- Fronto-basal fractures
- Trauma to frontal bone or roof of nose
- Escher classification
- Escher 1 – High fracture (forehead, calvaria)
- Escher 2 – Central fracture (low forehead)
- Escher 3 – Low fracture (along nasal cavity? – midface separated from skull base)
- Escher 4 – latero-orbital fracture (above and lateral to orbit)
- Clinical features
- CSF rhinorrhoea
- Cranial nerve palsy
- Raccoon eyes – haematoma around eyes
- Diagnosis
- Complications
- Ascending infection -> meningitis, brain abscess
- Vision loss
- Oculomotor palsy
- Treatment
- All fractures should be surgically treated
- Maxillo-facial fractures
- Etiology
- Car accident
- Assault
- Fall
- Le Fort classification
- Le Fort 1 – separates maxilla from mid-face
- Le Fort 2 – separates nasomaxillary complex (goes above nose)
- Le Fort 3 – separates mid-face from skull
- Clinical features
- Facial oedema
- CSF rhinorrhoea
- Epistaxis
- Mobile maxilla
- Hypoesthesia of infraorbital nerve
- Raccoon eyes
- Treatment
- Ensure airways
- Facial reconstruction
- Blowout fracture
- Isolated fracture of the orbital floor with herniation of orbital content into maxillary sinus
- Etiology
- High-velocity blunt trauma to the eye
- Punch
- Tennis ball
- Clinical features
- Periorbital pain, oedema, ecchymosis
- Posteriorly depressed eye
- Hypoesthesia of infraorbital nerve
- Epistaxis
- Treatment