3D CT for Diagnosis of Facial/Mandibular Fractures

Abstract

Objective To describe how the use of 3-D reformatted computer tomographic (CT) images increases the accuracy of diagnosis of facial and mandibular fractures and influences surgical planning. Methods Retrospective review of 20 patients with facial and/or mandibular fractures between 2005 and 2006, diagnosed with CT facial bones (axial and coronal images and 3-D renderings). The study was conducted at a university- affiliated institution. Standard CT facial bones protocol consisting of 1.5mm contiguous axial and coronal sections were performed on a 40-slice scanner (Philips Medical Systems, Cleveland, OH). 3-D reconstructions were then obtained. Scans were reviewed by the consulting surgeon. Pre-operative diagnoses were confirmed intraoperatively. Results Patient mean age was 31 years (17–46). Pre-operative diagnoses included: 18 mandible fractures, 8 zygomatico-maxillary/orbital floor, and 4 midface fractures. Mechanisms of injury included assault, motor-vehicle accidents, sports- and work-related injuries, and falls. Diagnosis and surgical planning was influenced in 1/3 of fractures after reviewing 3-D reformatted images. 3-D reformatting did not add any cost to the CT scans performed, did not expose patients to additional radiation, nor did it significantly increase the time to obtain the study. Conclusions 3-D CT reformatting is an inexpensive, easy-to-obtain diagnostic imaging modality that increases the accuracy of diagnosis and helps improve planning of surgical repair of facial and mandibular fractures.