Findings
- Acute right Le Fort type I and II and left Le Fort type I, II, and III fractures with a nondisplaced left zygomatic arch fracture, fractures of the medial and inferior walls of the right orbit, fractures of all walls of the left orbit, fractures of all walls of both maxillary sinuses, fracture of the nasal septum, comminuted bilateral nasal arch fractures extending to the nasofrontal suture, and bilateral pterygoid plate fractures
- Bilateral nasoorbitoethmoid fractures with multiple bilateral ethmoid fractures in addition to the above discussed fractures
- Herniation of orbital fat through the left inferior orbital wall fracture with asymmetric rounding of the left inferior rectus muscle
- Left greater than right retrobulbar hemorrhage with left proptosis
- Fractures involving the bilateral infraorbital foramina and nasolacrimal canals
- Bilateral maxillary, ethmoid, and sphenoid hemosinus
- Secretions layering in the nasal cavity and nasopharynx
- Extensive facial swelling/contusion and subcutaneous gas
- Heavy atherosclerotic calcification of the cavernous carotid arteries
- Bilateral lens replacements
Diagnosis
Le Fort I, II, and III fractures, NOE fractures, nasolacrimal duct involvement
Sample Report
Acute right Le Fort type I and II and left Le Fort type I, II, and III fractures including a nondisplaced left zygomatic arch fracture. Additionally there are bilateral nasoorbitoethmoid fractures. Fractures notably involve the bilateral infraorbital foramina and nasolacrimal canals.
Herniation of orbital fat through the left inferior orbital wall fracture with asymmetric rounding of the left inferior rectus muscle. Recommend correlation with clinical signs of extraocular muscle entrapment.
Left greater than right retrobulbar hemorrhage with left proptosis.
Bilateral maxillary, ethmoid, and sphenoid hemosinus.
Secretions layering in the nasal cavity and nasopharynx, which place the patient at risk for aspiration.
Discussion