midfacial

Midfacial refers to the middle portion of the face, occupying the central area between the forehead and the lower face. In anatomical terms, it includes the maxilla, zygomatic bones, nasal bones, lacrimal bones, and the palatine bones, forming the central third of the facial skeleton. The midface supports the orbital rims and the nasal framework and contains the maxillary sinuses. It houses important neurovascular structures, such as the infraorbital nerve and vessels, and several foramina and sinuses that connect the orbit, nose, and oral cavity. The soft tissues overlaying the midface contribute to facial expression and function, while the bony framework provides attachment for muscles of mastication, expression, and the soft tissues of the nose and upper lip.

Clinical relevance: Midfacial anatomy is central to the assessment of trauma, congenital anomalies, and reconstructive surgery. Fractures of the midface are commonly categorized by the Le Fort system: Le Fort I involves a horizontal fracture of the maxilla above the teeth; Le Fort II is a pyramidal fracture involving the maxilla with nasal bones and orbital walls; Le Fort III, or craniofacial disjunction, involves the zygomatic arches and orbital rims. Midfacial injuries can disrupt occlusion, vision, and breathing and may require surgical fixation, orbital reconstruction, and correction of associated dental malocclusion. Midfacial hypoplasia, seen in certain craniofacial syndromes, reduces midface projection and can be treated with orthognathic procedures, distraction osteogenesis, or other reconstructive techniques.

In medical imaging and practice, midfacial assessment is essential in planning cosmetic, reconstructive, and dental treatments. Radiographic evaluation, including CT or cone-beam CT, aids in delineating bony anatomy and detecting fractures, dental alveolar relationships, and sinus involvement.