The Imaging of

Maxillofacial Trauma
and its Pertinence to
Surgical Intervention
Nisha Mehta, MDa, Parag Butala, MDb,
Mark P. Bernstein, MDa,*

Radiol Clin N Am 50 (2012) 43–57

doi:10.1016/j.rcl.2011.08.005
0033-8389/12/$ – see front matter
2012 Elsevier Inc. All rights reserved.
Introduction
• Maxillofacial skeletal injuries account for a large
proportion of emergency department visits
• The goal of imaging studies in the trauma setting is
to define the number and location of facial
fractures, with particular attention toward
identifying injuries to functional portions of the
face and those with cosmetic consequence
Technology

MDCT
Plain
CT-scan (multidetector
radiograph
CT)
Nasal Fractures
• The nose is the most prominent facial projection.
• Consequently, nasal bone fractures account for
approximately 50% of all facial fractures, with the
majority involving the distal third of the nose
• Diagnosis is usually made clinically
NASO-ORBITAL-ETHMOID
FRACTURES
• bony confluence of the nose, orbit, maxilla, and cranium.
• thin medial orbital walls laterally,
• the sphenoid sinus posteriorly,
• the cribriform plate superiorly,
• the bony pillar (the frontal process of the maxilla, nasal
process of the frontal bone, and the thick proximal nasal
bones) anteriorly.
olfactory nerves,
the lacrimal sac,
the nasolacrimal duct,
the ethmoid vessels,
the medial canthal tendon.
• Once an anteriorly directed force is sufficient to
fracture the nasal bones, the posterior ethmoid air
cells offer little resistance and are easily fractured
with impaction and resultant telescoping.
• The fracture pattern then progresses from simple
nasal fracture into the NOE type, which additionally
involves the medial orbit, septum, and nasofrontal
junction. This pattern is most often seen in blunt
trauma directed at the nasal bridge.
• CT typically demonstrates blood in the ethmoid air
cells and impacted fractures in the NOE region
 ORBITAL FRACTURES
Seven bones make up the bony orbit: the frontal
bone, zygoma, maxilla, lacrimal bone, ethmoid
bone, sphenoid bone, and palatine bone.
ORBITAL FRACTURES
ORBITAL FRACTURES
ZYGOMA
MAXILLARY FRACTURES
• Facial buttressess
MAXILLARY FRACTURES
MAXILLARY FRACTURES
MANDIBULAR FRACTURES
Thank You