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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