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Maxillofacial Trauma

Maxillofacial trauma is primarily caused by road traffic accidents, interpersonal violence, sports injuries, industrial accidents, and domestic falls. It involves various types of injuries, including soft tissue and hard tissue fractures, with mandible and maxilla being the most commonly affected areas. Emergency management focuses on airway management and hemorrhage control, followed by thorough patient evaluation through history taking and physical examination.

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Keith chaambwa
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24 views24 pages

Maxillofacial Trauma

Maxillofacial trauma is primarily caused by road traffic accidents, interpersonal violence, sports injuries, industrial accidents, and domestic falls. It involves various types of injuries, including soft tissue and hard tissue fractures, with mandible and maxilla being the most commonly affected areas. Emergency management focuses on airway management and hemorrhage control, followed by thorough patient evaluation through history taking and physical examination.

Uploaded by

Keith chaambwa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Introduction to:

MAXILLOFACIAL TRAUMA
CAUSES:
△ Road traffic accident (RTA)

△ Fight and assault (interpersonal violence)

△ Sport and recreational injuries

△ Industrial accidents

△ Domestic injuries and falls

2
TYPES OF INJURIES
Soft tissue: (skin, muscles, mucous
membrane)

Hard tissue: (teeth, facial bone fractures)

Special region injuries: (eyes, facial


nerves and salivary glands)
HARD TISSUE FRACTURE
Specific hard tissue:
Denta-alveolar fracture
Mandibular fracture
Maxillary fracture (Lefort)
Zygomatic fracture
Orbital fracture
INCIDENCE
Literatures reported different
incidence in different parts of the
WORLD and at different TIMES

Current trend – RTA (leading cause).


Hard tissue involvement:
Mandible (61%)
Maxilla (46%)
Zygoma (27%)
Nasal (19.5%)
5
FACIAL BONES
FACIAL BONE-Anterior view
FACIAL BONE- Lateral view
EMERGENCY MANAGEMENT
Emergency Management and Resuscitation
Airway Management
– Options
• Intubation
• Laryngeal Mask Airway
• Fiberoptic intubation
• Lateral or semi-prone position
• Cricothyroidotomy
• NB; avoid nasal intubation!
Emergency Management and
Resuscitation (cont.)

Hemorrhage Control
– Rarely develop shock from facial
bleeding alone
– Direct Pressure
– Suturing and vessel ligation
– Nasal hemorrhage may require packing
PATIENT EVALUATION
History
– Causes of the injuries
– Normal sequence of Hx taking if no
LOC.
– Associated risk factors (social and
family history)
Physical Exam

Inspection
– Facial elongation
– High grade LeFort Fracture
– Asymmetry
– Bruises and lacerations
– Deformities and cranial nerve injury
Physical Exam (cont.)
Palpation
– Tenderness
– Step offs
– Facial stability
– Crepitus
– Subcutaneous air
– Cutaneous anesthesia
Physical Exam (cont.)
Subconjuctival
Periorbital and Orbital
Exam haemorrhage
– Look for exophthalmos
or enophthalmos
– Pupil shape
– Subconjuctival
haemorrhage
– Visual acuity
– Entrapment signs
– Raccoon sign
– Bimanual Palpation
Test
Physical Exam (cont.)
Nose
• Septal hematoma
• CSF Rhinorrhea
• Nasal bone fracture
Physical Exam (cont.)
Ears
– Subperichondral hematoma
– Hemotympanum
– Battle sign
(sign of basal skull fracture)
sign of basal skull fracture
Battle’s Sign Hemotympanum
Physical Exam (cont.)
Oral and Mandibular Exam
– Mandible deviation
– Teeth malocclusion
– Step deformity
– Dislocation
– Paresthesia
– Mucosal laceration
– Submucosal echymosis
MAXILLOFACIAL TRAUMA-IMAGING

• Skull vies (conventional)


• CT
• Obital views
• 3D Images
• NB: Relevant view for the specific defects.
Skull, neck & upper chest.
OPG
SKULL VIEWS cont.
AP ( townes) view indication

• Mandibular rami
• Mandibular neck
• Condylar head
• Craniofacial
fractures
CT Scan
sections views
3D’s CT scan
Anterior Lateral

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