Facial Fracture Complex
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0102-Facial Fracture Complex
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CA0102-Facial Fracture Complex
Case ReportHistory
Exam
Prior Study
Findings
Facial and Scalp Soft Tissues and Airway
There is soft tissue swelling over the nasal bones and midface. There is no evidence of an open fracture or penetrating injury.
Intracranial
There is no evidence of intracranial injury.
Midface - Maxillary Region
There is a comminuted fracture of the nasal bones that is displaced to the right and slightly depressed without evidence of a nasal septal hematoma although the nasal septum does appear to be fractured.
There are fractures of all walls of the maxillary sinuses which are minimally to non-displaced on the right and more displaced on the left with a somewhat depressed orbital floor injury. The infraorbital rim on the right is fractured.
There are fracture of the left alveolar ridge that goes through the left premolar socket where there has been a previous extraction. There is no fracture of the premaxilla. There is also a fracture of the left palatine process of the maxillary bone. The hard palate is fractured on the left.
The pterygoid processes of the sphenoid bone are fractured on both sides.
Fronto-Naso-Ethmoidal Complex
The mesial naso-orbito-ethmoid complex is fractured predominately anterior to the anterior ethmoid artery with minimal posterior displacement and no obvious significant encroachment on the frontal recess. There is a comminuted fracture of the nasal bones which is depressed slightly and displaced to the right. There are slightly displaced fractures of the frontal processes of the maxilla and a minimal relatively anterior medial orbital wall injury on the left. The intercanthal distance is not significantly increased.
There is a non-displaced fracture of the outer table of the funnel bone.
Zygomatico-Orbital Region and Globes
There is a fracture of the zygomatic arch, frontozygomatic suture, infraorbital rim and lateral wall of the orbit on the left.
The facial fractures do not extend into the central skull base. There is no injury in the region of the optic canal or orbital apex.
There is minimal orbital edema. There is minimal swelling of the left lateral rectus muscle. There is no significant proptosis or tension orbit.
There is minimal evident optic sheath swelling, mainly at the junction of the globe and sheath; this does not suggest a significant optic sheath hematoma.
There is no entrapment of the muscles of mastication by fractures of the coronoid process and/or zygomatic arch.
Central Skull Base
There is no fracture of the greater or lesser wing of the sphenoid bone or basisphenoid.
Mandible and Temporomandibular Joints
There is no evidence of injury to the mandible or temporomandibular joints.
Dentition
There are no dental fractures and/or missing or displaced teeth. There is a fracture through a previous left upper 1st molar extraction site.
Cervical Spine
The visualized portions of the cervical spine are normal.
Impression
2-Left Orbital zygomatic with minimal displacement of the zygoma with a displaced but not comminuted orbital floor fracture without complications - extent described above.
3-Fronto- naso-ethmoidal complex limited to the nasoethmoidal and nasal frontal regions anteriorly without complications - extent described above.
