Face is usually uncovered and is vulnerable to trauma in daily life and road traffic accidents. Oroantral fistula indications, Diagnosis and management.
14. Nasal bone and septum
Naso orbital fractures
15. Nasal bone and septum
Naso orbital fractures
Fractures of zygoma
Fractures of zygomatic arch
16. Nasal bone and septum
Naso orbital fractures
Fractures of zygoma
Fractures of zygomatic arch
Fractures of orbital floor
17. Nasal bone and septum
Naso orbital fractures
Fractures of zygoma
Fractures of zygomatic arch
Fractures of orbital floor
Fractures of maxilla
18. Most prominent part
◦ More likely
Amount of injury
◦ Magnitude of trauma
◦ Direction
Ant
lateral
33. H shaped incision
Nasal bones reduced under vision
Medial canthal ligaments fixed with
wire
Repair of lacrimal apparatus
Preference
◦ Medical canthal ligament
◦ Lacrimal apparatus
Nasal bridge and shape
◦ Can be corrected later
34.
35. Second most common
Direct trauma
Lower segment pushed medially posteriorly
◦ Flattening of malar prominance
◦ Zygoma – fractured -separated
Zygomatico frontal
Zygomatico maxillary- orbital floor
Zygomatico temporal
37. Zygomatico maxillary - orbital floor
Orbital contents - herniates – maxillary sinus
Tear drop sign
38. Flattening of malar prominance
Step deformity of infra orbital margin
Trismus (inability to open mouth)
Oblique palpebral fissure
◦ Displacement of LPL
Restriction of ocular movement – diplopia
Peri-orbital echymosis
Infra orbital anaesthesia
39. Waters’ view (Occipito-Mental View)
Blood in maxillary sinus - opaque
CT scan – more beneficial
Fracture of zygoma (Tripode fracture)
40. No displacemment - no treatment
Open reduction
Lateral brow incision
Reduction - putting elevator behind
the zygoma
Fixation - wire
Transantral approach
◦ Caldwell luc operation
◦ Intra nasal antrostomy
41. Zygomatic arch fractures in two segments
Fractures at both ends
Depressed fracture
43. Clinical examination
X ray sub mento vertical view
Waters’ view
Diagnosis
Fractures of zygomatic arch
44. Incision - anterior to ear in the hair
Elevator
◦ Deep to the temporalis fascia
Intra oral superior sulcus
Usually does not require fixation
Treatment
Fractures of zygomatic arch
45. Accompanies
◦ Zygomatic fractures
◦ Maxilla fracture Le Fort II
Isolated blow out fractures
◦ Large blunt object strikes globe
◦ Orbital contents herniate in the maxillary antrum
60. X Ray
◦ Waters’ view
◦ Postro anterior view
◦ Lateral view
CT CSAN
61.
62. Complex
General management
Interdental wiring
Intermaxillary wiring
Open reduction and fixation
Wire slings
◦ Frontal bone
◦ Zygoma
◦ Infra orbital rim
63.
64. Mandible
Classified according to the location
◦ Chondylar process
◦ Angle
◦ Body
◦ Symphysis
◦ Choronoid process
◦ Ramus
◦ Alveolar process
◦ Combination
65.
66.
67. If not displaced
◦ Pain
◦ Trismus
Inability to open
◦ Tenderness
If displaced
◦ Malocclusion
◦ Deviation