Images in Clinical Medicine

Kim Eagle, M.D., Editor

Three-Dimensional CT Diagnosis of Maxillofacial Trauma

Lee A. Fox, B.S.

N Engl J Med 1993; 329:102July 8, 1993

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Article

Figure 1 Three-Dimensional CT Diagnosis of Maxillofacial Trauma.

Spiral computed tomographic (CT) slices (Panel A and Panel B) from which three-dimensional images were reconstructed (Panels C, D, E, and F) were obtained in a 16-year-old boy with facial fractures sustained in a head-on collision. The boy was not wearing a seat belt, and his car was traveling at 50 mph (80 km per hour). He had a slightly limited upward gaze on the right side, a small subconjunctival hemorrhage, and infraorbital pain. There were no other findings on physical examination.

A zygomaticomaxillary complex (“tripod”) fracture is present. The zygomatic arch is fractured, and the zygomaticomaxillary complex is displaced posteromedially. There are comminuted fractures of the anterior and posterolateral walls of the maxillary sinus, as well as fractures of the medial, lateral, and inferior orbital walls.

Three-dimensional images reconstructed from the spiral CT slices are shown in four views. The frontal view (Panel C) shows the fractured frontal and maxillary processes of the zygomatic bone and the comminuted fracture of the anterior maxillary-sinus wall. The left oblique view (Panel D) shows the course of the fracture along the lateral wall of the right orbit. The right oblique view (Panel E) shows the zygomatic displacement, as well as the fracture of the orbital floor. The basal view (Panel F) shows the posterolateral displacement of the right zygomatic arch and the intact left arch for comparison.

The patient was admitted for observation and discharged the next day. He returned to the hospital eight days after the injury for surgical repair involving an open reduction and internal fixation. The postoperative course was uncomplicated, and he was discharged two days later.

Kim Eagle, M.D.

Lee A. Fox, B.S.
Mallinckrodt Institute of Radiology, St. Louis, MO 63110

Citing Articles (2)

Citing Articles

1. 1

   Hisakazu Seno, Masanari Mizunuma, Masanobu Nishida, Masahiro Inoue, Akira Yanai, Masahiro Irimoto. (1999) 3D-CT Stereoscopic Imaging in Maxillofacial Surgery. Journal of Computer Assisted Tomography 23:2, 276-279
   CrossRef

2. 2

   (1994) Three-Dimensional CT Diagnosis of Maxillofacial Trauma. New England Journal of Medicine 330:1, 69-69
   Full Text

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