Usefulness of Intraoperative Computed Tomography in Facial Bone Fracture Repair and Sinus Surgery

Abstract

Background and Objectives : The usefulness of intraoperative CT (iCT) in rhinologic surgery including reduction of facial bone fracture and sinus surgery was evaluated. Subjects and Method : Medical records and radiological findings of 17 patients who took iCT at the Medical Center between December 2008 and February 2010 were reviewed retrospectively. The mean follow-up period was 2.2 months. The 17 patients included 14 facial bone fractures and three sinus surgeries. Indications for iCT and the need for additional procedure after iCT were investigated. All operations were performed by the senior author. Results : Indications for iCT were comminuted nasal bone fracture with or without septal fracture, displaced zygoma fracture and orbital blowout fracture. The complex frontal sinus anatomy either by anatomic variation or tumor invasion was an indication for iCT in sinus surgery cases. Additional surgeries were necessary after iCT for five patients (29.4%) as follows: nasal bone reduction (2), zygomatic bone reduction (1), and the removal of meningioma (1) and inverted papilloma (1). Except for one patient, all patients showed satisfactory surgical outcomes in terms of completeness of fracture reduction or surgical removal of sinus pathology. Conclusion : In complex facial bone fracture or sinus diseases, an iCT helps to evaluate the completeness of fracture reduction or sinus dissection during the surgery and to decide the necessity for further surgery.