华西口腔口腔颌面影像诊断学外伤课件

Diagnostic Radiology Diagnostic Radiology Of MaxillofacialOf Maxillofacial Part of Injury 吴红兵 Most common responsibleMost common responsible Fall Automobile accident Blows from foreign bodies strking Others 头部、颌面部受伤的处理头部、颌面部受伤的处理 l危险的颅内出血。 l意识消失或神智模糊，呼吸困难，呕吐，抽 搐，手脚麻痹，口或鼻腔流血或透明的液体 ，剧烈头痛持续不止等等。 l原则：先处理颅脑症状，稳定全身生命体征 ，后治疗颌面部损伤。 Applied radiologyApplied radiology The prescription of appropriate film can be made only after a careful clinical examination Radiology aids in identifying the location and orientation of fractures and indicates the degree of separation or displacement of fracture margins. Radiographs are very useful after an injury Test technicsTest technics Waters position （华氏位、鼻颏位） Panoramic 曲面断层片（全景） Cephalometric (X线头影测量片)or lateral film(侧位片） Occlusal film咬合片 Submentovertex （颅底位、颏顶位、颧弓位） Zygomatic bone-PA（颧骨后前位、顶颏位） Postanterior position（下颌骨后前位） Obligue lateral projection（下颌骨斜侧位） Schullars position （薛氏位、颞下颌关节片） CT and MRI Diagnostic principleDiagnostic principle 1. position and number 2. types 3. displacement 4. relation between the fracture line and teeth 5. differentiate from nutrition canal and normal sutures 6. concrescence of fractures position and number position and number of fracturesof fractures TypesTypes DisplacementDisplacement relation between the relation between the fracture line and teethfracture line and teeth differentiate from nutrition canal differentiate from nutrition canal and normal suturesand normal sutures Alveolar fractureAlveolar fracture Alveolar fracture company with Alveolar fracture company with tooth inlaytooth inlay Maxillary fractureMaxillary fracture Fracture Types of maxillar bone Lefort Lefort Lefort Lefort Lefort (horizontal fracture ) Lefort Lefort Lefort Lefort Lefort Lefort fracture fracture Waters positionWaters position Right-lefort Right-lefort left-lefort left-lefort andand Waters positionWaters position （眶-上颌-颧骨OMZ、复合骨折） Fractures of Zygomatic bone and Fractures of Zygomatic bone and archarch After operationAfter operation Comminute Fracture of zygomatic Comminute Fracture of zygomatic archarch “M” type of submentovertex Fracture of nose boneFracture of nose bone Pay attention to the maxillary bone Pay attention to the maxillary bone fracture!fracture! 1、双侧眼眶及上颌窦大小不一，窦腔积液昏暗 2、骨折线多样，骨折块移位，左右眶下缘不在 、同一水平 3 、牙弓不对称 4、颌间间隙形态不对称 5、张口受限是否由于喙突受压？ 6、骨折是否波及颅及颅底？ Fracture of mandibleFracture of mandible The most ommon fracture sites mental body angle condyle and its neck Classification of the condyle Classification of the condyle fracturefracture Please look at book P158P161 Panoramic viewPanoramic view Panoramic viewPanoramic view Y字型 Panoramic viewPanoramic view Panoramic viewPanoramic view Panoramic viewPanoramic view Panoramic viewPanoramic view PostPost anterior position(PA)anterior position(PA) PostPost anterior positionanterior position CT viewCT view 3D dimension reconstruction Tomographic view and CT-3DTomographic view and CT-3D Pathologic fracturePathologic fracture lOriented from tumors ,Osteomyelitis, tooth extraction, operation etc. 陈旧性骨折陈旧性骨折 lX-ray appearance ltime 异物定位异物定位 横向位片 轴向位片