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Thirty patients with fractures of the apex of the orbit were examined by clinical and x-ray methods. The types of fractures of facial skull bones were specified, which were aggravated by the patients state, as was the type of injuries to osseous structures participating in the formation of the orbital apex. A purposeful x-ray examination of the orbital apex in patients with injuries to facial bones helps to rule out undervaluation of the severity of injury which can be assessed only on the basis of clinical signs. Use of a modified panoramic sonography for examination of the apex of the orbit in accordance with the standard program of Sonark device for the examination of orbital nerve canals helps assess the nature of injuries to bone structures in this area.

Under study were 248 patients with fractures of the upper and middle zone of face including injury of the zygomatic bone. The examination performed has revealed a joint character of the injury of the zygomatic bone and the maxillary sinus walls. The rational grouping of fractures of the zygomatic bone includes isolated fractures of its processes and lower edge of the orbit as well as fractures of the zygomatic-maxillary complex. The panorama zonography is an effective method of diagnosing fractures of the zygomatic bone and the zygomatic-maxillary complex.

Fifty-two patients with naso-orbital fractures were examined. Regularities in isolated and multiple injuries of such bones were detected. Specific features of the injuries of individual osseous structures of the naso-orbital complex in various types of fractures were analyzed. Traumatic injuries of this site are characterized by a high incidence of injuries to the frontal sinus walls and to the structures of the anterior segment of the skull. Panoramic sonography better demonstrates the volume and extension of the injuries. Linear tomography in a lateral projection should supplement panoramic sonography, specifying the status of the frontonasal anastomosis, posterior wall of the frontal sinuses, cerebral wall of the ethmoidal labyrinth and the cribriform plate.

Le Fort's fractures of maxillary bones are referred to grave injuries that require an accurate and urgent diagnosis. A total of 70 patients with different variants of such fractures were examined. The x-ray examination included polypositional roentgenography, linear tomography and panoramic sonography with the Sonarc apparatus. The injuries with all signs of Le Fort's fractures of two and even three types predominated, asymmetric injuries were rather frequent. Panoramic sonography with the patient in a modified position helped specify the volume and extension of the injury to the facial bones, but it should be supplemented with linear tomography to detect the injuries of the pterygoid processes of the major bone of the anterior and posterior walls of the maxillary sinuses, of the frontonasal channel opening, of the posterior wall of the frontal sinuses and the anterior cranial fossa structures, the detection of injuries of the pterygoid processes being the key sign in the differential diagnosis of Le Fort fractures.

The authors examined 436 patients with acute trauma of the upper and middle zones of the visceral cranium. Injury to the anterior cranial fossa was discovered in fractures of the orbitonasal complex, isolated fractures of the upper zone, fractures of the Le Fort II and Le Fort III types, and multiple fractures of the upper and middle zones of the face. Such fractures were found in 158 cases, in 76 of them (48.1%) damage to the anterior cranial fossa was recognized. A relationship was found between the frequency of fractures of the anterior cranial fossa and the type of injury to the bones of the face. The features of injury to the separate structures of the anterior cranial fossa are specified. The modified program of panoramic sonography by means of a Zonark apparatus makes it possible to examine the anterior cranial fossa of a patient in a supine position with a small number of exposures, which makes the examination much easier for the patient.

A total of 453 patients with acute injuries of the upper and median zones of the facial skull were examined. The most frequent injury was that to the orbital entrance, fractures of the inferior wall; fractures of the exterior, interior, and anterior walls were less incident, and fractures of the orbital apex were the most rare. Types of the skull bone fractures, associated with injury to the orbital walls, were distinguished. The x-ray semeiotics of injuries to the orbital walls was specified making use of panoramic sonography. Panoramic zonography [correction of sonography] with the use of the Zonark [correction of Sonarc] apparatus helps identify the volume and extension of the injuries on all the orbital walls and is altogether an effective method for the diagnosis of the orbital wall fractures.

Altogether 32 patients with blow-out fractures of the orbit were investigated, using an x-ray study that included panoramic zonography. Isolated blow-out fractures and blow-out fractures combined with injured adjacent facial bones, were singled out. X-ray signs were divided into direct ones, characterizing a parietal fracture, and secondary ones, determined by secondary traumatic changes. Fractures of the lower and medial walls of the orbit were considered.