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Liew YM, Ooi JH, Azman RR, Ganesan D, Zakaria MI, Mohd Khairuddin AS, Tan LK. Innovations in detecting skull fractures: A review of computer-aided techniques in CT imaging. Phys Med 2024; 124:103400. [PMID: 38996627 DOI: 10.1016/j.ejmp.2024.103400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/25/2024] [Accepted: 06/05/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND/INTRODUCTION Traumatic brain injury (TBI) remains a leading cause of disability and mortality, with skull fractures being a frequent and serious consequence. Accurate and rapid diagnosis of these fractures is crucial, yet current manual methods via cranial CT scans are time-consuming and prone to error. METHODS This review paper focuses on the evolution of computer-aided diagnosis (CAD) systems for detecting skull fractures in TBI patients. It critically assesses advancements from feature-based algorithms to modern machine learning and deep learning techniques. We examine current approaches to data acquisition, the use of public datasets, algorithmic strategies, and performance metrics RESULTS: The review highlights the potential of CAD systems to provide quick and reliable diagnostics, particularly outside regular clinical hours and in under-resourced settings. Our discussion encapsulates the challenges inherent in automated skull fracture assessment and suggests directions for future research to enhance diagnostic accuracy and patient care. CONCLUSION With CAD systems, we stand on the cusp of significantly improving TBI management, underscoring the need for continued innovation in this field.
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Affiliation(s)
- Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Jia Hui Ooi
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia; Graduate School of Biomedical Engineering, UNSW Sydney, New South Wales, Australia
| | - Raja Rizal Azman
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Dharmendra Ganesan
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohd Idzwan Zakaria
- Academic Unit Emergency Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Li Kuo Tan
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
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2
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Deininger C, Wichlas F, Necchi M, Deluca A, Deininger S, Trieb K, Tempfer H, Kriechbaumer L, Traweger A. Enhancing Cranio-Maxillofacial Fracture Care in Low- and Middle-Income Countries: A Systematic Review. J Clin Med 2024; 13:2437. [PMID: 38673709 PMCID: PMC11050981 DOI: 10.3390/jcm13082437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Cranio-maxillofacial (CMF) injuries represent a significant challenge in low- and middle-income countries (LMICs), exacerbated by inadequate infrastructure, resources, and training. This systematic review aims to evaluate the current strategies and solutions proposed in the literature to improve CMF fracture care in LMICs, focusing on education, patient transfer, and off-label solutions. Methods: A comprehensive literature search was conducted using PubMed/Medline from January 2000 to June 2023. Studies were selected based on the Preferred Reporting Items for Systematic Review and Meta-analysis Statement (PRISMA). Solutions were categorized into three main areas: education (digital and on-site teaching, fellowships abroad), patient transfer to specialized clinics, and off-label/non-operative solutions. Results: Twenty-three articles were included in the review, revealing a consensus on the necessity for enhanced education and training for local surgeons as the cornerstone for sustainable improvements in CMF care in LMICs. Digital platforms and on-site teaching were identified as key methods for delivering educational content. Furthermore, patient transfer to specialized national clinics and innovative off-label techniques were discussed as immediate solutions to provide quality care despite resource constraints. Conclusions: Effective CMF fracture care in LMICs requires a multifaceted approach, prioritizing the education and training of local healthcare professionals, facilitated patient transfer to specialized centers, and the adoption of off-label solutions to leverage available resources. Collaborative efforts between international organizations, local healthcare providers, and educational institutions are essential to implement these solutions effectively and improve patient outcomes in LMICs.
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Affiliation(s)
- Christian Deininger
- University Clinic for Orthopedics and Traumatology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria; (F.W.); (K.T.); (L.K.)
| | - Florian Wichlas
- University Clinic for Orthopedics and Traumatology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria; (F.W.); (K.T.); (L.K.)
| | - Marco Necchi
- Department of Surgery and Orthopaedics, Hospital Sterzing, Margarethenstraße 24, 39049 Sterzing, Italy;
| | - Amelie Deluca
- Institute of Tendon and Bone Regeneration, Spinal Cord Injury & Tissue Regeneration Center Salzburg, 5020 Salzburg, Austria; (A.D.); (H.T.); (A.T.)
| | - Susanne Deininger
- Department of Urology and Andrology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria;
| | - Klemens Trieb
- University Clinic for Orthopedics and Traumatology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria; (F.W.); (K.T.); (L.K.)
- Department for Orthopaedics and Traumatology, Center for Clinical Medicine, Faculty of Medicine and Dentistry, Danube Private University, 3500 Krems, Austria
| | - Herbert Tempfer
- Institute of Tendon and Bone Regeneration, Spinal Cord Injury & Tissue Regeneration Center Salzburg, 5020 Salzburg, Austria; (A.D.); (H.T.); (A.T.)
| | - Lukas Kriechbaumer
- University Clinic for Orthopedics and Traumatology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria; (F.W.); (K.T.); (L.K.)
| | - Andreas Traweger
- Institute of Tendon and Bone Regeneration, Spinal Cord Injury & Tissue Regeneration Center Salzburg, 5020 Salzburg, Austria; (A.D.); (H.T.); (A.T.)
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3
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Wichlas F, Necchi M, Gruber T, Hofmann V, Deininger S, Deininger SHM, Deluca A, Steidle-Kloc E, Pruszak J, Wittig J, Deininger C. Off-Label Use of an External Hand Fixator for Craniomaxillofacial Fractures-An Anatomical Feasibility Study. Bioengineering (Basel) 2024; 11:279. [PMID: 38534553 DOI: 10.3390/bioengineering11030279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/25/2024] [Accepted: 03/11/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND The lack of resources limits the treatment of craniomaxillofacial fractures (CMF) in low-income countries (LIC). Therefore, Barton bandages and/or interdental wiring are considered in these regions. Fracture reduction is maintained by permanent occlusion for 6 weeks, which often leads to limited compliance and dissatisfying results. The aim of this cadaver-based study is to evaluate the feasibility of the use of an external face fixator (EFF) for the treatment of CMF, its biomechanical values and to define the optimal pin insertion points and angles. MATERIALS AND METHODS An AO hand fixator was used. CMF of types Le Fort 1-3 with split fractures of the hard palate were treated with EFF on 13 anatomical specimens. Fractures were created using a chisel, and pins were placed in specific anatomical regions. The maximal pull-out force [N] of pins was analysed by a tensile force gauge, and Fmax of the mandibular pins was evaluated. Computer tomography scans were performed on the healthy, fractured and EFF-treated skulls. RESULTS The pull-out forces for the single pins were mandibular pins (n = 15, median 488.0 N), supraorbital pins (n = 15, median 455.0 N), zygomatic pins (n = 14, median 269.1 N), medial hard palate pins (n = 12, median 208.4 N) and lateral hard palate pins (n = 8, median 49.6 N). CONCLUSIONS The results indicate that the operation technique is feasible, and the stability of the EFF is sufficient for maintaining the reduction. The required pins can safely be inserted into the described areas with good reduction results. Using EFF offers a feasible alternative to the non-surgical treatment of CMF in LIC.
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Affiliation(s)
- Florian Wichlas
- Department of Orthopedics and Traumatology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
- No Limit Surgery, Ernest-Thun-Strasse 6, 5020 Salzburg, Austria
| | - Marco Necchi
- No Limit Surgery, Ernest-Thun-Strasse 6, 5020 Salzburg, Austria
- Department of Surgery and Orthopaedics, Hospital Sterzing, Margarethenstraße 24, 39049 Sterzing, Italy
| | - Teresa Gruber
- Department of Orthopedics and Traumatology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Valeska Hofmann
- No Limit Surgery, Ernest-Thun-Strasse 6, 5020 Salzburg, Austria
- BG Trauma Centre, Department of Trauma and Reconstructive Surgery, University of Tübingen, 72076 Tübingen, Germany
| | - Susanne Deininger
- No Limit Surgery, Ernest-Thun-Strasse 6, 5020 Salzburg, Austria
- Department of Urology and Andrology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | | | - Amelie Deluca
- Institute of Tendon and Bone Regeneration, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Eva Steidle-Kloc
- Institute of Anatomy and Cell Biology|Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
- Center of Anatomy and Cell Biology, Salzburg and Nuremberg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Jan Pruszak
- Institute of Anatomy and Cell Biology|Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
- Center of Anatomy and Cell Biology, Salzburg and Nuremberg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Jörn Wittig
- Department of Oral and Maxillofacial Surgery, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Christian Deininger
- Department of Orthopedics and Traumatology, University Hospital Salzburg, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
- No Limit Surgery, Ernest-Thun-Strasse 6, 5020 Salzburg, Austria
- Institute of Tendon and Bone Regeneration, Paracelsus Medical University, 5020 Salzburg, Austria
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Kwofie M, Policeni B. Reconstructive Surgeries After Head And Neck Trauma: Imaging Appearances. Semin Roentgenol 2023; 58:311-330. [PMID: 37507172 DOI: 10.1053/j.ro.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/10/2023] [Accepted: 04/22/2023] [Indexed: 07/30/2023]
Affiliation(s)
- Michael Kwofie
- Department of Radiology, The University of Iowa Hospital and Clinics, Iowa City, IA.
| | - Bruno Policeni
- Department of Radiology, The University of Iowa Hospital and Clinics, Iowa City, IA
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5
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Sandeep Reddy B, Naik D, Kenkere D. Role of Multidetector Computed Tomography in the Evaluation of Maxillofacial Trauma. Cureus 2023; 15:e35008. [PMID: 36938234 PMCID: PMC10021354 DOI: 10.7759/cureus.35008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION Maxillofacial fractures are among the commonest injuries occurring in trauma patients. Multislice computed tomography (CT) is a widely used radiological investigation that accurately reveals the number, location, and extent of the fractures as well as concomitant soft tissue injuries and has been found to be superior in the diagnosis of maxillofacial fractures owing to high sensitivity and specificity. This study was performed to assess the efficacy of axial, coronal, sagittal, and three-dimensional (3D) reformatted images in the detection of fractures in maxillofacial trauma. MATERIALS AND METHODS This was a cross-sectional descriptive study conducted on 49 adult patients with maxillofacial injuries undergoing multislice CT using a multidetector SiemensSOMATOM Emotion eco 16 slice CT scanner (Siemens AG, Munich, Germany). CT protocol consisted of non-contrast axial 16-slice helical series beam collimation ~ 3 mm, pitch ~ 0.8 - 1, tube current ~ 270 mAs, voltage ~ 130 kV, Total exposure time ~ 18 seconds, total radiation ~ 200 mGy. Along with the axial, coronal and sagittal images were reconstructed with 0.5 mm increment. 3D volume-rendering images were also obtained. 3D images were compared with axial images, coronal and sagittal plane images. RESULTS The maximum number of cases was in the age group of 21-30 years with the male: female ratio being 5.12:1. The most common cause of injury was road traffic accidents (RTA). Mandible fractures were found to be the most common (20 patients, 40.8%) followed by fractures of nasal bone (18 patients, 36.7%). The incidence of frontal bone fractures was found to be the least (six patients, 12.24%). Our study found that 3D images are superior to axial in assessing the extent and degree of displacement of maxillofacial fractures in general. The maxillary sinus was found to be the most commonly fractured sinus (19 patients, 38.7%). Sphenoid sinus fractures were the least common (seen in two patients, 4.08%). CT findings correlated with the operative findings in most types of fractures. CONCLUSION Multidetector CT with multiplanar and 3D reformation is highly accurate in the identification of fractures and assessing the extent and degree of displacement of fractures; hence, it is the imaging modality of choice in maxillofacial trauma. 3D images are much better for the detection of maxillofacial fractures compared to axial, coronal, or sagittal views, especially in maxilla and mandibular bone fractures. It is also found to be better at providing information on the patterns of the fracture lines and the displacement of the fracture fragments. Another added advantage of multidetector CT is that it is a non-invasive technique with good accuracy and a short scan time.
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Affiliation(s)
| | - Deepti Naik
- Radio-Diagnosis, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND
| | - Deepika Kenkere
- Oral and Maxillofacial Surgery, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND
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6
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Managing Temporomandibular Joint Dislocations. Ann Emerg Med 2022; 80:539-547. [PMID: 35842342 DOI: 10.1016/j.annemergmed.2022.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 11/22/2022]
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7
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Rana M, Moellmann HL, Schorn L, Lommen J, Rana M, Wilkat M, Hufendiek K. Primary Orbital Reconstruction with Selective Laser Melting (SLM) of Patient-Specific Implants (PSIs): An Overview of 96 Surgically Treated Patients. J Clin Med 2022; 11:jcm11123361. [PMID: 35743432 PMCID: PMC9224837 DOI: 10.3390/jcm11123361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 01/27/2023] Open
Abstract
Contemporary advances in technology have allowed the transfer of knowledge from industrial laser melting systems to surgery; such an approach could increase the degree of accuracy in orbital restoration. The aim of this study was to examine the accuracy of selective laser melted PSIs (patient-specific implants) and navigation in primary orbital reconstruction. Ninety-six patients with orbital fractures were included in this study. Planned vs. achieved orbital volumes (a) and angles (b) were compared to the unaffected side (n = 96). The analysis included the overlay of post-treatment on planned images (iPlan 3.0.5, Brainlab®, Feldkirchen, Germany). The mean difference in orbital volume between the digitally planned orbit and the postoperative orbit was 29.16 cm3 (SD 3.54, presurgical) to 28.33 cm3 (SD 3.64, postsurgical, t = 5.00, df = 95.00; p < 0.001), resulting in a mean volume difference (planned vs. postop) of less than 1 cm3. A 3D analysis of the color mapping showed minor deviations compared to the mirrored unaffected side. The results suggested that primary reconstruction in complex orbital wall fractures can be routinely achieved with a high degree of accuracy by using selective laser melted orbital PSIs.
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Affiliation(s)
- Majeed Rana
- Department of Oral and Maxillofacial Surgery, Heinrich Heine University Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany; (M.R.); (L.S.); (J.L.); (M.W.)
| | - Henriette L. Moellmann
- Department of Oral and Maxillofacial Surgery, Heinrich Heine University Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany; (M.R.); (L.S.); (J.L.); (M.W.)
- Correspondence:
| | - Lara Schorn
- Department of Oral and Maxillofacial Surgery, Heinrich Heine University Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany; (M.R.); (L.S.); (J.L.); (M.W.)
| | - Julian Lommen
- Department of Oral and Maxillofacial Surgery, Heinrich Heine University Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany; (M.R.); (L.S.); (J.L.); (M.W.)
| | - Madiha Rana
- Department of Psychology, University of Applied Sciences, Doberaner Weg 20, 22143 Hamburg, Germany;
| | - Max Wilkat
- Department of Oral and Maxillofacial Surgery, Heinrich Heine University Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany; (M.R.); (L.S.); (J.L.); (M.W.)
| | - Karsten Hufendiek
- Department of Ophthalmology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany;
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8
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Sheng K. Radiological investigation of acute mandibular injury. Natl J Maxillofac Surg 2022; 13:165-171. [PMID: 36051802 PMCID: PMC9426694 DOI: 10.4103/njms.njms_27_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/15/2019] [Accepted: 01/09/2020] [Indexed: 12/04/2022] Open
Abstract
This article focuses on the different imaging modalities used to evaluate acute mandibular fractures and explores important concepts relating to their diagnosis, investigation, and treatment. Significant focus will be given to exploring general management principles, considerations regarding first-line imaging, and recent technological advancement. Computed tomography (CT) is the preferred method when attempting to identify acute mandibular fractures, particularly in trauma patients, and has very high specificity and sensitivity. Multidetector CT now represents the standard of care, enabling fast scan times, reduced artifact, accurate reconstructed views, and three-dimensional (3D) reconstructions. Cone-beam CT is a newer advanced imaging modality that is increasingly being used worldwide, particularly in the ambulatory and intraoperative setting. It produces high-resolution images with submillimeter isotropic voxels, 3D and multiplanar reconstruction, and low radiation dose, however is less widely available and more expensive. Ultrasound is a valuable method in identifying a fracture in unstable patients, but is limited in its ability to detect nondisplaced fractures. Magnetic resonance imaging is useful in determining the presence of soft-tissue injury. CT angiography is invaluable in the assessment of potential vascular injury in condylar fracture dislocations.
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Naidu B, Vivek V, Visvanathan K, Shekhar R, Ram S, Ganesh K. A study of clinical presentation and management of base of skull fractures in our tertiary care centre. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2020.100906] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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10
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Itakura G, Ito K, Muraoka H, Hirahara N, Okada H, Kaneda T. Risk Assessment of Jawbone Fracture by Mandibular Cortical Bone Width Using Computed Tomography. J HARD TISSUE BIOL 2021. [DOI: 10.2485/jhtb.30.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Go Itakura
- Department of Radiology, Nihon University School of Dentistry at Matsudo
| | - Kotaro Ito
- Department of Radiology, Nihon University School of Dentistry at Matsudo
| | - Hirotaka Muraoka
- Department of Radiology, Nihon University School of Dentistry at Matsudo
| | - Naohisa Hirahara
- Department of Radiology, Nihon University School of Dentistry at Matsudo
| | - Hiroyuki Okada
- Department of Oral Pathology, Nihon University School of Dentistry at Matsudo
| | - Takashi Kaneda
- Department of Radiology, Nihon University School of Dentistry at Matsudo
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11
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Prasetyo E, Oley MC, Faruk M. Split hypoglossal facial anastomosis for facial nerve palsy due to skull base fractures: A case report. Ann Med Surg (Lond) 2020; 59:5-9. [PMID: 32983440 PMCID: PMC7494824 DOI: 10.1016/j.amsu.2020.08.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 08/30/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction Traumatic brain injury (TBI) is the most prevalent causes of morbidity and mortality worldwide. The biomechanics of primary TBI involve a direct impact, practically extended to the base of the skull, and most of the skull base fractures (SBF) are identified in anterior and medial cranial fossa. Furthermore, those predicted in the medial area are related to fissures from temporal bones. Presentation of case We report two cases of right facial nerve palsy initiated by SBF's, which were diagnosed and treated at our institution. The 3D CT evaluation in our first case showed a longitudinal fracture of the right petrosal bone, which was longitudinal and transverse for the second case. Two cases of facial nerve palsy were managed with split hypoglossal facial anastomosis to restore functional reanimation. All patients were adequately achieved after the procedure, and the hypoglossal nerve function was preserved. Conclusion Split hypoglossal facial anastomosis technique was used to treat patients with facial nerve paralysis resulting from SBF's. This was to achieve good recovery outcome, in terms of facial reanimation and preservation of tongue function. A skull base fracture (SBF) is about 4% of all cases Traumatic brain injury (TBI). SBF which frequently occurs in the petrous part of the temporal bone, is implicated in facial nerve palsy. Split hypoglossal facial anastomosis technique showed good recovery of facial reanimation with HB scale assessment.
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Affiliation(s)
- Eko Prasetyo
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University Sam Ratulangi, Manado, Indonesia.,Division of Neurosurgery, Department of Surgery, R. D. Kandou Hospital, Manado, Indonesia
| | - Maximillian Christian Oley
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University Sam Ratulangi, Manado, Indonesia.,Division of Neurosurgery, Department of Surgery, R. D. Kandou Hospital, Manado, Indonesia
| | - Muhammad Faruk
- Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
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12
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RETRACTED: The association between metformin therapy and risk of gynecological cancer in patients: two meta-analyses. Br J Oral Maxillofac Surg 2019; 57:782-787. [DOI: 10.1016/j.bjoms.2019.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 07/12/2019] [Indexed: 11/19/2022]
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13
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Aydin U, Gormez O, Yildirim D. Cone-beam computed tomography imaging of dentoalveolar and mandibular fractures. Oral Radiol 2019; 36:217-224. [PMID: 31102106 DOI: 10.1007/s11282-019-00390-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 05/06/2019] [Indexed: 11/28/2022]
Abstract
Three-dimensional imaging methods have an important role in the diagnosis of dentomaxillofacial fractures that can not be seen on the plain films. Cone-beam computed tomography (CBCT) is one of the three-dimensional imaging methods and has facilitated dental professionals' access to cross-sectional imaging. CBCT units allow different technical parameters and the data acquired by CBCT, can be reformatted. Osseous structures are correctly examined with this technique but the technique is not useful for the examination of soft tissues. Therefore, the purpose of its use should be based on the expected diagnostic gain. The aim of this review is to present the use of CBCT with different multi-planar reformatted sections and three-dimensional reconstructions of dentoalveolar and mandibular fractures.
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Affiliation(s)
- Ulkem Aydin
- Department of Dentomaxillofacial Radiology, Cyprus Health and Social Sciences University School of Dental Sciences, Morphou, North Cyprus
| | - Ozlem Gormez
- Department of Dentomaxillofacial Radiology, Suleyman Demirel University Faculty of Dentistry, Doğu Kampüsü, Çünür, 32000, Isparta, Turkey.
| | - Derya Yildirim
- Department of Dentomaxillofacial Radiology, Suleyman Demirel University Faculty of Dentistry, Doğu Kampüsü, Çünür, 32000, Isparta, Turkey
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14
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Bächinger D, Goosmann MM, Schuknecht B, Nadol JB, Adams JC, Huber A, Eckhard AH. Clinical Imaging Findings of Vestibular Aqueduct Trauma in a Patient With Posttraumatic Meniere's Syndrome. Front Neurol 2019; 10:431. [PMID: 31073295 PMCID: PMC6495004 DOI: 10.3389/fneur.2019.00431] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 04/09/2019] [Indexed: 12/17/2022] Open
Abstract
Posttraumatic Meniere's syndrome is a rare clinical entity. The pathomechanism by which temporal bone trauma leads to fluctuating audiovestibular symptoms, in some cases with a delay of onset many years after trauma, remains elusive. Here, a clinical case and the respective temporal bone imaging data were reviewed to investigate the underlying inner ear pathology. A 44-year-old patient presented with left-sided Meniere's syndrome 34 years after he suffered an ipsilateral temporal bone fracture caused by a car accident. Clinical imaging showed left cochleovestibular hydrops (gadolinium-enhanced MRI) and bony obliteration of the left VA (CT imaging), resulting in discontinuity of the ES. Our findings suggest that a temporal bone fracture with a “retrolabyrinthine” course, traversing the VA, caused intraaqueductal callus bone formation and progressive blockage of the VA. As a result, the extraosseous (distal) endolymphatic sac (eES) became separated from the cochleovestibular labyrinth, an event that presumably underlies endolymphatic hydrops formation and that precipitates the onset of clinical Meniere's symptoms in this case.
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Affiliation(s)
- David Bächinger
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | | | | | - Joseph B Nadol
- Department of Otolaryngology, Harvard Medical School, Boston, MA, United States.,Otopathology Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA, United States
| | - Joe C Adams
- Department of Otolaryngology, Harvard Medical School, Boston, MA, United States.,Otopathology Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA, United States
| | - Alexander Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Andreas H Eckhard
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
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15
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Quality assurance in CT: implementation of the updated national diagnostic reference levels using an automated CT dose monitoring system. Clin Radiol 2018; 73:677.e13-677.e20. [DOI: 10.1016/j.crad.2018.02.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/13/2018] [Indexed: 11/19/2022]
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16
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Crijns CP, Weller R, Vlaminck L, Verschooten F, Schauvliege S, Powell SE, Bree HJJ, Gielen IMVL. Comparison between radiography and computed tomography for diagnosis of equine skull fractures. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12863] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - R. Weller
- Veterinary Clinical Sciences Royal Veterinary College Hatfield Hertfordshire UK
| | - L. Vlaminck
- Department of Surgery and Anaesthesia of Domestic Animals Faculty of Veterinary Medicine, Ghent University Merelbeke Belgium
| | - F. Verschooten
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - S. Schauvliege
- Department of Surgery and Anaesthesia of Domestic Animals Faculty of Veterinary Medicine, Ghent University Merelbeke Belgium
| | | | - H. J. J. Bree
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - I. M. V. L. Gielen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
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17
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Dreizin D, Nam AJ, Tirada N, Levin MD, Stein DM, Bodanapally UK, Mirvis SE, Munera F. Multidetector CT of Mandibular Fractures, Reductions, and Complications: A Clinically Relevant Primer for the Radiologist. Radiographics 2017; 36:1539-64. [PMID: 27618328 DOI: 10.1148/rg.2016150218] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
After the nasal bones, the mandible is the second most common site of facial fractures, and mandibular fractures frequently require open reduction. In the trauma injury setting, multidetector computed tomography (CT) has become the cornerstone imaging modality for determining the most appropriate treatment management, fixation method, and surgical approach. Multidetector CT is also used to assess the adequacy of the reduction and evaluate potential complications in the postoperative period. For successful restoration of the mandible's form and function, as well as management of posttraumatic and postoperative complications, reconstructive surgeons are required to have a detailed understanding of mandibular biomechanics, occlusion, and anatomy. To provide added value in the diagnosis, treatment planning, and follow-up of mandibular fractures, radiologists should be aware of these concepts. Knowledge of the techniques commonly used to achieve occlusal and anatomic reduction and of the rationale behind the range of available treatment options for different injury patterns-from isolated and nondisplaced fractures to multisite and comminuted fractures-also is essential. This article focuses on the use of multidetector CT for pre- and postoperative evaluation of mandibular fractures and outlines fundamental concepts of diagnosis and management-beginning with an explanation of common fracture patterns and their biomechanical underpinnings, and followed by a review of the common postoperative appearances of these fractures after semirigid and rigid fixation procedures. Specific considerations regarding fractures in different regions of the tooth-bearing and non-tooth-bearing mandible and the unique issues pertaining to the edentulous atrophic mandible are reviewed, and key features that distinguish major from minor complications are described. (©)RSNA, 2016.
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Affiliation(s)
- David Dreizin
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Arthur J Nam
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Nikki Tirada
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Martin D Levin
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Deborah M Stein
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Uttam K Bodanapally
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Stuart E Mirvis
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Felipe Munera
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
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18
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Postoperative CT of the Orbital Skeleton After Trauma: Review of Normal Appearances and Common Complications. AJR Am J Roentgenol 2016; 206:1276-85. [DOI: 10.2214/ajr.15.15477] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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19
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Hong B. Discovery from a lateral oblique radiograph. BMJ Case Rep 2016; 2016:bcr-2015-213621. [PMID: 26791125 DOI: 10.1136/bcr-2015-213621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
In many oral and maxillofacial surgery units and emergency departments, lateral oblique radiographs are not routinely included in radiological investigations for suspected mandibular fractures because orthopanoramic and posteroanterior mandible views usually suffice. This paper reports a case where a lateral oblique radiograph proved to be very useful in managing a fractured atrophic mandible. This case report highlights the importance of considering the use of alternative radiographs for suspected fracture(s) of an atrophic mandible to exclude the unexpected.
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Affiliation(s)
- Bosun Hong
- Department of Oral and Maxillofacial Surgery, Royal Cornwall Hospital, Truro, UK
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20
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Yellinek S, Cohen A, Merkin V, Shelef I, Benifla M. Clinical significance of skull base fracture in patients after traumatic brain injury. J Clin Neurosci 2015; 25:111-5. [PMID: 26724846 DOI: 10.1016/j.jocn.2015.10.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 10/10/2015] [Indexed: 10/22/2022]
Abstract
About 4% of all head injuries include skull base fractures. Most of these fractures (90%) are secondary to closed head trauma; the remainder are due to penetrating trauma. We reviewed the records from January 2006 through December 2008 of all patients older than 18 years of age who arrived at Soroka Medical Center in Be'er-Sheva, Israel, with skull base fractures following a traumatic brain injury (TBI). We identified 107 patients with a mean age of 42 years at the time of TBI. Glasgow Coma score on arrival predicted the clinical outcome. We observed temporal fractures in 30% of these patients, occipital fractures in 20%, pyramidal fractures in 19%, anterior skull base fractures in 17%, and multiple fractures in 14%. Cerebrospinal fluid (CSF) leak was observed in 16 patients (15%). Of the patients experiencing CSF leaks, otorrhea occurred in 10 (62%) and rhinorrhea occurred in six (37%). Three patients required surgical intervention to repair the leak. Meningitis occurred in four patients with clinically evident CSF leak. Multiple skull base fractures are associated with poor neurological outcome. The low rate of meningitis in this patient sample implies that there is no indication to administer prophylactic antibiotics to patients with skull base fractures.
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Affiliation(s)
- Shlomi Yellinek
- Neurosurgery Department, Soroka Medical Center and Ben-Gurion University, Be'er-Sheva, Israel
| | - Avi Cohen
- Neurosurgery Department, Soroka Medical Center and Ben-Gurion University, Be'er-Sheva, Israel
| | - Vladimir Merkin
- Neurosurgery Department, Soroka Medical Center and Ben-Gurion University, Be'er-Sheva, Israel
| | - Ilan Shelef
- Neuroradiology Division, Soroka Medical Center and Ben-Gurion University, Be'er-Sheva, Israel
| | - Mony Benifla
- Neurosurgery Department, Hadassah Medical Center, Jerusalem, Israel.
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21
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A Missed Case of Occult Bilateral Temporomandibular Dislocation Mistaken for Dystonia. Case Rep Emerg Med 2015; 2015:753260. [PMID: 26435859 PMCID: PMC4576001 DOI: 10.1155/2015/753260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 08/26/2015] [Indexed: 12/02/2022] Open
Abstract
A 24-year-old male with a history of psychiatric disorder and no prior significant temporomandibular joint (TMJ) pathology presented to the emergency department for “lockjaw.” Plain film X-rays of the mandible were read as unremarkable by an attending radiologist, leading to the initial diagnosis of medication-induced dystonic reaction. Following unsuccessful medical treatment a maxillofacial computed tomography (CT) was ordered. CT confirmed bilateral dislocation, illustrating the importance of clinical judgment, and limitations of certain radiographic images. The authors believe this case to be the first reported case in the medical literature of bilateral anterior TMJ dislocation with a false negative X-ray.
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22
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Ogura I, Kawashima Y, Muramatsu T, Ito K, Kaneda T. Characteristic computed tomographic findings of midface fractures relative to the cause of injury: a fall or violence. Oral Radiol 2014. [DOI: 10.1007/s11282-014-0195-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Ogura I, Sasaki Y, Kaneda T. Multidetector computed tomography of maxillofacial fractures. JAPANESE DENTAL SCIENCE REVIEW 2014. [DOI: 10.1016/j.jdsr.2014.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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24
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Zilinskiene L, Idle MR, Colley S. Emergency radiology: Maxillofacial and skull-base trauma. TRAUMA-ENGLAND 2014. [DOI: 10.1177/1460408614539619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Craniofacial trauma is common following road-traffic accidents, assaults and falls and may occur in isolation or associated with other body injuries. Due to the complexity of the maxillofacial and skull-base region, initial diagnosis may be inaccurate or delayed, leading to significant morbidity. Multidetector computed tomography is the modality of choice following high-energy blunt or penetrating trauma. It allows accurate evaluation of the fracture patterns and associated soft tissue complications and aids the appropriate medical and surgical treatment. In this article, we review and classify the most common traumatic injuries to the maxillofacial and skull-base region and outline the role of imaging in establishing complications and prognosis.
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Affiliation(s)
- Laura Zilinskiene
- Department of Radiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Matthew R Idle
- Department of Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Steve Colley
- Department of Radiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK
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25
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Perheentupa U, Mäkitie AA, Karhu JO, Koivunen P, Blanco Sequieros R, Kinnunen I. Frontobasilar fractures: proposal for image reviewing algorithm. J Craniomaxillofac Surg 2014; 42:305-12. [PMID: 24525027 DOI: 10.1016/j.jcms.2013.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 05/24/2013] [Accepted: 05/27/2013] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE The aim of this study was to develop and test the utility of a novel systematic protocol to analyze CT images of patients with trauma in the anterior cranial base and upper midface. MATERIAL AND METHODS The radiological data and primary reports of 27 consecutive patients with a frontal skull base fracture treated in two tertiary care hospitals from 2007 to 2011 were scrutinized. A novel algorithm for systematic image reviewing was used to assess the CT images and the findings were compared with the primary radiological reports. RESULTS The systematic review detected a substantial number of fractures and defects in anatomical structures that had not been systematically reported in the primary, on-call reports. Anterior skull base fracture was not initially reported in 32% of the patients; however, the algorithm detected this in 93% of them. The corresponding rates for fracture through cribriform plate were 28% and 72% and for fracture through the sella or hypophyseal area 22% and 78%. There were two fractures of the clivus and these were initially missed. CONCLUSIONS Despite the failure to identify these fractures radiologically in the primary setting, all patients were still considered to have received appropriate treatment, but, the use of an image-reviewing algorithm will enhance the specificity of CT in the diagnosis of frontobasilar fractures.
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Affiliation(s)
- Ulla Perheentupa
- Department of Otolaryngology - Head and Neck Surgery (Head: Prof. Reidar Grénman), Turku University Hospital and University of Turku, P.O. Box 52, FI-20521 Turku, Finland.
| | - Antti A Mäkitie
- Department of Otolaryngology - Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, Finland; School of Science, Department of Industrial Engineering and Management, BIT Research Centre, Aalto University, Finland
| | - Jari O Karhu
- Department of Radiology, Turku University Hospital and University of Turku, Finland
| | - Petri Koivunen
- Department of Otolaryngology - Head and Neck Surgery, Oulu University Hospital and University of Oulu, Finland
| | | | - Ilpo Kinnunen
- Department of Otolaryngology - Head and Neck Surgery (Head: Prof. Reidar Grénman), Turku University Hospital and University of Turku, P.O. Box 52, FI-20521 Turku, Finland
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26
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Imai T, Sukegawa S, Kanno T, Fujita G, Yamamoto N, Furuki Y, Michizawa M. Mandibular fracture patterns consistent with posterior maxillary fractures involving the posterior maxillary sinus, pterygoid plate or both: CT characteristics. Dentomaxillofac Radiol 2013; 43:20130355. [PMID: 24336313 DOI: 10.1259/dmfr.20130355] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine the incidence of posterior maxillary fractures involving the posterior maxillary sinus wall, pterygoid plate or both, unrelated to major midface fractures in patients with mandibular fractures, and to characterize associated fractures. METHODS A CT study was performed in patients with mandibular fractures to identify posterior maxillary fractures. Patients aged under 16 years, those with mandibular fractures involving only dentoalveolar components and those with concurrent major midfacial fractures were excluded. RESULTS 13 (6.7%) of 194 patients with mandibular fractures also had posterior maxillary fractures (case group). The injury pattern correlated with the external force directed to the lateral side of the mandible (p < 0.001), alcohol consumption (p = 0.049), the presence of multifocal fractures (p = 0.002) and the fracture regions in the symphysis/parasymphysis (p = 0.001) and the angle/ramus (p = 0.001). No significant difference between the case and non-case groups was seen for age, sex or cause of trauma. Non-displaced fractures in the ipsilateral posterior mandible occurred with significant frequency (p = 0.001) when the posterior maxillary fractures involved only the sinus. CONCLUSIONS Mandibular fractures accompanied by posterior maxillary fractures are not rare. The finding of a unilateral posterior maxillary fracture on CT may aid the efficient radiological examination of the mandible based on possible patterns of associated fractures, as follows: in the ipsilateral posterior region as a direct fracture when the impact is a medially directed force, and in the symphysis/parasymphysis or contralateral condylar neck as an indirect fracture.
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Affiliation(s)
- T Imai
- Department of Oral and Maxillofacial Surgery, Saiseikai Senri Hospital, Suita, Osaka, Japan
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27
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Wani AA, Ramzan AU, Raina T, Malik NK, Nizami FA, Qayoom A, Singh G. Skull base fractures: An institutional experience with review of literature. INDIAN JOURNAL OF NEUROTRAUMA 2013. [DOI: 10.1016/j.ijnt.2013.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Gelesko S, Markiewicz MR, Bell RB. Responsible and Prudent Imaging in the Diagnosis and Management of Facial Fractures. Oral Maxillofac Surg Clin North Am 2013; 25:545-60. [DOI: 10.1016/j.coms.2013.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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29
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Current perspective of multidetector computed tomography (MDCT) in patients after midface and craniofacial trauma. Clin Imaging 2013; 37:728-33. [DOI: 10.1016/j.clinimag.2012.11.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 08/01/2012] [Accepted: 11/07/2012] [Indexed: 12/21/2022]
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30
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Chess MA, Chaturvedi A, Stanescu AL, Blickman JG. Emergency pediatric ear, nose, and throat imaging. Semin Ultrasound CT MR 2013; 33:449-62. [PMID: 22964411 DOI: 10.1053/j.sult.2012.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Pediatric ear, nose, and throat emergencies broadly comprise infection, trauma, and airway obstruction secondary to a multitude of etiologies. Imaging occupies center stage in the diagnosis of many of these conditions and their complications, making it imperative for radiologists and other physicians covering the pediatric emergency department to familiarize themselves with the imaging appearances of these entities. Toward this goal, this article describes the imaging features of common pediatric ear, nose, and throat emergencies. Differential considerations, potential fallacies, and complications have been discussed when appropriate. Because a sound knowledge of the most relevant, efficient, time, and cost-effective imaging modality is of undisputable value in the acute setting, the preferred modality for each specific condition has been outlined. Finally, in alignment with our commitment to using radiation judiciously, we have suggested using ultrasonography and magnetic resonance instead of computed tomography, where possible, to optimize cost-benefit ratio for our young patients.
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Affiliation(s)
- Mitchell A Chess
- Department of Diagnostic Imaging Sciences, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY 14642, USA.
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31
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Stübinger S, Buitrago-Tellez C, Cantelmi G. Deviations between Placed and Planned Implant Positions: An Accuracy Pilot Study of Skeletally Supported Stereolithographic Surgical Templates. Clin Implant Dent Relat Res 2012; 16:540-51. [DOI: 10.1111/cid.12019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Stefan Stübinger
- Musculoskeletal Research Unit; Equine Hospital; Vetsuisse Faculty ZH; University of Zurich; Zurich Switzerland
- Center of Applied Biotechnology and Molecular Medicine (CABMM); Vetsuisse Faculty; University of Zurich; Zurich Switzerland
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32
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Abstract
Mandibular fracture is a common injury and generally treated with or without surgery depending on the case. Diagnosing mandibular fracture may be difficult because of its location and anatomic characteristics. This article presents a case of an unusual split mandibular fracture after an episode of seizure in a patient with epilepsy. This fracture was missed on routine radiographs; however, it was visualized by three-dimensional computed tomography (TCT). The TCT is crucial and should be mandatory for all suspected mandibular fractures instead of routine radiography. The diagnostic efficacies of panoramic radiographs, digitized radiographs, and TCT scans are discussed for the diagnosis of mandibular fractures in this case report.
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33
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Ogura I, Kaneda T, Mori S, Sekiya K, Ogawa H, Tsukioka T. Characterization of mandibular fractures using 64-slice multidetector CT. Dentomaxillofac Radiol 2012; 41:392-5. [PMID: 22282503 DOI: 10.1259/dmfr/67127210] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to characterize mandibular fracture locations using 64-slice multidetector CT (MDCT). METHODS CT scans of 138 patients with mandibular fractures who underwent 64-slice MDCT were studied. Mandibular fractures were classified into five types: median, paramedian, angle, condylar and coronoid process. Statistical analysis for the relationship between multiple fractures and type of mandibular fractures was performed using χ(2) test with Fisher's exact test. RESULTS The percentage of multiple mandibular fractures was 80.9% median type, 74.3% paramedian type, 52.9% angle type and 60.9% condylar type. The resultant data showed a significant relationship between multiple fractures and the median type (p = 0.000), paramedian type (p = 0.002) and condylar type (p = 0.003). CONCLUSION The results suggest that multiple fractures are related to the type of mandibular fractures.
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Affiliation(s)
- I Ogura
- Department of Radiology, Nihon University School of Dentistry, Matsudo, Chiba, Japan.
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34
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Abstract
Traumatic head and facial injuries are common causes of emergency department admissions. Head trauma, in particular, is the commonest reason for emergency out of hours computed tomography (CT) performed. Most patients with traumatic brain injuries (TBIs) have mild head injuries, but up to 20% require hospitalisation or further management. The fixed size of the bony cranial cavity means that only small increases in volume within the intracranial compartment can be tolerated before pressure within the cavity increases dramatically leading to secondary brain injury, with potentially catastrophic consequences. Head and brain injuries are commonly associated with facial trauma, particularly of the upper face, and it is important to be aware of this because the treatment of the former injuries may need to take precedence over the facial injuries. This review aims to summarise the epidemiology of blunt trauma to the head and face and the various patterns of TBI. The role of CT, both in the acute setting and in follow-up these patients, is described.
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Affiliation(s)
- Mohammed Varnamkhasti
- MRI/Neuroradiology, Queen Elizabeth Hospital Birmingham, NHS Trust, Edgbaston, Birmingham, UK
| | - Allan Thomas
- MRI/Neuroradiology, Queen Elizabeth Hospital Birmingham, NHS Trust, Edgbaston, Birmingham, UK
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35
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Akinbami BO. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation. Head Face Med 2011; 7:10. [PMID: 21676208 PMCID: PMC3127760 DOI: 10.1186/1746-160x-7-10] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 06/15/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Virtually all the articles in literature addressed only a specific type of dislocation. The aim of this review was to project a comprehensive understanding of the pathologic processes and management of all types of dislodgement of the head of the mandibular condyle from its normal position in the glenoid fossa. In addition, a new classification of temporomandibular joint dislocation was also proposed. METHOD AND MATERIALS A thorough computer literature search was done using the Medline, Cochrane library and Embase database. Key words like temporo-mandibular joint dislocation were used for the search. Additional manual search was done by going through published home-based and foreign articles. Case reports/series, and original articles that documented the type of dislocation, number of cases treated in the series and original articles. Treatment done and outcome of treatment were included in the study. RESULT A total of 128 articles were reviewed out which 79 were found relevant. Of these, 26 were case reports, 17 were case series and 36 were original articles. 79 cases were acute dislocations, 35 cases were chronic protracted TMJ dislocations and 311 cases were chronic recurrent TMJ dislocations. Etiology was predominantly trauma in 60% of cases and other causes contributed about 40%. Of all the cases reviewed, only 4 were unilateral dislocation. Various treatment modalities are outlined in this report as indicated for each type of dislocation. CONCLUSION The more complex and invasive method of treatment may not necessarily offer the best option and outcome of treatment, therefore conservative approaches should be exhausted and utilized appropriately before adopting the more invasive surgical techniques.
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Affiliation(s)
- Babatunde O Akinbami
- University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
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Role of preoperative 3-dimensional computed tomography reconstruction in depressed skull fractures treated with craniectomy: a case report of forensic interest. Am J Forensic Med Pathol 2011; 32:172-5. [PMID: 21512384 DOI: 10.1097/paf.0b013e318219c88c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patients affected by cranial trauma with depressed skull fractures and increased intracranial pressure generally undergo neurosurgical intervention. Because craniotomy and craniectomy remove skull fragments and generate new fracture lines, they complicate forensic examination and sometimes prevent a clear identification of skull fracture etiology. A 3-dimensional reconstruction based on preoperative computed tomography (CT) scans, giving a picture of the injuries before surgical intervention, can help the forensic examiner in identifying skull fracture origin and the means of production.We report the case of a 41-year-old-man presenting at the emergency department with a depressed skull fracture at the vertex and bilateral subdural hemorrhage. The patient underwent 2 neurosurgical interventions (craniotomy and craniectomy) but died after 40 days of hospitalization in an intensive care unit. At autopsy, the absence of various bone fragments did not allow us to establish if the skull had been stricken by a blunt object or had hit the ground with high kinetic energy. To analyze bone injuries before craniectomy, a 3-dimensional CT reconstruction based on preoperative scans was performed. A comparative analysis between autoptic and radiological data allowed us to differentiate surgical from traumatic injuries. Moreover, based on the shape and size of the depressed skull fracture (measured from the CT reformations), we inferred that the man had been stricken by a cylindric blunt object with a diameter of about 3 cm.
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Preventing iatrogenic injury from inadvertent intracranial migration of a urinary foley catheter while controlling profuse epistaxis after severe craniofacial trauma. J Craniofac Surg 2011; 22:748-9. [PMID: 21415655 DOI: 10.1097/scs.0b013e31820854ea] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The massive nasopharyngeal bleeding that may accompany complicated comminuted fractures of the craniofacial bones can be controlled by pressure tamponade using an inflatable urinary Foley catheter. However, inadvertent intracranial catheter penetration poses a serious risk in such situations. Management of a relevant case is described, and a simple preventive measure is suggested.
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Reichelt A, Zeckey C, Hildebrand F, Grosshennig A, Shin HO, Galanski M, Keberle M. Imaging of the brain in polytraumatized patients comparing 64-row spiral CT with incremental (sequential) CT. Eur J Radiol 2011; 81:789-93. [PMID: 21349671 DOI: 10.1016/j.ejrad.2011.01.090] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 01/20/2011] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Up to now, due to a better image quality, for brain imaging the substantially slower sequential examination mode has been preferred during CT in polytraumatized patients. We aimed to re-evaluate modern ultrafast 64-row spiral CT regarding image quality in brain imaging of polytraumatized patients. METHODS In 30 polytraumatized patients, both 64-row spiral and sequential CT of the brain were performed within 24h. Retrospectively, two radiologists subjectively evaluated the delineation of the internal capsule, the pons, the medial rectus muscle of the orbita, the differentiation of grey/white matter, and the extent of artifacts at the inner skull. Image noise was also evaluated objectively. Statistics were performed using Cohen's kappa and a two-sided t-test. RESULTS Perfect or clear agreements were noted regarding the delineation of the inner skull, the medial rectus muscle, the internal capsule, and grey/white matter differentiation. Due to beam hardening artifacts at the level of the pons, no agreement and no superiority of one of the CT-methods was noted. No differences were obtained regarding the objective evaluation of image noise. DISCUSSION Image quality is generally equivalent. Since 64-row spiral CT can substantially save examination time we recommend to perform a spiral examination of the brain in polytraumatized patients.
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Affiliation(s)
- Angela Reichelt
- Department of Diagnostic Radiology, Hannover Medical School, Carl Neuberg Str. 1, 30625 Hannover, Germany.
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Chu ZG, Yang ZG, Dong ZH, Chen TW, Zhu ZY, Deng W, Xiao JH. Features of cranio-maxillofacial trauma in the massive Sichuan earthquake: analysis of 221 cases with multi-detector row CT. J Craniomaxillofac Surg 2010; 39:503-8. [PMID: 21112795 DOI: 10.1016/j.jcms.2010.10.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 10/05/2010] [Accepted: 10/19/2010] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE In a massive earthquake, cranio-maxillofacial trauma was common. The present study was to determine the features of cranio-maxillofacial trauma sustained in the massive Sichuan earthquake by multi-detector row computed tomography (MDCT). METHODS The study included 221 consecutive patients (123 males and 98 females; age range, 1-83 years; median age, 35 years) with cranio-maxillofacial trauma in the Sichuan earthquake, who underwent cranio-maxillofacial MDCT scans. The image data were retrospectively reviewed focusing on the injuries of the cranio-maxillofacial soft tissue, facial bones and cranium. RESULTS All patients had soft tissue injuries frequently with foreign bodies. Ninety-seven (43.9%) patients had fractures (1.5 involved sites per patient, range from 1 to 8) including single cranial fractures in 36 (37.1%) cases, single maxillofacial fractures were seen in 48 (49.5%) and cranio-maxillofacial fractures in 13 (13.4%). Single bone fracture was more common than multiple bone fractures (p<0.05). Nasal, ethmoid bones and the orbits were the most commonly involved sites of the craniofacial region. Thirty-eight (17.2%) patients had intracranial injuries, the commonest being subarachnoid haemorrhage and the commonest sites were the temporal and frontal regions. Coexisting intracranial injuries were more common in patients with cranial fractures than in patients with maxillofacial fractures (p<0.05). CONCLUSION Our results indicate that the cranio-maxillofacial trauma arising from the massive Sichuan earthquake had some characteristic features, and a significant number of individuals had the potential for combined cranial and maxillofacial injuries, successful management of which required a multidisciplinary approach.
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Affiliation(s)
- Zhi-gang Chu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, China
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Abstract
Although diseases of the paranasal sinuses have a relatively homogeneous clinical presentation, their causes can vary considerably. Radiological imaging only became relevant in paranasal sinus diagnostics following the introduction of cross-sectional imaging. In addition to technical details on imaging procedures and the individual criteria of the different modalities, anatomic details and congenital variations are presented. Particularly in acute inflammatory diseases as well as traumatic lesions, imaging is essential in preoperative planning and postoperative control. The article gives a detailed description of options in radiologic imaging of the paranasal sinuses.
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Affiliation(s)
- M Cohnen
- Institut für Klinische Radiologie, Städtische Kliniken Neuss-Lukaskrankenhaus GmbH, Neuss, Deutschland.
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Ouyang T, Branstetter BF. Advances in Head and Neck Imaging. Oral Maxillofac Surg Clin North Am 2010; 22:107-15. [DOI: 10.1016/j.coms.2009.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Jacobsen C, Lynnerup N. Craniocerebral trauma - Congruence between post-mortem computed tomography diagnoses and autopsy results. Forensic Sci Int 2010; 194:9-14. [DOI: 10.1016/j.forsciint.2009.10.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Revised: 05/25/2009] [Accepted: 10/05/2009] [Indexed: 10/20/2022]
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A comparative study of cranial, blunt trauma fractures as seen at medicolegal autopsy and by computed tomography. BMC Med Imaging 2009; 9:18. [PMID: 19835570 PMCID: PMC2770453 DOI: 10.1186/1471-2342-9-18] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Accepted: 10/16/2009] [Indexed: 11/10/2022] Open
Abstract
Background Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechanical trauma analysis by Finite Element Analysis. If CT scan data are to be used for creating individual head models for retrograde trauma analysis in the future we need to ascertain how well cranial fractures are captured by CT scan. The purpose of this study was to compare the diagnostic agreement between CT and autopsy regarding cranial fractures and especially the precision with which cranial fractures are recorded. Methods The autopsy fracture diagnosis was compared to the diagnosis of two CT readings (reconstructed with Multiplanar and Maximum Intensity Projection reconstructions) by registering the fractures on schematic drawings. The extent of the fractures was quantified by merging 3-dimensional datasets from both the autopsy as input by 3D digitizer tracing and CT scan. Results The results showed a good diagnostic agreement regarding fractures localised in the posterior fossa, while the fracture diagnosis in the medial and anterior fossa was difficult at the first CT scan reading. The fracture diagnosis improved during the second CT scan reading. Thus using two different CT reconstructions improved diagnosis in the medial fossa and at the impact points in the cranial vault. However, fracture diagnosis in the anterior and medial fossa and of hairline fractures in general still remained difficult. Conclusion The study showed that the forensically important fracture systems to a large extent were diagnosed on CT images using Multiplanar and Maximum Intensity Projection reconstructions. Difficulties remained in the minute diagnosis of hairline fractures. These inconsistencies need to be resolved in order to use CT scan data of victims for individual head modelling and trauma analysis.
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Tonini M, Krainik A, Bessou P, Lefournier V, Boubagra K, Chiquet C, Le Bas JF. How helical CT helps the surgeon in oculo-orbital trauma. J Neuroradiol 2009; 36:185-98. [DOI: 10.1016/j.neurad.2008.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Skull base and maxillofacial fractures: Two centre study with correlation of clinical findings with a comprehensive craniofacial classification system. J Craniomaxillofac Surg 2009; 37:305-11. [DOI: 10.1016/j.jcms.2009.01.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2008] [Revised: 01/03/2009] [Accepted: 01/22/2009] [Indexed: 11/24/2022] Open
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Shintaku WH, Venturin JS, Azevedo B, Noujeim M. Applications of cone-beam computed tomography in fractures of the maxillofacial complex. Dent Traumatol 2009; 25:358-66. [PMID: 19515071 DOI: 10.1111/j.1600-9657.2009.00795.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Imaging plays an essential role in the evaluation of maxillofacial fractures both pre- and postoperatively. Several studies support the use of conventional two-dimensional imaging for traumas involving mainly the mandible, but for more complex situations advanced imaging modalities such as computed tomography (CT) and magnetic resonance imaging have higher indication. Nowadays, besides CT, cone-beam computed tomography (CBCT) has appeared as a reasonable and reliable alternative considering radiation dosage, image quality and comfort for the patient. The purpose of this study was to review the fracture patterns involving the maxillofacial complex, provide a technical and practical comparison between CT and CBCT, and finally present the potential applications of CBCT illustrated with clinical examples.
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Affiliation(s)
- Werner H Shintaku
- The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.
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Romeo A, Pinto A, Cappabianca S, Scaglione M, Brunese L. Role of Multidetector Row Computed Tomography in the Management of Mandible Traumatic Lesions. Semin Ultrasound CT MR 2009; 30:174-80. [DOI: 10.1053/j.sult.2009.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ringl H, Schernthaner R, Philipp MO, Metz-Schimmerl S, Czerny C, Weber M, Gäbler C, Steiner-Ringl A, Peloschek P, Herold CJ, Schima W. Three-dimensional fracture visualisation of multidetector CT of the skull base in trauma patients: comparison of three reconstruction algorithms. Eur Radiol 2009; 19:2416-24. [PMID: 19440716 DOI: 10.1007/s00330-009-1435-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Revised: 03/11/2009] [Accepted: 04/12/2009] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to retrospectively assess the detection rate of skull-base fractures for three different three-dimensional (3D) reconstruction methods of cranial CT examinations in trauma patients. A total of 130 cranial CT examinations of patients with previous head trauma were subjected to 3D reconstruction of the skull base, using solid (SVR) and transparent (TVR) volume-rendering technique and maximum intensity projection (MIP). Three radiologists independently evaluated all reconstructions as well as standard high-resolution multiplanar reformations (HR-MPRs). Mean fracture detection rates for all readers reading rotating reconstructions were 39, 36, 61 and 64% for SVR, TVR, MIP and HR-MPR respectively. Although not significantly different from HR-MPR with respect to sensitivity (P = 0.9), MIP visualised 18% of fractures that were not reported in HR-MPR. Because of the relatively low detection rate using HR-MPRs alone, we recommend reading MIP reconstructions in addition to the obligatory HR-MPRs to improve fracture detection.
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Affiliation(s)
- Helmut Ringl
- Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
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Temporal Bone Fracture: Evaluation and Management in the Modern Era. Otolaryngol Clin North Am 2008; 41:597-618, x. [PMID: 18436001 DOI: 10.1016/j.otc.2008.01.006] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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BAR-AM YOAV, POLLARD RACHELE, KASS PHILIPH, VERSTRAETE FRANKJ. The Diagnostic Yield of Conventional Radiographs and Computed Tomography in Dogs and Cats with Maxillofacial Trauma. Vet Surg 2008; 37:294-9. [DOI: 10.1111/j.1532-950x.2008.00380.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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