Maxillofacial and Orbital Injuries Evaluation by Three Dimensional MDCT

Abstract

There has been considerable increase in maxillofacial and orbital injuries due to road traffic accidents, falls and assaults. There is need for accurate detection of these maxillofacial bony fractures. MDCT is the method of choice in the evaluation of maxillofacial traumas, as it allows accurate determination of the presence, location and extent of fractures especially in cases of communited fractures, rotational deformities and multiple bone fractures also having advantage to diagnose even in patients with facial edema, lacerations and altered sensorium. PURPOSE: The objective of the study is to compare axial, coronal and 3D reformatted CT images for the study of maxillofacial and orbital fractures. MATERIALS AND METHODS: Multislice CT scan was done for 131 patients attending BTGH Gulbarga with history of maxillofacial and orbital trauma during the period of December 2012 to September 2014 using Philips Brilliance 6 slice CT scanner. RESULTS: Majority of the patients were males (85.5%) belonged to age group of 21-30 years (42%). Most common cause of maxillofacial trauma was road traffic accident (78.6%). Fractures of nasal bones were most common followed by walls of maxillary sinuses and least common fractured bone was cribriform plate. Most common type of complex fracture was naso-ethmoido-orbital complex fracture followed by zygomaticomaxillary complex. Lateral wall of the orbit was most commonly fractured followed by medial wall and floor. DISCUSSION: Axial CT was better in diagnosing anterior maxillary wall, zygomatic arch fractures. Coronal CT was better in detecting orbital floor, Orbital roof, Pterygoid plate fractures, Classification of Le Fort fractures and orbital floor blow out fractures. 3D CT was slightly better to 2D CT in evaluating anterior maxillary wall fractures and frontal bone fractures. 2D and 3D CT were almost similar in evaluating fractures of nasal bone, zygomatic bone and zygomatic arch fractures. 3D CT was inferior to 2D in medial wall of maxillary sinus, medial wall of orbit, pterygoid plate fractures. CONCLUSION: MDCT offers excellent spatial resolution, which in turn enables exquisite multiplanar reformations and 3-D reconstructions allowing enhanced diagnostic accuracy and surgical planning.

Role of Computed Tomography in the Evaluation of Patients with Maxillofacial Trauma

“…The total number of fractures recorded were 102. By far the commonest fracture on CT was maxillary sinus wall fracture (20.65%) followed by followed by orbital floor fractures (16.6%), nasal fractures (14.7% ), mandibular fractures (11.7% ), tripod fractures (8.8%), isolated zygomatic arch fractures (7.8%), Le Fort fractures (6.8%), orbital wall fractures (4.9%), NOE complex fractures (2.9%), dento-alveolar fractures of maxilla (1.9%) and other fractures (2.9% ) which was similar to study done by Gabriela Tomlich et al [13], Kaleem Ahmad et al [7], Shrisail Patil et al [14].…”

“…Motorbike is one of the major source of transport in Nepal as Nepal is low income country and its easy to travel with motorbike in hilly areas. Out of 22 patients involved in RTA, alcohol by any means was found to be involving in 12 patients (54.54%) which is in accordance with study conducted by V. Ravindran et al [12], Gabriela Tomlich et al [13], Shrisail Patil et al [14], Subhasraj K et al [15], Rajib khadka et al [10].…”

Role of Multidetector Computed Tomography in the Evaluation of Maxillofacial Trauma

“…Zygomaticomaxillary fractures were also quite common in their study (14%); whereas in our study, nasal bone fractures were the second-most common. Similarly, Patil et al also found the nasal bone to be the most common bone to be fractured, followed closely by naso-ethmoidal and zygomatic-maxillary complex fractures [13]. Axial and coronal images were found to be better for fractures of orbit fractures.…”