TRAUMA OF THE FACIAL SKELETON AND CALVARIA

Facial trauma is frequent and mainly caused by motor vehicle accidents . Due to this main etiologic factor, trauma to the facial skeleton is often associated with serious injuries, commonly involving the brain, chest or abdomen. As a consequence, the initial clinical management of these patients includes control of hemorrhage and immediate assessmen t of life-threatening injuries, including the maintenance of the airwa ys. Patients presenting with facial trauma are initially evaluated wit h a systematic clinical examination because many fractures can be accu rately diagnosed by inspection and palpation alone. In these cases pla in film radiographs serve only for confirmation and documentation of t he diagnosis. In many other cases accompanying and extensive soft tiss ue swelling may clinically obscure fractures. A complete and accurate evaluation of these patients requires additional radiological imaging methods. A series of plain films may be generally sufficient but in mo st of the cases they can be regarded as initial screening methods for more thorough diagnosis with computed tomography (CT). In trauma patie nts CT is the imaging method of choice because it shows more fracture lines and displaced fragments than any other imaging modality. CT deli neates soft tissue and bony structures and can localize and even chara cterize foreign bodies. A complete and accurate characterization of th e fracture type and potentially associated complications is mandatory for the appropriate treatment and can only be achieved by careful radi ological (CT) evaluation.