안면 손상(Facial injury)의 개요와 영상

1. 개요

1. 안면부는 교통사고, 폭력, 구타 등에 의해서 잘 손상된다. 

2. 대개 안면 중앙부(midface)나 하악골에 일어난다. 

3. 교통사고 환자의 70%이상에서 안면부 손상이 발생하며, 주로 연부조직의 손상이다. 

4. 안면 손상 환자 중 50%에서 안면골 골절을 동반하지만, 이에 비해 경추손상은 약 2% 정도로 극히 드물다.

2. Facial Bone Radiography

• Non Trauma Protocol : PA(Caldwell), Occipitomental(Waters), Lateral   -> Supplementary view : PA 30°(Caldwell), Occipitomental 30°(Waters)   • Paediatric Protocol : PA(Caldwell), Occipitomental(Waters), Lateral

1) Adequacy

(1) 안면부 손상의 일반적인 촬영은 Occipitomental 또는 Occipitomental 30º 영상이다. 

(2) 일반적으로 안면손상에서 측면촬영이 권장되지만, 실제 거의 도움이 되지 않아 추천되지 않는다.

2. Adult Facial Bones - Occipitomental(Waters) View

  

3) Adult Facial Bones - Occipitomental(Waters) 30º View

 

 

(1) Dolan & Jacoby’s line

	1 : Orbital line   2 : Zygomatic line   3 : Maxillary line

(2) McGrigor-Campbell lines

Red line  Passes through the zygomatico-frontal sutures and  across the upper edge of the orbits     Orange line  Follows the zygomatic arch, crosses the zygomatic  bone and follows the inferior orbital margins to the  opposite side   Green line  Passes through the condyle (1) and coronoid  process (2) of the  mandible and through the lateral  and medial walls of the maxillary antra on each  side   Midline  Used to assess symmetry

4) Adult Facial Bones - PA Caldwell

 

5) Adult Facial Bones - PA 30° (Modified Parietocanthial)

 

6) Adult Facial Bones - Lateral View

 

7) Adult Facial Bones - Submentovertex(SMV) / Slit Basal / Jughandles View

 

8) Adult Facial Bones - Slit Townes

 

3. Nasal Bone Radiography

• Trauma Protocol : Occipitomental(Waters), Lateral   -> Supplementary view : Superoinferior (Axial)     • Non Trauma Protocol : Occipitomental(Waters), Lateral   -> Supplementary view : Superoinferior (Axial)   • Paediatric Protocol : Occipitomental(Waters), Lateral

1) Adult Nasal Bones - Lateral View

 

2) Adult Nasal Bones - Superoinferior (Axial) View

 

3) Adult Nasal Bones - Occipitomental (Waters) View

 

4. Mandible Radiography

• Trauma Protocol : PA, Lateral, Oblique(Left, Right)   -> Supplementary view : Orthopantogram (OPG), Submentovertex   • Non Trauma Protocol : PA, Lateral, Oblique(Left, Right)   -> Supplementary view : Orthopantogram (OPG), Submentovertex

1) Adult Mandible - PA

 

2) Adult Mandible - Oblique

 

3) Adult Mandible - Lateral

 

4) Adult Mandible - Orthopantogram (OPG)

(1) The Orthopantomogram (OPG) is a panoramic view of the mandible. 

(2) Structures crossing over the mandible can be distracting. For example, the air-filled oropharynx is often seen as a smooth black line passing across the mandible. 

(3) Carefully following the cortical outline of the mandible shows no fracture.

(4) The mandible has varying appearance according to the developmental stage of teeth.