced fractures)
      • Closed (simple injuries, unilateral with medial displacement)
      • Open (severe injuries, bilateral, depressed fracture with septal and cartilagenous involvement)
    • Lateral midface fracture
      Fracture caused by blunt trauma to the lateral side of the face, affecting the maxillary sinus, bony orbit, zygoma or zygomatic arch
    • Blow-out fracture
      Isolated fracture of the orbital floor with partial herniation of the orbital contents into the maxillary sinus
    • Symptoms of lateral midface fracture
      • Facial asymmetry (fracture of the zygoma)
      • Limited mouth opening (depression of the zygomatic arch)
      • Diplopia (orbital floor fracture)
      • Sensory disturbances (cheek, ipsilateral upper lip, lateral nasal wall, infraorbital nerve affected)
    • Treatment of lateral midface fracture

      • Observe (undisplaced, asymptomatic fracture)
      • Surgery (reduction and fixation using miniplates, intraosseous wiring or both) (displaced, symptomatic fracture)
    • Central midface fractures

      Le Fort fractures - types of facial fractures involving the maxillary bone and surrounding structures
    • Types of Le Fort fractures
      • Le Fort I (Guerin) - extends from the pyriform aperture through the lateral maxillary and lateral nasal walls to the posterior region
      • Le Fort II (Pyramidal) - extends from the pterygoid region, zygomaticomaxillary buttress, medial portion on the infraorbital rim, lacrimal bone, medial wall of the orbit towards the dorsum
      • Le Fort III (Craniofacial Dysjunction) - entire mass of the facial bones is separated from the cranial base
    • Symptoms of central midface fractures
      • Le Fort I: Swelling of the upper lip, malocclusion, mobile palate
      • Le Fort II: Edema of the midface, epistaxis, CSF rhinorrhea, diplopia, dish face deformity, bilateral subconjuctival hemorrhage
      • Le Fort III: Tenderness on the fronto-zygomatic suture, lengthening of the face, depression of ocular levels, enopthalmos, diplopia
    • Diagnosis of central midface fractures
      • Physical examination (otoscopy, rhinoscopy & endoscopy, palpation of facial bones, oral cavity exam, ophthalmologic exam)
      • Imaging studies (plain radiograph, PNS CT scan with 3D reconstruction)
      • Other tests (glucose test, beta 2 transferrin test, olfactory testing, hearing and balance tests)
    • Treatment of central midface fractures
      • Stabilize the patient
      • Fixation of unstable fracture segments to stable structure
      • Surgery
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