# Investigations

Investigations

The nature of  the injury sustained will determine the specific investigations required to facilitate diagnosis. Systemic inves - tigations may include routine haematology and biochemistry investigations, and imaging requests such as cervical spine, chest, abdominal or limb radiographs depending on the site of  injury . If a mandibular fracture is suspected, an orthopantomo- gram (OPT) and a posteroanterior (PA) radiograph of the mandible should be obtained ( Figure 31.5 ). It is extr emely important to have two views at right angles to each other to avoid missing any fractures. V ery occasionally a lateral mandibular view may have to be utilised as a screening radiograph if  the patient is unable to cooperate for the OPT (e.g. patients with dementia). For a suspected midface fracture, occipitomental (OM) radiographs at 10° and 30° should be obtained ( Figure 31.6 ). A CT of  the facial bones would be more suitable if  an orbital fracture is suspected or in the case of  a high-impact injury; this will pr ovide the gold standard detail of  bony structures and, as previously mentioned, should include the brain if  there is any suggestion of  a head injury . A three-dimensional (3D) reformatting of  the CT scan allows for excellent visualisation of  the maxillofacial bony structures. 

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History, examination and investigation /uni25CF /uni25CF /uni25CF 

A detailed history of the mechanism of injury is crucial in any
initial assessment
A systematic approach should be adopted in examination of
the craniomaxillofacial structures; a top-down approach is
recommended
The most common radiographs requested in facial fracture
investigation are OPT and PA mandible for mandibular
fractures, and OM facial views for midface fractures

Investigations

The nature of  the injury sustained will determine the specific investigations required to facilitate diagnosis. Systemic inves - tigations may include routine haematology and biochemistry investigations, and imaging requests such as cervical spine, chest, abdominal or limb radiographs depending on the site of  injury . If a mandibular fracture is suspected, an orthopantomo- gram (OPT) and a posteroanterior (PA) radiograph of the mandible should be obtained ( Figure 31.5 ). It is extr emely important to have two views at right angles to each other to avoid missing any fractures. V ery occasionally a lateral mandibular view may have to be utilised as a screening radiograph if  the patient is unable to cooperate for the OPT (e.g. patients with dementia). For a suspected midface fracture, occipitomental (OM) radiographs at 10° and 30° should be obtained ( Figure 31.6 ). A CT of  the facial bones would be more suitable if  an orbital fracture is suspected or in the case of  a high-impact injury; this will pr ovide the gold standard detail of  bony structures and, as previously mentioned, should include the brain if  there is any suggestion of  a head injury . A three-dimensional (3D) reformatting of  the CT scan allows for excellent visualisation of  the maxillofacial bony structures. 

-

History, examination and investigation /uni25CF /uni25CF /uni25CF 

A detailed history of the mechanism of injury is crucial in any
initial assessment
A systematic approach should be adopted in examination of
the craniomaxillofacial structures; a top-down approach is
recommended
The most common radiographs requested in facial fracture
investigation are OPT and PA mandible for mandibular
fractures, and OM facial views for midface fractures

Investigations

The nature of  the injury sustained will determine the specific investigations required to facilitate diagnosis. Systemic inves - tigations may include routine haematology and biochemistry investigations, and imaging requests such as cervical spine, chest, abdominal or limb radiographs depending on the site of  injury . If a mandibular fracture is suspected, an orthopantomo- gram (OPT) and a posteroanterior (PA) radiograph of the mandible should be obtained ( Figure 31.5 ). It is extr emely important to have two views at right angles to each other to avoid missing any fractures. V ery occasionally a lateral mandibular view may have to be utilised as a screening radiograph if  the patient is unable to cooperate for the OPT (e.g. patients with dementia). For a suspected midface fracture, occipitomental (OM) radiographs at 10° and 30° should be obtained ( Figure 31.6 ). A CT of  the facial bones would be more suitable if  an orbital fracture is suspected or in the case of  a high-impact injury; this will pr ovide the gold standard detail of  bony structures and, as previously mentioned, should include the brain if  there is any suggestion of  a head injury . A three-dimensional (3D) reformatting of  the CT scan allows for excellent visualisation of  the maxillofacial bony structures. 

-

History, examination and investigation /uni25CF /uni25CF /uni25CF 

A detailed history of the mechanism of injury is crucial in any
initial assessment
A systematic approach should be adopted in examination of
the craniomaxillofacial structures; a top-down approach is
recommended
The most common radiographs requested in facial fracture
investigation are OPT and PA mandible for mandibular
fractures, and OM facial views for midface fractures