Multi detector computed tomography in maxillofacial injuries

Abstract

Background: Imaging is an important step after the clinical evaluation in the workup of patients with facial trauma .It helps to define the extent of injury and to plan the surgical, interventional, or conservative therapy. Multidetector computed tomography (MDCT) is the imaging technique of choice to detect and characterize the number of fractures, fragments, the degree of dislocation, and the involvement of anatomical structures. It provides a three-dimensional (3D) mapping of the smallest fractures and abnormalities in a short period of time in trauma and emergency setting.Results: The study included 30 patients with mean age of 41.07± 13.92 years with age range of 21 – 68 years. In most of the cases the mode of injury was road traffic accidents among 23(76.7%). Fracture maxilla in 63.3% followed by mandible in 56.7% was the most common bone involved in facial fractures. Hemosinus (56.7%) was the most common associated finding in the patients who presented with facial trauma. Brain contusions were the next common finding seen in 30% patients. Medial wall of the orbit was the most common wall involved in orbital fractures. The mandibular injuries were most common in the condyle and the body of the mandible. Le Fort fracture lines were identified in 17 patients with the most common Le Fort line being the Le Fort II & Le Fort III which was seen 7 patients (23.3%) each.Conclusion: The complex anatomy of the facial bones requires multiplanar imaging techniques for a proper evaluation. The main purpose of diagnostic imaging is to detect and localize the exact number, site of facial fractures and soft tissue injuries. 3D images are useful, although variable for different bones, in the assessment of complex fractures involving the face. Coronal images are useful adjunct in detection of facial fractures. MDCT offers excellent spatial resolution, which in turn enables exquisite multiplanar reformations, and 3-D reconstructions, allowing enhanced diagnostic accuracy and surgical planning.