Maxillofacial Injuries: Pathophysiology

Today I used the class period to review for a test in AP Calculus AB but he majority of the time was spent on thesis and studying kinetic energy and its relation to Maxillofacial Injuries. 

The kinetic energy present in a moving object is a function of the mass multipled by the velocity: Below I listed some fractures. 

• Frontal bone fractures: These result from a severe blow to the forehead. The anterior and/or posterior table of the frontal sinus may be involved. Assume a dural tear is present if the posterior wall of the frontal sinus is fractured. The nasofrontal duct often is disrupted.

• Orbital floor fractures: Injury to the orbital floor can result in an isolated fracture or can be accompanied by a medial wall fracture. When a force strikes the globe or orbital rim, the intraorbital pressure increases with transmission of this force and damages the weakest aspects of the orbit, the floor and medial wall. Herniation of the orbital contents into the maxillary sinus is possible. The incidence of ocular injury is high, but globe rupture is rare.

• Nasal fractures: These are the result of the forces transmitted during direct trauma.
• Nasoethmoidal fractures (NOE): These extend from the nose to the ethmoid bones and can result in damage to the medial canthus, lacrimal apparatus, or nasofrontal duct. They also can result in a dural tear at the cribriform plate.
• Zygomatic arch fractures: A direct blow to the zygomatic arch can result in an isolated fracture involving the zygomaticotemporal suture.
• Zygomaticomaxillary complex fractures (ZMC): These fractures result from direct trauma. Fracture lines extend through zygomaticotemporal, zygomaticofrontal, and zygomaticomaxillary sutures and the articulation with the greater wing of the sphenoid bone. The fracture lines usually extend through the infraorbital foramen and orbital floor. Concurrent ocular injuries are common.