High-resolution CT analysis of facial struts in trauma: 1. Normal anatomy

The recent availability of high-spatial-resolution thin-section computed tomography (CT), capable of accurately depicting the thin body septa of the facial skeleton, has expanded the role that diagnostic radiology can play in the evaluation of the patient with facial trauma. A detailed knowledge of the normal CT anatomy of the face, however, is essential to optimally utilize this modality. The normal anatomy of the face was investigated in six cadavers using thin-section (1.5 mm) high-resolution CT. A systematic method of analysis that can facilitate evaluation of the face is presented. The face is conceptualized as three groups of interconnected osseous struts or buttresses that are oriented in the horizontal, sagittal, and coronal planes. Each group of struts is closely related to specific soft-tissue structures that are susceptible to injury. Sequential evaluation of each strut and its associated soft tissue assures a comprehensive evaluation of the face. While both axial and coronal sections are of value in some circumstances, the coronal ones are most helpful in accurately depicting the structures of the face that are most likely to be injured in trauma.