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

Abstract

Introduction: Maxillofacial injuries are one of the most frequently encountered cases accounting for a large proportion of patients in emergency department. Multidetector Computed tomography (MDCT) is now an important imaging tool for evaluating maxillofacial trauma, having largely replaced plain radiographs due to its ability to detect the exact site, number and extent of fractures as well as added advantages of 3D reconstruction and multiplanar reformatting.Objective: This study was performed to assess the role of MDCT in patients of maxillofacial trauma and to describe the demographic variations as well as frequency and types of fractures that underwent CT scans.Materials and methods: Maxillofacial trauma patient sent for needful CT scan from emergency room to Department of Radiology from September 2015 to March 2017 were included in the study. Total of 50 cases were included. Following parameters were obtained: age, sex, time of injury, cause of injury, history of LOC (loss of consciousness), influence of alcohol and presence and type of fractures. The imaging findings were studied, multiplanar reconstructions were performed in all cases using high resolution bone window and soft tissue window, as well as 3D reconstructions and fractures were identified and classified.Results: There were 42 male and 8 female patients, the majority of whom were below 40 years of age. Most injuries occurred during evening (36%) and the most common cause of injuries in our study was road traffic accidents (44%), physical assault (32%), fall from height (20%) and sport injuries (4%). 70% patients had RTA under the influence of alcohol. Motorbike accidents were common (55%) in RTA patients. 44% had loss of consciousness following trauma. Out of 50 patients, 48 patients had total of 102 fractures while the rest 2 had minor soft tissue injuries. The frequency and types of fracture was as follows: maxillary sinus wall fracture (20.6%) 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% ). Conclusion:Maxillofacial trauma is one of the most common emergency requiring accurate and early diagnosis. MDCT is useful diagnostic tool for the identification and classification of maxillofacial region fractures and aiding in surgical planning.