الفهرس 
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Abstract
Summary 83
SUMMARY
Several bones contribute to the bony skeleton of the face
including the mandible, which forms the only freely mobile joint of
the skull. The frontal bone, maxilla, zygomata and mandible
contribute most to the shape of the face. The orbits, nose and para
nasal sinuses form bony cavities contained by the facial skeleton.
There has been a rising incidence of maxillofacial injuries
during the past decade as a result of an increasing number of assaults
and motor vehicle accidents. The maxillofacial region is one of the
most complex areas of the human body.
Computed tomography is the imaging method of choice for an
accurate diagnosis and for depicting the complex anatomic structures
of the maxillo-facial region. Fracture lines, bony fragments, and
associated skeletal deformities are clearly identified by CT scan.
Compared to the 3D CT of 1990s, the latest CT has made
significant improvement thus resulting in higher accuracy of
diagnosis. Multidetector CT represents a breakthrough in CT
technology. It has transformed CT from a transaxial cross-sectional
technique into a true 3D imaging modality that allows for arbitrary cut
planes as well as excellent 3D displays of the data volume.
Previously, streak artifacts from surgical hardware made CT
imaging almost impossible. With MDCT and improved reconstruction
algorithms, imaging in the vicinity of hardware is much less of a
problem.
MDCT is often the first and only imaging procedure a
polytrauma patient will need. Each patient’s clinical findings should,
however, serve as guidelines for the use of CT. Thus, the radiologist
must be an active member of the trauma team.
Summary 84
To attain the best possible acute management of the midfacial
trauma, it is imperative for the surgeon to understand the morphology
and extent of the injuries
CT scan images have replaced plain films as the main imaging
tool to assist in the diagnosis and treatment planning for NOE
fractures. CT scanning of the midface without contrast enhancement is
considered the criterion standard for radiologic diagnosis of ZMC
fractures and imaging of choice for Le Fort fractures.
It is important to analyze the whole face for fractures, including
the entire mandible, because of the high rate of fracture of the upper
and lower face when midface fractures occur.
With sagittal and coronal reconstructions, CT scans can depict
all the portions of the mandible in 3 planes, but direct coronal views
are always preferred. Besides identifying the fracture, it is easier to
determine the degree of fragment displacement with CT scanning than
with plain radiography.
CT scanning is considered to be the top choice in the imaging
study for evaluating orbital trauma. The study should be performed
with nonenhanced axial and coronal 3-mm cuts; multiplanar
reformation sections are then performed.
Patients with traumatic injuries frequently require CT scans of
the brain to evaluate intracranial injuries.
Preoperative photographs are important to document the degree
of deformity. This allows the surgeon to estimate the distance of
correction needed to approximate the preinjury state.
Reformatted CT images are also of high quality and have been
shown to be reliable and accurate in surgical reconstructive efforts.
Summary 85
The use of computer-aided rendering of 3D images of the
disease process or defects allows for the surgeon to manipulate the
information in the preoperative setting to aid in the planning of the
surgery. This preoperative planning is, in effect, a simulation of the
planned surgery
Computer modeling and intraoperative navigation is a relatively
new tool that can assist surgeons with reconstruction of the
maxillofacial skeleton.