EVALUATION OF MAXILLOFACIAL AND ORBITAL INJURIES BY MULTI DETECTOR COMPUTED TOMOGRAPHY
Main Article Content
Keywords
Maxillofacial, Orbital Injuries, Multi Detector Computed Tomography
Abstract
Background: The rapid pace of twenty first century, living with high speed travel, our increasingly violent and less tolerant society has made facial trauma an ever increasing problem. Facial trauma can be regarded as a form of social disease from which no one is immune..
Objective: To study the role of computed tomography in the evaluation of maxillofacial trauma thus helping the surgeon in proper management of the cases.
Methods: The main source of data for the study is patients referred to department of Radiology, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda. All patients with trauma to the maxillofacial region, usually acquired in motor vehicle accidents or personal altercations referred to the Department of Radiodiagnosis in a period of 2 years from December 2014 to June 2016 were subjected to study
Results: In our study majority of the patients were males (80%) and in the age group of 25-35 years (40%).We found that anterior maxillary sinus wall (12.6%) was the most commonly fractured site, followed by zygomatic arch (11.8%). Cribriform plate was the least commonly fractured site (0.4%). In our study, zygomatico-maxillary fractures (26.4%) were the most common type of fractures, followed by mandibular fractures (21.5%). In the mandible, body (43%) was the most frequently fractured site, followed by condyle (22%)
Maxillary wall, orbital wall, and pterygoid plate fractures were detected on CT which were least suspected on clinical assessment. Axial CT sections were superior in detecting the fractures of anterior maxillary sinus wall and zygomatic arch. Coronal CT was better for detecting fractures of orbital floor, orbital roof, pterygoid plates and mandible. Both axial and coronal were equally efficient in detecting fractures of the nasal bones, medial orbital wall and posterolateral maxillary sinus wall.
Conclusions: CT is the most accurate diagnostic method in the evaluation of maxillofacial injuries when compared to clinical assessment. CT sections taken in a plane perpendicular to a strut provides the best information about the fractures and displacements of that strut,
References
2. Shekar RC, Reddy CV. A five-year retrospective statistical analysis of maxillofacial injuries in patients admitted and treated at two hospitals of Mysore city. Indian Journal of Dental Research 2008;19(4):304-8.
3. White LM, Marotta TR, McLennan MK, Kassel EE. Facial Fractures using imaging methods to discover facial injuries. Can Fam Physician 1992 Mar;38:645-56.
4. Alvi A, Doherty T, Lewen G. Facial Fractures and Concomitant Injuries in Trauma Patients. The Laryngoscope 2009 Jan 2;113(1):102-6.
5. Chain TT, Sun TW, Tzung CC, Pin LJ, Ray CY. Acute Life-Threatening Injuries in Facial Fracture Patients: A Review of 1,025 Patients. J Trauma 2000 Sep;49(3):420-4.
6. Lee KH, Chou HJ. Facial fractures in road cyclists. Aust Dent 2008 Aug 18;53(3):246-9.
7. Anbiaee N, Vaezi T, Khamchin F, Hafez Maleki F. Maxillofacial Fractures in CT scan Images of Adult, Adolescent, and Child Patients in Radiology Ward of Mashhad’s ShahidKamyab Emergency Hospital in 2010. Journal of Dental Materials and Techniques. 2015 Jun 1;4(2):95-100.
8. Gentry LR, Manor WF, Turski PA, Strother CM. High-resolution CT analysis of facial struts in trauma: 2. Osseous and soft-tissue complications. AJR 1983 Mar;140:533-41.
9. Kreipke DL, Moss JJ, Franco JM, Mayes MD, Smith DJ. Computed tomography and thin-section tomography in facial trauma. AJR Am J Radiol1984;142:1041-45
10. Tanrikulu R, Erol B. Comparison of computed tomography with conventional radiography for midfacial fractures. Dentomaxillofacial Radiology 2001;30:141-146.
11. Al Ahmed HE, Jaber MA, Fanas SHA, Karas M. The pattern of maxillofacial fractures in Sharjah, United Arab Emirates: a review of 230 cases. Oral Surg Oral Med Oral Pathol Oral RadiolEndod 2004 Aug;98(2):166-70.
12. Rai B, Dhattarwal SK, Jain R, Kangra V, Anand SC, Bhardawaj DN. Road Traffic Accidents: Site Of Fracture Of The Mandible. The Internet Journal of Epidemiology 2007; 4(2).
13. Bernard LM, Jordan DS, Henry KK Jr, Kris S, Farhad K. Prospective Comparison of Axial Computed Tomography and Standard and Panoramic Radiographs in the Diagnosis of Mandibular Fractures. Ann Plast Surg. 1999 Aug;43(2):220-5.
14. Thapliyal GK, Sinha R, Menon PS, Chakranarayan A. Management of mandibular fractures. MJAF1 2008;64:218-220.
15. Dibaie A, Raissian S, Ghafarzadeh S. Evaluation of maxillofacial traumatic injuries of Forensic Medical Center of Ahwaz, Iran, in 2005. Pak J Med Sci 2009;25(1):79-82.
16. Lee Hi, Jilani M, Frolunan L, Baker S. CT of orbital trauma. Emergency Radiology 2004;10:168-72.
17. Erol B, Tanrikulu R, Gorgun B. Maxillofacial Fractures. Analysis of demographic distribution and treatment in 2901 patients (25-year experience). J Craniomaxillofac Surg 2004 Oct;32(5):308-13.
18. Giovanni G, Fabio R, Pier DG, Sid B. Maxillofacial trauma in the elderly. J Oral Maxillofac Surg 1999;57:777-82.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Kancherlapalli Divya Rani
Assistant Professor, Department of Radiodiagnosis, Government Medical College. Mahabubnagar, Telangana
Nagateja Bonala
Associate Professor, Department of Radiodiagnosis, IQ City Medical College, Durgapur Westbengal
Padala Mohan Kumar
Assistant Professor, Department of Orthopaedics, Government Medical College, Sangareddy,Telangana.