Computed tomography in medial maxilla-orbital fractures

The frontal process of the maxilla together with the anterior wall of the antrum constitute a major support of the midface. If this is fractured and goes unrecognized, serious facial deformities result. Fractures through this process occurred in 13 of 50 patients who received computed tomographic examination for facial trauma. The fracture had been missed on plain film examination in all but three of the 13 patients. The frontal process is usually displaced directly posteriorly in the more complex midface fractures. It may rotate about its long axis when associated with trimalar fractures and in some of the isolated injuries of the medial maxilla. Computed tomography is the ideal technique for demonstrating these fractures because of ease of examination, optimal anatomical display for demonstrating rotational and posterior displacements, and superior contrast in the severely traumatized facial skeleton.