Resident Manual of Trauma to the Face, Head and Neck

1. Symptoms (Subjective)...........................................................53 2. Signs (Objective).......................................................................53 C. Classification of Medial Canthal Tendon Injuries................... 57 D. Lacrimal System Injuries............................................................... 57 1. Primary Jones Dye Test............................................................58 2. Secondary Jones Dye Test......................................................58 E. Isolated Orbital Fractures..............................................................59 F. Diagnostic Evaluations. .................................................................59 1. Full-Body Trauma Assessment .............................................59 2. Head and Neck Examination .................................................59 3. Ophthalmological Evaluation ................................................59 4. Inspection of the Nasal Interior............................................ 60 5. Interpupillary and Intercanthal Distance Measurements ......................................................................... 60 6. Imaging Studies ....................................................................... 60 7. Forced Duction Testing .......................................................... 60 8. Plain Radiographs of the Face ................................................61 9. Digital Photographs ..................................................................61 G. Surgical Management....................................................................62 1. Indications for Surgery.............................................................62 2. Timing of Surgical Procedures...............................................62 3. Surgical Exposure Options......................................................62 4. Reconstructive Options...........................................................66 H. Prevention and Management of Complications......................69 1. Indications for Antibiotics.......................................................69 2. CSF Leaks....................................................................................69 3. Corneal Injuries..........................................................................69 4. Lower Lid Abnormalities.........................................................70 5. Persistent Telecanthus.............................................................70 6. Failure to Correct Medial Orbital Tissue Entrapment......70 7. Persistent Diplopia.....................................................................71 8. Anosmia.......................................................................................71 9. Frontoethmoid Sinusitis............................................................71 III. Summary and Conclusion ..................................................................72 A. Frontal Sinus and Anterior Skull Base Trauma.........................72 B. NOE Fractures..................................................................................72 IV. References ..............................................................................................73 V. Recommended Reading ......................................................................73

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