الفهرس | Only 14 pages are availabe for public view |
Abstract Fracture morphology of maxillofacial trauma is often complex, so the clinicians should be familiar with the imaging findings. Various radiographic methods have been used for diagnosing maxillofacial trauma. In recent years, Multidetector computed tomography (MDCT) with multiplanar reformation (MPR) and three-dimensional (3D) images has become a standard part of the assessment of maxillofacial injury because of the exquisite sensitivity of this imaging technique for fracture (Sasaki et al. 2014). Plain radiography is the initial imaging modality in trauma patients; but due to inadequate information its significance in maxillofacial trauma has declined in assessing the severity of the injury. Although there is a risk of radiation, computed tomography (CT) scan has the advantage of providing images of thin slices of the facial skeleton, overcoming the problem of the superimposition of structures that inevitably occurs on plain radiographs. Furthermore, the digital acquisition of information, as opposed to the analogue information of plain films, allows electronic manipulation of the data by altering the settings to provide images either at bony window levels or for optimal soft tissue evaluation (Mussa et al 2009). The advantages of CT and 3D images include assessment of accuracy and extension of fracture in the maxillofacial region. The easier detection of frontal and maxillary bones as well as their displacement in patients with complex midface fractures could be described. The coronal reconstructed images are superior in the detection of fractures in the orbit and maxilla. 3D images have a limited role in fracture involving the naso-orbital, naso-ethamoid region and also when there is minimal fracture displacement. Though CT is time consuming technique, it become superior or higher radiological investigation for better treatment outcome (Sasaki et al. 2014). CT imaging of the mandible, in particular MDCT, has been demonstrated to have higher sensitivity in detecting a mandible fracture in comparison to X-ray, and provide excellent detail in detecting a condylar fracture. This is due to high z-axis resolution and detailed coronal and sagittal reconstructions which have minimal artefact. In addition, the benefit of a 3D reconstructed view with CT, allows the classification and severity of the fracture to be evaluated due to the spatial information it provides. This can also be achieved with an OPG but requires an ambulant patient and a radiographer with high technical skill (Sasaki et al. 2014). Conclusion MDCT with MPR and 3D images has be come astandard part of the assessment of maxillofacial injury because of the exquisite sensitivity of this imaging technique for fracture. In this review, we summarized the maxillofacial fractures using MDCT, especially mandibular fractures and midfacial fractures including maxillary fractures. Fracture morphology of maxillofacial trauma is often complex, and maxillofacial bones support functions such as breathing, smelling, seeing, speaking, and eating. Therefore, maxillofacial fractures require accurate radiologic diagnosis using MDCT and surgical management to prevent severe functional debilities and cosmetic deformity. |