Zygomatico Orbital Trauma Flashcards
Signs seen in zygomatic orbital trauma
Orbital swelling
Blueish discolouration
Swelling on side of face
Sclera is red - subconjunctival haemorrhage
What is the protective mechanism when eye is swollen
Fracture of orbital floor allows it to expand so it doesn’t compress on optic nerve
Classification of maxillofacial fractures
- naso ethmoidal fractures
- lateral middle third (zygoma)
- central middle third
- mandibular fractures
What type of fractures included in central mid third
- nasal bone
- unilateral maxillary fracture
- le fort I fracture
- le fort II fracture
- le fort III fracture
- various combinations
3 sutures in zygoma
- zygomatico frontal suture
- zygomatico maxillary suture
- zygomatico temporal suture
Anatomy anterior in orbit and possible injuries
Eyelids cornea and sclera
If injured
- lid injury
Periorbital haematoma
Globe trauma
Anatomy in medial wall and possible injuries
- medial rectus muscle
-nose
-lacrimal duct and sac
-ethmoid sinus
-cribriform plate
Injury
- CSF
- medial wall blow out
- lacrimal apparatus damage
Nerves in superior orbital fissure
superior orbital fissure
- occulomotor nerve III
- trochlear nerve IV
- abducens nerve VI
- branch of opthalmic nerve
- opthalmic veins
Signs of malar fracture
- periorbital bruising and swlling
- sensory deficit- infraorbital nerve
- subconjunctival ecchymoses
- diplopia/vision impairment - entrapment of the muscle or damaged muscle or damaged nerve that moves eye
- subcutaneous emphysema
- epistaxis - maxillary sinus bleeding even if nose intact , as maxillary sinus is close to zygoma and the sinus connects to nose through middle meatus
- step deformity
Management of zygomatico orbital fractures
- prophylactic antibiotics
-review - radiographs
-closed reduction +/- fixation
Open reduction + internal fixation - malar reduction
-gillies temporal reduction
