Pediatric emergency medicine trisk 3290 3290

visualization of the superior orbital rim, frontal sinuses, and nasoethmoid complex; however, the orbital floor is often obscured The lateral view is useful for the detection of fractures to the anterior wall of the frontal sinus, the anterior and posterior walls of the maxillary sinus, and the nasal bones The submentovertex view provides visualization of the zygomatic body and arch Posterior–anterior, right and left lateral oblique, and Towne views are used to detect fractures of the mandible; however, fractures of the symphysis may be difficult to discern Panorex views provide visualization of the entire mandible and lower teeth Obtain Subspecialty Consultation When Indicated The clinician must evaluate whether subspecialist input is warranted for the management of facial trauma in children Plastic surgeons, ophthalmologists, otorhinolaryngologists, and oral and maxillofacial surgeons have expertise in the management of patients with facial trauma Once it is determined that subspecialist input is warranted, the decision of which subspecialist to involve will depend largely on availability and expertise of such individuals within the institution FACIAL FRACTURES Mandible Fracture Goals of Treatment The primary goals in treatment of mandible fractures include (1) airway stabilization, (2) pain control, and (3) evaluation for the need for subspecialty consultation and possible surgical intervention CLINICAL PEARLS AND PITFALLS Clinical evaluation of any chin laceration should include palpation of the mandible, particularly the mandibular condyles, to evaluate for mandible fracture The majority of mandibular fractures can be managed conservatively with closed reduction and/or maxilla–mandibular fixation Preauricular swelling and inability to fully close the mouth are key features of temporomandibular joint dislocation Clinical Considerations