Findings
- Extensive impacted midface smash injury with bilateral Le Fort type I, II, and III fractures and bilateral zygomaticomaxillary complex (ZMC) fractures. Fractures notably involve the bilateral cribriform plates, nasolacrimal canals, and infraorbital foramina as well as the hard palate
- Herniation of orbital fat through bilateral orbital floor fractures without imaging evidence of extraocular muscle entrapment. Trace bilateral retrobulbar hemorrhage
- Displaced fracture involving the right angle of the mandible extending through the socket of the remaining right mandibular molar. Mildly displaced fracture of the left mandibular ramus
- Extensive bilateral hemosinus
- Extensive soft tissue edema and subcutaneous emphysema throughout the visualized face and scalp
- Punctate radiodensity along the anterior margin of the left globe, lateral to the lens
- Intracranial hemorrhage, which is incompletely assessed on this study
Diagnosis
Midface smash
Sample Report
Extensive impacted midface smash injury with bilateral Le Fort type I, II, and III fractures and bilateral zygomaticomaxillary complex (ZMC) fractures. Fractures notably involve the bilateral cribriform plates, nasolacrimal canals, and infraorbital foramina as well as the hard palate.
Herniation of orbital fat through bilateral orbital floor fractures without imaging evidence of extraocular muscle entrapment. Trace bilateral retrobulbar hemorrhage without proptosis. Globes are intact.
Displaced fracture involving the right angle of the mandible extending through the socket of the remaining right mandibular molar. Mildly displaced fracture of the left mandibular ramus. Temporomandibular joints are located.
Extensive bilateral hemosinus.
Extensive soft tissue edema and subcutaneous emphysema throughout the visualized face and scalp.
Punctate radiodensity along the anterior margin of the left globe, lateral to the lens, which may represent a foreign body or senescent calcification. Recommend correlation with exam.
Intracranial hemorrhage, which is incompletely assessed on this study.
Discussion