Chapter 3 - Craniofacial Trauma Flashcards Preview

Brant - 5th Edition > Chapter 3 - Craniofacial Trauma > Flashcards

Flashcards in Chapter 3 - Craniofacial Trauma Deck (15)
Loading flashcards...
1
Q

Physical signs of temporal bone fracture: (3)

A
  1. Hemotympanum
  2. CSF otorrhea
  3. Ecchymosis
2
Q

CT scan findings that should raise suspicion of temporal bone fracture: (4)

A
  1. Opacification of the mastoid air cells
  2. Fluid in the middle ear cavity
  3. Pneumocephalus
  4. Pneumolabyrunth (occasional)
3
Q

Classification of temporal bone fractures (According to orientation): (3)

A
  1. Longitudinal Fracture
  2. Transverse Fracture
  3. Mixed fracture
4
Q

This represents 70 to 90% of temporal bone fractures

A

Longitudinal temporal bone fracture

5
Q

What are the complications of longitudinal temporal bone fractures? (5)

A
  1. Conductive hearing loss
  2. Dislocation or fracture of the ossicles
  3. CSF otorhinorrhea
  4. Facial nerve palsy (often delayed or incomplete)
  5. Sensorineural hearing loss
6
Q

Transverse temporal bone fracture usually results from a blow to what area of the head?

A

Occiput or frontal region

7
Q

What are the complications of transverse temporal bone fractures? (6)

A

Usually more severe:

  1. Sensorineural hearing loss
  2. Severe vertigo
  3. Nystagmus
  4. Perilymphatic fistula
  5. Facial palsy (30 to 50% - often complete)
  6. May involve carotid canal or jugular foramen (Carotid artery or jugular vein injury)

*Note
TCJ (Transverse -carotid / jugular vein injury)
Perilymph fistula!
Complete facial palsy!
Sensorineural hearing loss - as opposed to conductive hearing loss of longitudinal fracture

8
Q

Compared with otic-sparing fractures, patients with otic capsule-violating fractures are more severe.

Why?

A

They are:
2 to 5 times more likely to develop facial injury.
4 to 8 times more likely to develop CSF leak
7 to 25 times more likely to experience hearing loss
More likely to sustain intracranial injuries (epidural hematoma and subarachnoid hemorrhage)

*Notes:
Violate! FCHH
Facial injury
CSF leak
Hearing loss
Hemorrhage (epidural / subarachnoid)
9
Q

Modality of choice for the evaluation of facial trauma

A

MDCT

  • Supplanted plain film radiography
10
Q

What are the four views usually used in plain film evaluation of acute facial trauma?

A
  1. Caldwell view
  2. Shallow Waters view
  3. Cross-table lateral view
    4 Submental vertex view
11
Q

What are the uses of MR in facial injury? (3)

A
  1. Injury of the orbital contents (optic nerve, globe, extraocular muscles)
  2. Vascular complications (arterial dissection, pseudoaneurysm, and arteriovenous fistulas)
  3. Best way to evaluate trauma to the temporomandibular joint

*Note:
Orbit, vessels, TMJ
TVO

12
Q

When is angiography indicated in facial trauma?

A

When clinical or radiographic evidence suggest a vascular injury

13
Q

Orbital emphysema is commonly caused by fracture of what bone?

A

Fracture of the thin medial orbital wall

14
Q

The most common fracture of the facial skeleton.

A

Nasal bone fracture

15
Q

Potential serious injury in nasal fracture that can cause cartilage necrosis (by disrupting the blood supply)

A

Septal hematoma