Age: 25
Sex: Male
Indication: Trauma
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Case #6
Findings
- Extensive right facial crush injury with acute right Le Fort type I, II, and III, nasoorbitoethmoid, and zygomaticomaxillary complex fractures. Fractures notably involve the nasolacrimal canal and infraorbital foramen. There is also an isolated left pterygoid plate fracture
- Comminuted fracture of the right orbital roof extending into the frontal bone, cribriform plate, and into the greater wing of the sphenoid bone, involving foramen rotundum and the superior and inferior orbital fissures
- Orbital fat herniates through the right orbital floor fracture with inferior deviation and rounding of the inferior rectus muscle
- Small amount of right retrobulbar hemorrhage extending along the lateral rectus muscles, inseparable from the lacrimal gland anteriorly, with scattered locules of retrobulbar gas
- Pneumocephalus in the anterior and middle cranial fossae with trace extraaxial hemorrhage
- Right hemosinus. Blood products also layer in the nasopharynx. Mucoperiosteal thickening of the frontal sinuses
Diagnosis
- Complex facial crush injury
Sample Report
Extensive right facial crush injury with acute right Le Fort type I, II, and III, nasoorbitoethmoid, and zygomaticomaxillary complex fractures. Fractures notably involve the nasolacrimal canal and infraorbital foramen. There is also an isolated left pterygoid plate fracture.
Comminuted fracture of the right orbital roof extending into the frontal bone, cribriform plate, and into the greater wing of the sphenoid bone, involving foramen rotundum and the superior and inferior orbital fissures.
Orbital fat herniates through the right orbital floor fracture with inferior deviation and rounding of the inferior rectus muscle. Recommend correlation with clinical signs of entrapment.
Small amount of right retrobulbar hemorrhage extending along the lateral rectus muscles, inseparable from the lacrimal gland anteriorly, with scattered locules of retrobulbar gas. Globes are intact. No proptosis.
Pneumocephalus in the anterior and middle cranial fossae with trace extraaxial hemorrhage. Recommend correlation with dedicated CT head imaging.
Right hemosinus. Blood products also layer in the nasopharynx. Mucoperiosteal thickening of the frontal sinuses.
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