Resident Manual of Trauma to the Face, Head and Neck

Chapter 4: Midfacial Trauma ........................................................................ 74 I. Maxillary and Orbital (and Zygomatic) Fractures ...................... 74 A. Dental Terminology........................................................................ 74 1. Maxillae and Mandible............................................................ 74 B. Midfacial Anatomy......................................................................... 75 1. Strong Areas of the Facial Bone.............................................76 2. Maxillae.......................................................................................76 3. Nasal Bones ...............................................................................77 4. Orbits ..........................................................................................77 C. Midfacial Fractures.........................................................................78 1. Le Fort Series of Fractures ......................................................78 2. Zygomatic Fractures................................................................ 80 3. Orbital Fractures....................................................................... 80 D. Diagnosis of Midfacial Trauma................................................... 80 1. Assessment of Vision ............................................................ 80 2. Assessment of Other Nerves .................................................81 3. Le Fort Fractures ........................................................................81 4. CT Scan ........................................................................................81 E. Considerations for Repair of Midfacial Trauma........................81 1. Orbital Fractures.........................................................................81 2. Zygomatic Fractures.................................................................82 3. Maxillary Fractures...................................................................82 F. Approaches to Repairing Midfacial Trauma ............................82 1. Orbital Fractures........................................................................82 2. Zygomatic Fractures.................................................................86 3. Maxillary Fractures...................................................................87 G. Fracture Reduction and Repair.....................................................87 1. Zygomatic Fractures ................................................................87 2. Maxillary and Extended Maxillary Fractures......................88 3. Blowout Fractures of the Orbits.............................................89 H. Complications...................................................................................89 1. Inadequate Reduction .............................................................89 2. Imprecise Reconstruction of the Orbit................................89 3. Globe Malposition ...................................................................89 4. Eyelid Malpositions ................................................................. 90 5. Reduced Vision and Blindness.............................................. 90 6. Scars and Hair Loss ................................................................. 90 7. Nonunion ................................................................................... 90 8. Dental Injury ............................................................................. 90 9. Cerebrospinal Fluid Leaks...................................................... 90 II. Nasal Bone Fractures ...........................................................................91 A. Introduction.......................................................................................91

Resident Manual of Trauma to the Face, Head, and Neck 4