Facial Bone Computed Tomography Research Articles

Facial Trauma Affects the Radiological Diagnosis of Nasal Bone Fractures.

Timely and accurate diagnosis of nasal bone fractures (NBFs) is crucial for preserving the cosmetic and functional aspects of the nose. This study aims to identify factors influencing radiographic and computed tomography (CT) diagnosis of NBF in patients with nasal trauma. Two hundred six patients with acute nasal trauma underwent both conventional radiography and facial bone CT. An experienced otorhinolaryngologist independently interpreted images. Results were categorized into "Concordance" or "Discrepancy" groups, with demographic and clinical data compared. The study classified 167 patients into "Concordance" and 39 into "Discrepancy" groups based on radiography and CT interpretations. The "discrepancy group" showed higher rates of previous nasal bone fractures (P=0.044), rhinoplasty history (P=0.044), and concomitant facial bone fractures (P=0.001). Adjusted odds ratios revealed significant associations between discrepancies and a history of nasal bone fracture (OR=5.197, 95% CI 1.165-23.171), rhinoplasty (OR=6.114, 95% CI 1.393-26.847), and concomitant facial bone fractures (OR=3.765, 95% CI 1.663-8.523). This study highlights the impact of facial trauma, including rhinoplasty, on the radiological diagnosis of NBF. Consequently, in the presence of signs of concurrent facial trauma, previous nasal trauma, or rhinoplasty history, a prompt CT scan and comprehensive evaluation are recommended for accurate diagnosis and timely treatment, ultimately improving the patient's prognosis.

Radiologic Findings of Complicated Alloplastic Implants in the Nasal Dorsum.

ObjectivesWhen performing cosmetic rhinoplasty with alloplastic materials, complications such as implant visualization, inflammation, dislocation, and extrusion should be thoroughly evaluated. Although computed tomography (CT) can provide useful information about the implant status and its interaction with the skin soft tissue envelope (SSTE), the radiologic findings of these interactions have rarely been reported.MethodsWe retrospectively reviewed the data of 80 patients who underwent facial bone CT or ostiomeatal unit CT at Asan Medical Center between July 2008 and January 2020 for the evaluation of dorsal implants with complications. We reviewed the implantation period, implant dislocation, implant curling or deformation, radiodensity (in Hounsfield units), and nasal bone changes including bone erosion or hyperostosis.ResultsOf the 80 patients, 67 (83.8%) had silicone implants and 13 (16.2%) had Gore-Tex implants. The radiologic findings of the silicone implants were as follows: maintenance of the implant shape (80.6%), radiolucency (similar density to that of fat tissue) halo (83.6%), and homogeneous attenuation (82.1%). Peri-implant calcification was often found in silicone implants with >20-year implantation periods. The findings of Gore-Tex were as follows: curling or deformation (84.6%), heterogeneous attenuation (84.6%), and consistent peri-implant calcification over time.ConclusionSilicone and Gore-Tex implants have distinctive radiologic features. These findings of alloplastic materials help us to understand how implants behave in the nasal dorsum and how they affect the SSTE.

Evaluation of temporal bone pneumatization with growth using 3D reconstructed image of computed tomography

ObjectiveTo evaluate temporal bone pneumatization with growth using 3D reconstructed computed tomography (CT) images. Patients and MethodsEighty-four temporal bones of 42 patients under the age of 16 years who had undergone head and facial bone CT were included in this retrospective study. The bony growth of the temporal bone and the head size were evaluated with horizontal- and vertical-plane CT images. Pneumatization of the temporal bone was investigated with 3D reconstruction software using axial CT images, dividing them as follows: medially, anterosuperiorly, posterolaterally, and inferiorly. Pneumatization of each individual part was compared with that of other parts and was also evaluated according to the aging process. ResultsThe mean pneumatization was measured as 1696.7mm3 in patients aged under 2 years, 3609.1mm3 in those aged 2–4 years, 5351.1mm3 in those aged 5–7 years, 7295.9mm3 in those aged 8–10 years, 7797.5mm3 in those aged 11–13 years, and 8526.6mm3 in those aged 14–16 years. The degree of temporal bone pneumatization of each part was correlated with that of other parts (p<0.05). The volume of pneumatization increased with growth of the temporal bone and with aging. The degree of pneumatization of specific parts might be related to developmental periods. ConclusionThe pneumatization of one part might affect the pneumatization of other nearby parts, or all parts might be affected by the same driving force of pneumatization.

Analysis of the Development of the Nasal Septum and Measurement of the Harvestable Septal Cartilage in Koreans Using Three-Dimensional Facial Bone Computed Tomography Scanning

BackgroundThe septal cartilage is the most useful donor site for autologous cartilage graft material in rhinoplasty. For successful nasal surgery, it is necessary to understand the developmental process of the nasal septum and to predict the amount of harvestable septal cartilage before surgery.MethodsOne hundred twenty-three Korean patients who underwent three-dimensional (3D) facial bone computed tomography (CT) were selected for evaluation of the midsagittal view of the nasal septum. Multiple parameters such as the area of each component of the nasal septum and the amount of harvestable septal cartilage were measured using Digimizer software.ResultsThe area of the total nasal septum showed rapid growth until the teenage years, but thereafter no significant change throughout the lifetime. However, the development of the septal cartilage showed a gradual decline due to ossification changes with aging after puberty in spite of a lack of change in the total septal area. The area of harvestable septal cartilage in young adults was 549.84±151.26 mm2 and decreased thereafter with age.ConclusionsA 3D facial bone CT scan can provide valuable information on the septal cartilage graft before rhinoplasty. Considering the developmental process of the septal cartilage identified in this study, septal surgery should not be performed until puberty due to the risk of nasal growth impairment. Furthermore, in elderly patients who show a decreased cartilage area due to ossification changes, septal cartilage harvesting should be performed carefully due to the risk of saddle nose deformity.

Orbital Morphology for Decompression Surgery in Thyroid Eye Disease Using 2-D Orbital CT and 4 Parameters

Purpose: To present easily measurable 2D orbit computed tomography (CT) reference data that can be used in a preoperative study for orbital decompression and classification of individual orbital morphologies. Methods: The study sample was composed of 77 patients with orbital contusion (42 Asian males + 35 Asian females = 154 orbits) who visited the emergency room of the Korea University Guro Hospital from September 2012 to June 2013. Patients with orbital wall fracture, retrobulbar hemorrhage, or eyeball rupture were excluded. Medical records including 2D orbit or facial bone CT were retrospectively reviewed and 4 orbital parameters (orbital length, OL; globe length, GL; GL/OL ratio and 2D cone angle) were measured. Results: The average OL was 42.53 ± 2.46 mm (35.63-49.09 mm) and average GL was 24.83 ± 1.09 mm (22.75-28.13 mm). The average GL/OL ratio using these 2 parameters was 0.59 ± 0.04 (0.50-0.68). The posterior cone angle was on average, 45.96 ± 5.91° (29.35-60.04°). Conclusions: Simple measurement of 4 parameters using 2D orbit CT and classification of Asian individual orbital morphology may help in the choice of the most effective surgical technique for decompression surgery in thyroid eye disease patients. J Korean Ophthalmol Soc 2014;55(9):1267-1271

Optic Canal Location Using Computed Tomography (CT)

Purpose: In this study we evaluated the location and shape of the optic canal using computed tomography (CT) for diagnosis and treatment of posterior orbital diseases. Methods: Fifty patients, who had received a facial bone CT between November 2012 and June 2013 at Korea University Hospital were included in the present study. The location and shape of the optic canal was evaluated using 9 parameters on CT (P1: nasal bone tip; P2: middle point of tuberculum sellae; P3: root of columella nasi; P4: orbit end of the optic canal; P5: cranium end or the optic canal; P6: P1’s projection on L2; L1: line that links P1 and P2; L2: goes through P3 and parallel to L1; L3: bisector of right and left and goes through P1). Results: The distance between P3 and P4 was 81.5 mm and 75.6 mm in males and females, respectively (p = 0.001). The distance between P3 and P5 was 88.5 mm and 82.1 mm in, males and females, respectively (p = 0.001). The width of the orbital end and cranium end of the optic canal, the length of the optic canal was 2.4 mm, 4.1 mm, 10.9 mm in males and 2.3 mm, 3.6 mm, 10.2 mm, in females, respectively. Conclusions: By determining the location and shape of the optic canal, these results can facilitate endoscopic approaches to diagnose and manage posterior orbital diseases as well as manage and prevent disorders associated with the optic canal. J Korean Ophthalmol Soc 2014;55(9):1272-1276

Trends of CT use in the pediatric emergency department in a tertiary academic hospital of Korea during 2001-2010.

ObjectiveWe wanted to assess the trends of computed tomography (CT) examinations in a pediatric emergency department (ED).Materials and MethodsWe searched the medical database to identify the pediatric patients who had visited the ED, and the number of CTs conducted from January 2001 to December 2010. We analyzed the types of CTs, according to the anatomic region, and the patients who underwent CT examinations for multiple regions. Data were stratified, according to the patient age (< 13 years and 13 ≤ ages < 18 years).ResultsThe number of CTs performed per 1000 patients increased by 92% during the 10-year period (per 1000 patients, increased from 50.1 CTs in 2001 to 156.5 CTs in 2006, and then decreased to 96.0 CTs in 2010). Although head CTs were performed most often (74.6% of all CTs), facial bone CTs showed the largest rate of increase (3188%) per 1000 patients, followed by cervical CTs (642%), abdominal CTs (474%), miscellaneous CTs (236%), chest CTs (89%) and head CTs (39%). The number of patients who had CT examinations for multiple regions in the same day showed a similar pattern of increase, to that of overall CT examinations. Increase of CT utilization was more pronounced in adolescents than in pediatric patients younger than 13 years (189% vs. 59%).ConclusionThe utilization of CTs increases from 2001 to 2006, and has declined since 2006. The increase of CTs is more pronounced in adolescents, and facial bone CTs prevail in increased number of examination followed by cervical CTs, abdominal CTs, miscellaneous CTs, chest CTs, and head CTs.

Three-Dimensional Computed Tomographic Analysis of Frontal Sinus in Asians

Although there are many reports on the measurement of the paranasal sinuses, few studies examined the development of frontal sinus with three-dimensional computed tomography (CT), especially in children. In this study, we evaluated the normal development of frontal sinus in Asian children, and we also analyzed the height, length, and width of the frontal sinus in Korean adults with three-dimensional CT imaging. We retrospectively reviewed three-dimensional facial bone CT of a total of 352 patients younger than 23 years. The occurrence of the frontal sinus was evaluated by their age. The maximal length, height, and width were measured with a computer device. The volume of the frontal sinus was also evaluated. In those older than 4 years, the pneumatization of frontal sinus was detected. Frontal sinus developed continuously and was observed in almost every child older than 17 years. The length, height, width, and volume of the frontal sinus continuously increased until the age of 20. The maximal growth of the frontal sinus was observed at puberty. The width and volume of the frontal sinus showed a high correlation coefficient (r=0.8) relative to the height or length. In adults, the mean height, width, depth, and volume of the frontal sinus were 27.2±7.0 mm, 52.5±17.1 mm, 22.0±6.3 mm, 8.39±3.78 cm, respectively. The results of this study may be helpful in understanding the normal development of frontal sinuses in children. It could be also helpful for further research and surgical approaches for frontal sinuses.

Computed Tomography Use in the Adult Emergency Department of an Academic Urban Hospital From 2001 to 2007

There is both increasing recognition and growing scrutiny of the increased utilization of computed tomography (CT) in medicine. For our primary objective, we determine and quantify the CT utilization rate in our emergency department (ED) during the last 7 years. As a secondary objective, we compare trends in utilization for various types of CT scans. We performed an electronic chart review at our inner-city, academic ED with an annual census of 110,000 patients. We identified all patients older than 21 years who had a CT scan performed during ED management from January 2001 to December 2007. Specific, predetermined data elements (eg, subject demographics, type of CT scan) were extracted on standardized data forms by trained abstractors. We analyzed our data with standard descriptive statistics and linear regression. The rate of CT utilization increased steadily at approximately 10 CTs per 1,000 (95% confidence interval 7.5 to 13.6 CTs) patients annually during our study period, from 51 per 1,000 patient visits in 2001 to 106 per 1,000 in 2007. Among these CTs, chest CTs increased most, with a 6-fold increase from 1 [corrected] per 1,000 patient visits to 6 [corrected] per 1,000. Neck CTs increased by 5-fold, from 2 [corrected] per 1,000 patient visits to 10 [corrected] per 1,000 patients. Similarly, the utilization of abdomen-pelvis CTs, facial bone CTs, and head CTs increased from 13 per 1,000 to 33 per 1,000 patient visits (150%), 1 per 1,000 to 2 per 1,000 patient visits (100%), and 33 per 1,000 to 53 per 1,000 patient visits (60%), respectively. Recent CT utilization in our ED increased in all anatomic categories assessed, with chest CTs and neck CTs increasing the most, followed by abdomen-pelvis CTs, facial bone CTs, and head CTs.