Maxillofacial Trauma

Question 1

Problems in the Airways

Answer 1

• Swelling
• Hemorrhage
• Fracture

Question 2

Problems in Shock

Answer 2

• Hypovolemia
• Pain

Question 3

Other Probkems in Maxillofacial Trauma

Answer 3

• Consciousness
• Cervical Vertebral Injuries

Question 4

Priorities Maxillofacial Trauma

Answer 4

• Circulation/hemorrhage
• Airway
• Shock
• Associated injuries which may be life-threatening
• Local injuries
• Triage of facial injuries

Question 5

Causes of Airway problems

Answer 5

• Tongue falls back
• Dentures, blood clots, aspiration
• Direct laryngeal trauma
• Multiple facial fractures

Question 6

• The central face has many fragile bones that could easily
be crushed when subjected to strong forces.
• They are surrounded by thicker bones of this system lending it some strength and stability.

Answer 6

Facial Buttresses

Question 7

2 Components of Buttress System

Answer 7

• Vertical
• Horizontal

Question 8

Bones of the Maxillofacial

Answer 8

• Nasal
• Lacrimal
• Inferior nasal concha
• Maxilla
• Mandible =1
• Sphenoid =1
• Palatine
• Ethmoid =1
• Zygomatic
• Vomer =1

Question 9

Vertical buttresses consists

Answer 9

• Nasomaxillary
• Zygomaticomaxillary
• Pterygomaxillary
• Vetical mandible

Question 10

Horizontal buttresses consists

Answer 10

1. Fontral bar
2. Infraorbital rim & nasal bones
3. Hard palate & maxillary alveolus

Question 11

• Resist occlusal load
• Interconnect and provide support for above question

Answer 11

• Vertical Buttresses
• Horizontal buttresses

Question 12

Most frequent traumatized bone
• Related to septal fracture
• Signs:
- Septal deviation/deformity
- Epistaxis
- Nasal obstruction
- Crepitation
• Management:
- X-ray and Closed reduction

Answer 12

Nasal bone

Question 13

• 2nd to nasal bone
• Parts:
  • Symphysis
  • Parasymphysis
  • Body
  • Angle
  • Ramus
  • Coronoid
  • Condyle
  • Alveolus

Answer 13

Mandible

Question 14

Protrusor muscles of the Mandible

Answer 14

Lateral pterygoid

Question 15

Elevator mmuscles of the Mandible

Answer 15

• Temporalis
• Masseter
• Median pterygoid
• Lateral pterygoid

Question 16

Depressor- retractor muscles of the Mandible

Answer 16

• Digastric
  -Geniohyoid
• Genioglossus
• Mylohyoid

Question 17

Types of fracture
- Muscle forces tend to keep fragments together
- Pull fragments apart

Answer 17

• Favorable
• Unfavorable

Question 18

Signs and symptoms
• Trismus
• Asymmetry
• Malocclusion
• Step-down deformity
• Paresthesia
• Sublingual hematoma
• Pain and tenderness
• Tooth loosening

Answer 18

Mandible

Question 19

Mandible
Diagnostics:

Answer 19

• Towne’s view X-ray
• Panoramic X-ray

Question 20

Mandible

Management:
Goals:

Answer 20

Management:
• Closed reduction
• Open reduction and Internal fixation

Goals:
• Restore occlusion
• Immobilize the mandible
• Maintain nutrition
• Avoid infection

Question 21

Maxillary fracture
Classifications

Answer 21

• LeFort I/Guerin fracture
• LeFort II/Pyramidal fracture
• LeFort III/Craniofacial dysjunction

Question 22

• are fractures of the mid face
• they collectively involve separation of all or a portion of the mid face from the skull base
• the pterygoid plate of the sphenoid bone needs to be involved as they connect to the mid face to the sphenoid bone dorsally

Answer 22

Le Fort Fractures (LFF)

Question 23

RADIOGRAPHIC FEATURES
- orbital line traces the inner margins of the lateral, inferior, medial orbital walls, and the nasal arch
- zygomatic line traces the superior margin of the zygomatic arch of the bbody, extening along the frontal process of the zygoma to the zygomaticofrontal suture
- maxillary line traces the inferior margin of the zygomatic arch, body, and buttress, and the materal wall of th emaxillary sinus. Lines 2+3 form “Dolan’s elephant”

Answer 23

Le Fort Fractures (LFF)

Question 24

• Hrizontal maxillary fracture, separating the teeth from the upper face
• fracture line passes through the alveolar ridge, lateral nose and inferior wall of the maxillary sinus

Answer 24

Le Fort Type I (FLoating Palate)

Question 25

• Pyramidal fracture, with the teeth at the pyramid base, and nasofrontal suture at its apex
• Fracture arch passes through the posterior alveolar ridge, lateral walls of the maxillary sinuses, inferior orbital rim and nasal bones

Answer 25

• Le Fort Type II (Floating Maxilla)

Question 26

• craniofacial dysfunction
• transverse fracture line passes through nasofrontal suture, maxillo-frontal suture, orbital wall and zygomatic arch/zygomaticofrontal suture

Answer 26

• Le Fort Type III (Floating Face)

Question 27

Signs and symptoms
• Drawer’s sign
• Open bite deformity
• Asmmetry
• Epistaxis
• Step-down deformity
• Swelling, hematoma crepitation, tenderness

Answer 27

Maxillary fracture

Question 28

Maxillary fracture
Management

Answer 28

Open reduction and internal fixation w/ titanium plate application

Question 29

Zygoma
Tripod fracture

Answer 29

• Zygomaticofrontal suture
• Zygomaticomaxillary suture
• Zygomaticotemporal suture

Question 30

Zygoma
Zygomaticomaxillary complex fracture

Answer 30

• Zygomaticofrontal suture
• Zygomaticomaxillary suture
• Zygomaticotemporal suture
• Zygomaticosphenoid suture
• Infraobital rim
• Lateral orbital rim

Question 31

Signs and symptoms
• Teardrop sign
• Limitation of eye motion
• Diplopia
• Paresthesia
• Unilateral epistaxis
• Trismus/limitation
• Step-down deformity
• Hypoglobus
• Enopthalmus

Answer 31

Zygoma

Question 32

Zygoma
• Management

Answer 32

Open reduction and internal fixation