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7/24/2019 Lefort fracturefinal.ppt
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LE FORT FRACTURES andLE FORT FRACTURES andNOE FRACTURESNOE FRACTURES
Kirstie Ann B. de LunaKirstie Ann B. de LunaFEU-NRMF Junior InternFEU-NRMF Junior InternQuezon Cit !enera" #os$ita" ENT-#NS RotationQuezon Cit !enera" #os$ita" ENT-#NS Rotation
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% Fa&ia" Buttresses% Fa&ia" Buttresses'erti&a" Buttress'erti&a" Buttress
Naso(a)i""arNaso(a)i""ar* +o(ati&o(a)i""ar* +o(ati&o(a)i""ar,ter +o(a)i""ar,ter +o(a)i""ar'erti&a" (andi "e'erti&a" (andi "e
#orizonta" Buttress Fronta" Bar In ra-or ita" Ri(
A"/eo"ar Rid+e0#ard ,a"ate
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Le ort Fra&turesLe ort Fra&tures
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C"ini&a"C"ini&a"
,resentation,resentationAnterior drawer signO$en ite de or(itE$ista)isE&&1 (osis0 1e(ato(aF"at a&e 2nasa" de$ressionor dis i+urationSu &on3u&ti/a" #e(orr1a+eMa"o&&"usionE"on+ation o a&e 2 Dish-shaped face)Air4a o stru&tionCSF "ea5a+eSte$ de or(it atin raor ita" (ar+inAnest1esia0$arest1esia o&1ee5
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6ia+nosti&s and6ia+nosti&s andTreat(entTreat(ent
7ATERS 'IE7 2O&&i$ito(enta"'ie48CAL67ELL 'IE72O&&i$ito ro(ta" 'ie48LATERAL 'IE7CT SCAN
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Treat(entTreat(entLe ort ILe ort I- redu&e ra&ture a"i+nin+ dentition- redu&e ra&ture a"i+nin+ dentition
Sur+i&a" a&&ess /ia i"atera" (a)i""arSur+i&a" a&&ess /ia i"atera" (a)i""ar+in+i/a" u&&a" su"&us in&ision+in+i/a" u&&a" su"&us in&isionInter(a)i""ar i)ation usin+ s5e"eta"Inter(a)i""ar i)ation usin+ s5e"eta"s&re4s or ar&1 arss&re4s or ar&1 arsOn&e redu&ed and i)ed9 titaniu( (ini$"atesOn&e redu&ed and i)ed9 titaniu( (ini$"atess&re4ed dire&t" to (a)i""a to &reates&re4ed dire&t" to (a)i""a to &reatesta i"itsta i"it
I (ini(a"" dis$"a&ed9 si($"eI (ini(a"" dis$"a&ed9 si($"eInter(a)i""ar i)ation a"one or :-% 4ee5sInter(a)i""ar i)ation a"one or :-% 4ee5s
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Le ort IILe ort II- ICU and CT 4it1 ;6- ICU and CT 4it1 ;6re&onstru&tionre&onstru&tionInter(a)i""ar i)ationInter(a)i""ar i)ation
Interosseous 4irin+ orInterosseous 4irin+ or$"atin+ o intraor ita"$"atin+ o intraor ita"ri(s9 naso ronta" andri(s9 naso ronta" and"atera" (a)i""ar 4a""s"atera" (a)i""ar 4a""sAnti ioti&s< ,eni&i""inAnti ioti&s< ,eni&i""in2due to in/o"/e(ent o2due to in/o"/e(ent oora" or nasa" &a/it 8ora" or nasa" &a/it 8
Le ort IIILe ort IIIInter(a)i""ar i)ationInter(a)i""ar i)ationBi&orona" a$$roa&1 toBi&orona" a$$roa&1 to
a&i"itate re$air oa&i"itate re$air o
rontoz +o(ati& androntoz +o(ati& andz +o(ati& ar&1z +o(ati& ar&1E"e&ti/e tra&1eoto( (aE"e&ti/e tra&1eoto( (a
e an o$tione an o$tion
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--Et1(oida" 2NOEEt1(oida" 2NOE
Fra&ture8Fra&ture8
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ORBITAL ANATOM=ORBITAL ANATOM=
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Media" Cant1a"Media" Cant1a"TendonTendon
-inserts to "a&ri(a" one-$u($in+ a&tion o t1e "a&ri(asa& and du&ts9 a""o4in+ or$ro$a+ation o tears t1rou+1 t
naso"a&ri(a" s ste(.-a&ts as a sus$ensor s"in+ ot1e +"o e9 (aintainin+ itssu$$ort a"on+ 4it1 t1e "atera"&ant1a" tendon.-ensures &"ose a$$osition o t
e e"id to t1e +"o e
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C"ini&a"C"ini&a"
,resentation,resentationSe/ere Or ita" S4e""in+Se/ere Or ita" S4e""in+
S4e""in+ 4it1 Trau(ati&S4e""in+ 4it1 Trau(ati&Te"e&ant1us 24idenin+ oTe"e&ant1us 24idenin+ ointer&ant1a" distan&e8inter&ant1a" distan&e8
6isru$tion o (edia" &ant1a"6isru$tion o (edia" &ant1a""i+a(ents"i+a(ents
CSF Lea5+eCSF Lea5+e
6e$ressed nasa" root6e$ressed nasa" root
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ra&turesra&tures
2Mar5o4itz-Manson82Mar5o4itz-Manson8
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T $e I- &entra" Se+(entT $e II- &o((inuted ut&ant1a" tendons atta&1edT $e III- &o((inuted ut&ant1a" tendons ree
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Treat(entTreat(ent
Re-esta "is1(ent $ (id"ine/erti&a" 1ei+1t o nasa" root
Bi&orona" ore1ead "a$ Mid- a&e de+"o/in+ in&ision
>O$en-s5 $ro&edure?