Diagnosis Of Maxillofacial Trauma Research Articles

Comparison of CT, 3D Reconstruction, and Virtual Reality in the Interpretation of Maxillofacial Fractures

Aim To assess the role of virtual reality (VR) in the diagnosis of maxillofacial trauma

Etiology, diagnosis, and demographic analysis of maxillofacial trauma in elderly persons: A 10-year investigation

PurposeThe aim of this study was to investigate etiologies and diagnoses of maxillofacial trauma in emergency services in Brazil over a period of 10 years. Additionally, associations among sex, age, accident location, and dependent variables were analyzed. Understanding the epidemiology of trauma and the physiology of aging is important in maintaining health and bettering service for the elderly population. Materials and methodsThe primary mode of investigation was analysis of medical records from 2003 to 2013. These researchers recorded the diagnosis and etiology of the trauma, the location where the accident occurred, and the sex and age of the participants. Variable categories were compared using Chi-squared distribution, and logistic regression was used to analyze the associated factors. ResultsOf the 677 individuals analyzed, the female sex was predominant (57.61%) and the most prevalent age ranges were between 60 and 69 years (40.18%) and between 70 and 79 years (35.16%). Chi-squared distribution showed that men suffered more fractures (18.47%, p = 0.028) and women suffered more contusions (21.54%, p = 0.028). With regard to the various etiologies related to the traumas, traffic accidents (17.77%, p < 0.001) and aggression (17.42%, p < 0.001) were more frequent in males, and falls (83.03%, p < 0.001) were more frequent in females. The primary etiologies for maxillofacial trauma in the elderly population were falls, and the primary diagnoses were fractures. ConclusionA deeper understanding of the physiological changes associated with aging, and preventive action to reduce falls, traffic accidents, and aggression in this population could be beneficial with regard to quality of life for elderly persons.

Comparative Study of Clinical Manifestation, Plain Film Radiography and Computed Tomography for Diagnosis of Maxillofacial Trauma

Objective: Maxillofacial injuries are one of the commonest injuries encountered. Roentgenographic evaluation of maxillofacial trauma is of prime importance for diagnosis and treatment of these injuries. Study Design: Forty patients were evaluated in the prospective four-year study. We studied and evaluated the demography and diagnostic efficacy of clinical, plain radiography, and computed scan in maxillofacial trauma. Result: Road traffic accidents were the commonest cause of maxillofacial injuries. Patients having multiple fractures, mandibular fractures were the commonest. Conclusion: Computed tomography proved a useful adjunct in midfacial trauma.

Patterns and etiology of maxillofacial fractures in Riyadh City, Saudi Arabia

The aim of the present study was to study the etiologies and patterns of maxillofacial fractures in patients treated in Riyadh City, Saudi Arabia, between 2007 and 2011. Data were obtained through a retrospective review of 237 patients admitted to the King Saud Medical City Dental Department with a diagnosis of maxillofacial trauma. After excluding patient files with incomplete or unclear records, and cases in which computed tomography showed no evidence of fracture, the files of 200 patients with a diagnosis of maxillofacial fracture were included in the study. For each case, patient's sex and age, pattern of facial fractures, and cause of injury were recorded on a data sheet. The data were transferred to an SPSS (ver. 16.0; SPSS Inc., Chicago, IL, USA) spreadsheet for statistical analysis. The chi-square test was used to test the association between two categorical variables or factors (age group, cause) with p value set at p<0.05, and t-test value at <0.05 and independent. Motor vehicle accidents were the most common cause of maxillofacial fractures in most age groups, especially in males. Within the study sample, mandibular fractures were significantly more common than middle-third facial fractures (56.4% vs. 43.6%; p=0.006). Among mandibular fractures, parasymphyseal fractures were most common (47%), followed by condylar fractures (35.3%). Most (77.2%) middle-third facial fractures involved the zygomatic complex, and the incidence of such fractures differed significantly between male and female patients. p=0.72, not significant. Males were more prone to maxillofacial fractures, perhaps as a result of the conservative nature of Saudi society, as the rules of Saudi Arabia do not allow the females to drive. Motor vehicle accidents were the most common cause of maxillofacial fractures in patients aged 10-29years, indicating the high demand for the application of stricter traffic rules to reduce the rate of such accidents.

Letter to The Editor: 3D CT Reconstruction of Mandibular Fractures

To the Editor Computed tomography (CT) has become a routine diagnostic tool in the management of maxillofacial trauma [1]. Advances in technology allow multiplanar 2-dimensional (2D) and 3-dimensional (3D) reconstructions [2]. 3D reconstruction imaging has found varied applications [3]. But can we take this to mean that imaging modalities like dental panoramic radiographs have no role in the diagnosis of maxillofacial trauma? We found the answer is not clear-cut. A maxillofacial trauma patient was examined and found to have soft tissue wounds over the midface and swelling over the right angle of mandible with sublingual ecchymosis. Palpation also revealed an acute tenderness of left body of mandible. CT scan was performed and 3D reconstruction generated. The images depicted horizontally unfavourable fracture of right mandibular angle with clarity (Fig. 1). This image was superior to traditional 2D CT or panoramic radiograph. However, no mandibular body fracture was evident in the 3D CT reconstruction (Fig. 2). Due to continuing clinical suspicion of mandibular body fracture, a panoramic radiograph was made. It revealed undisplaced left mandibular body fracture (Fig. 3). Fig. 1 3D CT reconstruction depicting mandibular angle fracture Fig. 2 No evident fractures of mandibular body on 3D CT reconstruction Fig. 3 Panoramic radiograph depicts undisplaced left mandibular body fracture Accurate and detailed images of the facial skeleton in polytrauma patients can be obtained speedily with spiral CT scans. However, in 3D CT reconstruction, volume averaging and threshold errors may lead to misrepresentation. Regardless of the investigated structure, careful analysis of 2D axial and secondarily reconstructed coronal images is mandatory [2]. In addition to thorough clinical examination, the dental panoramic radiograph remains a most important imaging tool for fractures of the mandible. In conclusion, though 3D CT reconstructed images can be impressive, they cannot be the sole basis for surgical decisions.

Usefulness of Ultrasonography in the Treatment of Nasal Bone Fractures

Ultrasonography has recently been used in assessment and diagnosis of maxillofacial trauma because it is easy and quick to perform, inexpensive, portable, and noninvasive. The aim of this study was to estimate ultrasonography as an intraoperative repositioning control of nasal bone fractures. We studied 32 patients with suspected nasal bone fracture. We performed preoperative computed tomography (CT) for evaluation of the type and extent of nasal bone fractures. We also took external photographs for evaluation of external deviation of the nose and nasal deformity. During surgery, we performed real-time ultrasonography-guided closed reduction using a 10 MHz linear transducer. After 1 year, we performed postoperative evaluation with CT and external photography. We classified patients into three groups according to their CT score. Patients were 23 males and 9 females aged 8-39 years. Clinical symptoms were pain, nasal swelling, nasal bleeding, and localized depression at the trauma site. In almost all patients, postoperative external photographs showed a symmetrical nasal dorsum without external deformity, and postoperative CT showed stabilization of bony fragments and good alignment of the nasal bone. Postoperatively, the CT score was 3 (excellent) in 25 patients, 2 (good) in 5 patients, and 1 (fair) in 2 patients. We suggest that ultrasonography is very useful for evaluating intraoperative repositioning of nasal bone fractures.

Computed tomography in the diagnosis of maxillofacial trauma

A study of 34 patients who were investigated for maxillofacial trauma using high resolution computed tomography (CT) scanning is presented. The areas where this increasingly available technique offers more accurate information than conventional plain radiographs are discussed.