Imagine modalities in Maxillofacial trauma patients

1. HP GDC SHIMLA
DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY
By – Dr. Abhijeet – Kamble
JR I
Imaging Modalities in maxillofacial trauma
patient

2. CONTENTS :
o Introduction
o Imaging modalities

3. INTRODUCTION :
 Facial fractures account for a large number of emergency department visits in
India and are associated with substantial levels of morbidity and mortality
dueto damage to facial structures , associated complications .
 Facial fractures are commonly caused by blunt or penetrating trauma
sustained during RSA , assaults , work related accidents and falls .
 Diagnostic imaging of patients with maxillofacial trauma is most often an
essential component in proper evaluation and treatment .
 It aims to facilitate in an accurate diagnosis and assists with treatment and
thus is an essential for optimizing clinical outcome , both functional and
esthetics .

4. Various imaging modalities :
 Conventional (Plain) Radiography
 Tomography
 Panoramic radiography
 Computed tomography
 Three-dimensional computed tomography
 Magnetic resonance imaging

5. X-Ray evaluation approach

6.  For fracture middle this of face
1. Occipitomental view
2. Submentovertex view
3. Lateral skull
4. PA View
Projections for facial fractures :

7. For zygomatic complex fractures:
1. Occipitomental view
2. Submentovertex view
3. PA view
For Mandibular fractures :
- OPG
- Right and left lateral oblique view of mandible
- PA view of mandible

8. CT Scan : Gold standard in multiplanar
evaluation of midface trauma
1. Horizontal plane :
- Superior : Orbital roof
- Middle : Orbital roof
- Inferior : Hard palate
- 2 Saggital plane :
- Midline : Perpendicular plate of ethmoid
- Para saggital : Medial orbital walls
- Lateral : Lateral orbital walls
- 3 Coronal plane :
- Anterior : Anterior wall of frontal sinus
- Posterior : Posterior wall of maxillary antrum

9. MRI : soft tissue injury , CSF leak
 Recent advances
o Spiral and Multi slice CT
o 3D CT Scan

11. Mandibular fractures :
 A right and left oblique view
 PA view
 Lateral skull
 Towns with OPG of – Subcondyler , coronoid , ramus , angle , body , symphysis
and alveolar fracture .

12. Mandibular condyle :
 OPG
 PA Face
 Reverse town
 Transcranial
 CT

14. Maxilla and Zygoma :
 Occipitomental projection
 Waters view
 Occipitofrontal projection
 Submentovertex view of arch
 CT images **

16. Nose :
 Lateral view of face
 Occipitomental projection
Orbit :
 OM view “ Hanging drop ‘ ,
 CT in all 3 planes
- Floor : Coronal and saggital sections
- Roof : All 3 planes
- Lateral and medial walls : Axial and coronal sections

17. REFERENCES :
 Oral and maxillofacial trauma – Fonseca Vol I
 Maxillofacial injuries – Rowe and Williams
 Textbook of oral and maxillofacial surgery – Peter
ward booth .