Signs and Symptoms
LEFORT I – Slight swelling of the upper lip, ecchymosis is present in the buccal sulcus beneath each zygomatic arch, malocclusion, mobility of teeth. Impacted type of fractures may be almost immobile and it is only by grasping the maxillary teeth and applying little firm pressure that a characteristic grate can be felt which is diagnostic of the fracture. Percussion of upper teeth results in cracked pot sound. Guerin’s sign is present characterised by ecchymosis in the region of greater palatine vessels.
Lefort II and Lefort III(common)- gross edema of soft tissue over the middle third of the face,bilateral circumorbital ecchymosis,bilateral subconjunctival haemorrhage,epistaxis,CSFrhinorrhoea,dish face deformity,diplopia,enophthalmos,cracked pot sound.
Lefort II- step deformity at infraorbital margin,mobile mid face,anesthesia or paresthesia of cheek.
Lefort III- tenderness and separation at frontozygomatic suture,lengthening of face,depression of occular levels, enophthalmos, hooding of eyes, tilting of occlusal plane with gagging on one side.
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