EURORAD ESR

Case 10237

Le Fort III Fracture (Craniofacial Disjunction)

Author(s)
Mohammed Noeman (1), Gunnar Gaffke (2).

(1) Radiology Resident, Department of Diagnostic and Interventional Radiology, KMG Klinikum Güstrow, Germany.
(2) Chief of Department of Diagnostic and Interventional Radiology, KMG Klinikum Güstrow, Germany.

KMG Klinikum Güstrow, Academic Teaching Hospital of the University of Rostock, Germany.

Friedrich-Trendelenburg Allee 1 18273 Güstrow, Germany;

E-mail: dr_noman99@hotmail.com
 
Patient
male, 50 year(s)
 
 
  • Figure 1
    3-D CT-Reconstruction image of the skull

    A midface fracture starting at zygomaticofrontal suture (blue arrow), running posteriorly through medial wall of the orbit (blue arrowheads) and passing through the nasofrontal suture (green arrow). Also fracture...

     
    Area of Interest: Eyes; Musculoskeletal bone; Trauma; Imaging Technique: CT; Procedure: Computer Applications-3D; Diagnostic procedure; Special Focus: Trauma;
     
     
  • Figure 2
    Axial non-enhanced CT image of the paranasal sinuses

    Bilateral fracture of the lateral wall of maxillary sinus (blue arrowheads) as well as medial wall (red arrowhead). Fracture of the nasal septum is also seen (green arrowhead). Bilateral haematosinus (yellow asterisk).

     
    Area of Interest: Ear / Nose / Throat; Musculoskeletal bone; Trauma; Imaging Technique: CT; Procedure: Computer Applications-3D; Diagnostic procedure; Special Focus: Haemorrhage; Trauma;
     
     
  • Figure 3
    Axial non-enhanced CT image of the paranasal sinuses

    The red arrow shows associated nasoethmoid fracture.

     
    Area of Interest: Ear / Nose / Throat; Musculoskeletal bone; Trauma; Imaging Technique: CT; Procedure: Computer Applications-3D; Special Focus: Trauma;
     
     
  • Figure 4
    3-D CT-Reconstruction image of the skull (view from below)

    Both red arrows show bilateral non-displaced fracture of the zygomatic arch which is a characterstic feature for this type of fractures.

     
    Area of Interest: Bones; Computer applications; Imaging Technique: CT; Image manipulation / Reconstruction; Procedure: Computer Applications-3D; Computer Applications-Detection, diagnosis; Diagnostic procedure; Special Focus: Trauma;
     
     
  • Figure 5
    Coronal non-enhanced CT image of the paranasal sinuses

    The blue arrows show bilateral fracture of the pterygoid processes, which is a common association in all three types of Le Fort fractures.

     
    Area of Interest: Ear / Nose / Throat; Musculoskeletal bone; Trauma; Imaging Technique: CT; Procedure: Computer Applications-3D; Special Focus: Trauma;
     
     
  • Figure 6
    Coronal non-enhanced CT image of the paranasal sinuses

    This section shows that orbital floor is bilaterally intact (red arrows) thus excluding Le Fort II fracture.

     
    Area of Interest: Bones; Ear / Nose / Throat; Musculoskeletal bone; Imaging Technique: CT; Procedure: Computer Applications-3D; Special Focus: Trauma;
     
     
  • Figure 7
    Diagramatic illustration of the different planes of Le Fort fractures

    A. Le Fort I: involves the anterolateral margin of the nasal fossa above the maxillary alveolar process. B. Le Fort II: involves the inferior orbital rim. C. Le Fort III: involves the zygomatic arch.

     
    Area of Interest: Ear / Nose / Throat; Musculoskeletal bone; Trauma; Imaging Technique: CT; Procedure: Computer Applications-3D; Special Focus: Trauma;
     
     
A midface fracture starting at zygomaticofrontal suture (blue arrow), running posteriorly through medial wall of the orbit (blue arrowheads) and passing through the nasofrontal suture (green arrow). Also fracture of the zygomatic arch (red arrow).
 
Bilateral fracture of the lateral wall of maxillary sinus (blue arrowheads) as well as medial wall (red arrowhead). Fracture of the nasal septum is also seen (green arrowhead). Bilateral haematosinus (yellow asterisk).
 
The red arrow shows associated nasoethmoid fracture.
 
Both red arrows show bilateral non-displaced fracture of the zygomatic arch which is a characterstic feature for this type of fractures.
 
The blue arrows show bilateral fracture of the pterygoid processes, which is a common association in all three types of Le Fort fractures.
 
This section shows that orbital floor is bilaterally intact (red arrows) thus excluding Le Fort II fracture.
 
A. Le Fort I: involves the anterolateral margin of the nasal fossa above the maxillary alveolar process. B. Le Fort II: involves the inferior orbital rim. C. Le Fort III: involves the zygomatic arch.
 
 
 
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