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Face & Neck - James Rhea, MD, MBA, FACR*; Diego Nuñez, MD, MPH*

1. Facial fractures

      a. Orbital fractures

          Blow-out fracture

          Blow-in fracture

          Orbital apex fracture

      b. Zygoma fractures

          Isolated arch fracture

          Zygomatic complex fracture

      c. Nasal fractures

      d. Naso-orbital-ethmoid fractures

          Posteriorly displaced


      e. Frontal fractures

      f.  Maxillary fractures

          Dentoalveolar fractures

          Maxillary sagittal fractures

          LeFort fractures

      g. Mandible fractures

2. Soft tissue injuries of the orbit

      a. Post bulbar emphysema and hemorrhage

      b. Extraocular muscle entrapment

      c. Ocular injuries



          Lens dislocation

          Vitreous hemorrhage

          Subchoroidal hemorrhage

3. Trauma to the aerodigestive tract

      a. Laryngeal trauma

      b. upper esophageal injuries


4. Infection of the paranasal sinuses

      a. Acute rhinosinusitis

      b. Aggressive fungal sinusitis

      c. Chronic and allergic sinusitis

      d. Complications

          1. cellulitis

          2. orbital subperiostial abscess

          3. osteomyelitis

          4. epidural abscess

          5. subdural empyema

          6. cavernous sinus thrombosis


5. Acute Infection of the suprahyoid neck

       a. retropharyngeal and prevertebral abscess and inflammation (edema)

       b. tonsillitis and tonsilar/peritonsilar abscess

       c. Odontogenic infections

            1. masticator abscess

            2. submandibular abscess

            3. sublingual abscess

       d. Ranula

       e. Parotitis

       f. submandibular sialoadenitis

       g. Ludwig’s angina and cervical necrotizing fascitis.

6. Acute infections of the infrahyoid neck

       a. epiglotitis

       b. croup

       c. lymphadenitis and suppurative adenopathy

       d. jugular thrombophebitis

7. Ear Infections

       a. External otitis

       b. Cholesteatoma

       c. otomastoiditis

       d. otitis media

       e. apical petrositis

8. Orbital infection

       a. orbital cellulitis

       b. orbital pseudotumor

       c. optic neuritis


AUTHORS: James T. Rhea, MD, MBA, FACR*; Diego Nunez, MD, MPH*
case illustration editor: Christopher A. Potter, MD

*Fellow of the American Society of Emergency Radiology (FASER)

Suggested Readings:

LeFort, R: E’tude experimentale sur les fractures de la machoire superieure. Rev Chir 23:208-227, 360-379, 479-507, 1901

Rhea JT, Rao PM, Novelline RA, Helical CT and three-dimensional CT of facial and orbital injury, Radiologic Clinics of North America 37:489-513, 1999

Novelline RA, Head and neck CD-ROM, RSNA, Chicago, 1996

Novelline RA, Rao PM, Rhea J, Sacknoff R, Lawrason N, CT diagnosis of orbital and ocular trauma, Radiographics CD-ROM, Neuroradiology teaching atlas, 1996

Lawrason JN, Diagnostic imaging of facial trauma, In: Imaging in trauma and critical care, Mirvis SE, Young JWR, editors, Williams and Wilkins, Baltimore MD, 243-290, 1992

Harris JH, Face, including intraorbital soft tissues; and Castillo M, Acute conditions of the intraorbital soft tissues, In: The Radiology of Emergency Medicine, Harris JH, Harris WH, Novelline RA, editors, Williams and Wilkins, Baltimore MD, 36-119 and 121-126, 1993

Gean AD, Maxillofacial trauma, In: Imaging of head trauma, Gean AD editor, Raven Press, NY NY, 427-495, 1994

Som PM, Curtin HD, Head and neck imaging, Mosby, St. Louis, 1996

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