Multidetector computed tomography in evaluation of maxillofacial injuries

Abstract

Facial injuries occur in significant proportion in trauma patients requiring prompt diagnosis and management. The number of maxillofacial injuries is continuously increasing due to rise in traffic, failure to take preventive measures in the traffic leads to road traffic accidents, which is the main etiological factor in maxillofacial fractures. To study role of multidetector tomography in evaluation of maxillofacial injuries. To describe the advantages of 3D reconstructed images over axial images in the imaging of facial fractures. This cross-sectional study included 100 patients who underwent CT evaluation of facial bones when they presented with evidence of fracture of maxillofacial bones on a 64-slice volume scanner (SIEMENS SOMATOM definition) in Geetanjali Medical College and Hospital, Udaipur during February 2019 to July 2020. RTA comprised of 76.19% cases. Assault and fall from height were 11.42 and 12.38%. The maxilla, the walls of its sinus were the most commonly involved bone with 71.42% next was Naso-orbito-ethmoid 68.57%. Zygomatic bone and mandible fractures were 50 and 38.09%. The type 2 frontal bone fractures were commonly seen 12 (31.5%) followed by Type 3, 10 (26.02%), Type 4 & Type 1 seen in 6 (15.7%) and Type 5 was the least common injury seen 4 (10.52%). The medial wall of the orbit was most commonly involved 49 (35.76%). Le Fort fracture lines were identified in 17 occasions with Le Fort II seen 9 (52.9%). The advantages of 3D images within the assessment of facial trauma might be described especially in mandible and cheekbone. 3D images were better within the identification of Le Fort fracture lines. The coronal reconstructed images are superior in the detection of fractures in the orbit and maxilla. 3D images have a limited role in fractures involving the naso-orbito-ethmoid region and also when there is minimal fracture displacement.