Navigating Complex Facial Trauma: A Comprehensive Guide to CT-Based Fracture Detection and Analysis

Abstract

Facial fractures are a common reason for the emergency department visits and can cause significant morbidity and mortality due to damage to facial structures and associated complications (Levy et al. Am J Neuroradiol. 1992;13(3):885–92; Thoren et al. J Oral Maxillofac Surg. 2010;68(4):805–10; Allareddy et al. J Oral Maxillofac Surg. 2011;69(10):2613–8; Alpert et al. Oral Maxillofac Surg Clin North Am. 2009;21(2):185–92). These fractures are often caused by blunt or penetrating trauma from various sources, such as motor vehicle accidents, falls, and assaults. Multidetector computed tomography (CT) is the gold standard imaging modality for evaluating facial fractures as it offers high spatial resolution, bone contrast, and acquisition speed.

Clinically relevant and organized reports are as crucial for appropriate management and surgical planning as accurately describing and identifying complex facial fractures and their complications. The facial buttress concept, which describes the structurally significant skeletal struts that play a role in facial “form” and “function,” helps identify the regions that require surgical reconstruction. This chapter provides an overview of facial skeletal anatomy, describes the system of facial buttresses, and outlines the different fracture patterns. Additionally, imaging features that influence clinical management and outcome are discussed.