- •Midface Fractures
- •Midface Fractures
- •Midface Fractures
- •Midface Fractures
- •Midface Fractures
- •Midface Fractures
- •Midface Fractures
- •Midface Fractures
- •Midface Fractures
- •Midface Fractures
- •Midface Fractures
- •Midface Fractures
- •Midface Fractures
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Midface Fractures
Evaluation and Management
E.RAZMPA M.D
OTOLARYNGOLOGIST
HEAD & NEACK SURGEON
ASSOCIATE PROFESSOR
TEHRAN UNIVERSITY OF MEDICAL SCIENCES
www.razmpa .com
Midface Fractures
Etiology
•Motor Vehicle Accidents
•Assault
•Sport
•Falls
•Work
•Pathological
Midface Fractures
•Osteology of the midface
–2 maxillae
–2 zygomata
–2 zygomatic proceses of temporal bone
–2 palatine bones
–2 nasal bones
–2 inferior conchae
–2 pterygoid plates of sphenoid bone
Midface Fractures
•Three buttresses allow face to absorb force
–Nasomaxillary (medial) buttress
–Zymaticomaxillary (lateral) buttress
–Pyterigomaxillary (posterior) buttress
Midface Fractures
Classification
•Anatomical
–Lefort
•I
•II
•III
•Unilateral
•Sagittal
–Wassmund
•Severity
–Cooter and David
–MFISS
Midface Fractures
Lefort Classification
•Weakest areas of midfacial complex when assaulted from a frontal direction at different levels (Rene’ Lefort, 1901)
–Lefort I: above the level of teeth
–Lefort II: at level of nasal bones
–Lefort III: at orbital level
Midface Fractures
Lefort Classification
–Provides uniform method to describe the level of major fracture lines
–Allows references regarding the probable points of stability for surgical treatment
–Does not incorporate vertical or segmental fractures, comminution or bone loss
Midface Fractures
•LeFort I : Transverse Maxillary
•Lefort II : Pyramidal
•Lefort III : Craniofacial Disjunction
•Zygomatic Complex
•Orbital Floor
•Nasal Fractures
•Naso-orbital/Ethmoid
Midface Fractures
LeFort - AP view
Midface Fractures
Le Fort I
•Low level
•Often mobile
•Mild swelling
•Disturbed occlusion
•Deviated midline