Imaging of high-energy midfacial XXXX : what the surgeon needs to know.

@entity174 @entity2123 @entity71 @entity130
Treatment goals in severe midfacial @entity130 are restoration of function and appearance. Restoration of function is directed at multiple organ systems, which support visual acuity, airway patency, mastication, lacrimation, smelling, tasting, hearing, and facial expression. Victims of blunt @entity2123 expect to look the same after surgical treatment as before injury. Delicate soft tissues of the midface often make cosmetic reconstructive surgery technically challenging. Generally, clinical evaluation alone does not suffice to fully characterize @entity174 associated with extensive swelling, and the deeper midface is not accessible to physical examination. Properly performed computed tomography (CT) overcomes most limitations of presurgical examination. Thus, operative approaches and sequencing of surgical repair are guided by imaging information displayed by CT. Restoration of function and appearance relies on recreating normal maxillofacial skeletal anatomy, with @entity71 , mandibular condyles, vertical dimension and orbital morphology. Due to its pivotal role in surgical planning, CT scans obtained for the evaluation of severe midfacial @entity130 should be designed to easily depict the imaging information necessary for clinical decision making. LEARNING OBJECTIVES: 1. Understand the facial skeletal buttress system; 2. Understand how the pattern of derangement of the buttress system determines the need for and choice of operative approach for repair of @entity174 in the middle third of the face; 3. Understand the role and importance of CT and CT reformations in the detection and classification of the pattern of buttress system derangement.
