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Morita D, Kawarazaki A, Soufi M, Otake Y, Sato Y, Numajiri T. Automatic detection of midfacial fractures in facial bone CT images using deep learning-based object detection models. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101914. [PMID: 38750725 DOI: 10.1016/j.jormas.2024.101914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/24/2024] [Accepted: 05/12/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Midfacial fractures are among the most frequent facial fractures. Surgery is recommended within 2 weeks of injury, but this time frame is often extended because the fracture is missed on diagnostic imaging in the busy emergency medicine setting. Using deep learning technology, which has progressed markedly in various fields, we attempted to develop a system for the automatic detection of midfacial fractures. The purpose of this study was to use this system to diagnose fractures accurately and rapidly, with the intention of benefiting both patients and emergency room physicians. METHODS One hundred computed tomography images that included midfacial fractures (e.g., maxillary, zygomatic, nasal, and orbital fractures) were prepared. In each axial image, the fracture area was surrounded by a rectangular region to create the annotation data. Eighty images were randomly classified as the training dataset (3736 slices) and 20 as the validation dataset (883 slices). Training and validation were performed using Single Shot MultiBox Detector (SSD) and version 8 of You Only Look Once (YOLOv8), which are object detection algorithms. RESULTS The performance indicators for SSD and YOLOv8 were respectively: precision, 0.872 and 0.871; recall, 0.823 and 0.775; F1 score, 0.846 and 0.82; average precision, 0.899 and 0.769. CONCLUSIONS The use of deep learning techniques allowed the automatic detection of midfacial fractures with good accuracy and high speed. The system developed in this study is promising for automated detection of midfacial fractures and may provide a quick and accurate solution for emergency medical care and other settings.
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Affiliation(s)
- Daiki Morita
- Department of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Plastic and Reconstructive Surgery, Tokai University School of Medicine, Kanagawa, Japan.
| | - Ayako Kawarazaki
- Department of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mazen Soufi
- Division of Information Science, Nara Institute of Science and Technology, Nara, Japan
| | - Yoshito Otake
- Division of Information Science, Nara Institute of Science and Technology, Nara, Japan
| | - Yoshinobu Sato
- Division of Information Science, Nara Institute of Science and Technology, Nara, Japan
| | - Toshiaki Numajiri
- Department of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Na Y, Seo C, Kwon Y, Kim J, Choi H, Shin D, Lee M. Treatment of a naso-orbito-ethmoid fracture using open reduction and suspension sutures: a case report. Arch Craniofac Surg 2022; 23:269-273. [PMID: 36596750 PMCID: PMC9816636 DOI: 10.7181/acfs.2022.00983] [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: 10/23/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
Naso-orbito-ethmoidal (NOE) fractures are complicated fractures of the mid-face. The treatment of NOE fractures is challenging and a comprehensive treatment strategy is required. We introduce a case of NOE fracture treated with open reduction and suspension sutures. A 28-year-old woman presented with a unilateral NOE fracture. To reduce the frontal process of the maxilla, a suspension suture was made by pulling the fragment using a double arm suture via a transcaruncular incision. The suture thread was placed in the horizontal plane. Another suspension suture on the inferior orbital rim assisted reduction procedure, and they passed through the overlying skin. The reduction alignment could be finely adjusted by tightening the transcutaneous suture threads while checking the degree of bone alignment through the subciliary incision. The two suture threads were suspended using a thermoplastic nasal splint. An additional skin incision on the medial canthal area, which would have resulted in a scar, could be avoided. Four months postoperatively, computed tomography showed an accurate and stable reduction. The patient was satisfied with her aesthetic appearance, and functional deficits were not present.
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Affiliation(s)
- Youngsu Na
- Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Seoul,
Korea
| | - Chaneol Seo
- Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Seoul,
Korea
| | | | - Jeenam Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Seoul,
Korea
| | - Hyungon Choi
- Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Seoul,
Korea
| | - Donghyeok Shin
- Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Seoul,
Korea
| | - Myungchul Lee
- Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Seoul,
Korea
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Abstract
We described a rare case of arteriovenous (AV) fistula after mandibular fracture in a 64-year-old man with chronic schizophrenia. The diagnosis was made by CT angiography. The patient suffered two episodes of mandibular fracture 3 months and 12 months ago. He was found to have a large AV fistula in left side of his neck. So the patient was scheduled for operation to correct fistula.
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Affiliation(s)
- Gholamreza Motazedian
- Department of Plastic and Reconstructive Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Khojasteh
- Department of Plastic and Reconstructive Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
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Facial fractures: classification and highlights for a useful report. Insights Imaging 2020; 11:49. [PMID: 32193796 PMCID: PMC7082488 DOI: 10.1186/s13244-020-00847-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/06/2020] [Indexed: 11/16/2022] Open
Abstract
In patients with facial trauma, multidetector computed tomography is the first-choice imaging test because it can detect and characterize even small fractures and their associated complications quickly and accurately. It has helped clinical management and surgical planning, so radiologists must communicate their findings to surgeons effectively. In Le Fort fractures, there is a breach between the pterygoid plates and the posterior maxilla. These fractures are classified in three basic patterns that can be combined and associated with various complications. Conceptualized when low-speed trauma was predominant, the Le Fort classification system has become less relevant giving more importance on maxillary occlusion-bearing segments. The classification of naso-orbito-ethmoid depends on the extent of injury to the attachment of the medial canthal tendon, with possible complications like nasofrontal duct disruption. Displaced fractures of the zygomaticomaxillary complex often widen the angle of the lateral orbital wall, resulting in increased orbital volume and sometimes in enophthalmos. Severe comminution or angulation can lead to wide surgical exposure. In orbital fractures, entrapment of the inferior rectus muscles can lead to diplopia, so it is important to assess its positioning and morphology. Orbital fractures can also result in injuries to the globe or infraorbital nerve. Frontal sinus fractures that extend through the posterior sinus wall can create a communication with the anterior cranial fossa resulting in leakage of cerebrospinal fluid, intracranial bleeding. It is essential to categorize fracture patterns and highlight features that may affect fracture management in radiology reports of facial trauma.
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Nardi C, Vignoli C, Pietragalla M, Tonelli P, Calistri L, Franchi L, Preda L, Colagrande S. Imaging of mandibular fractures: a pictorial review. Insights Imaging 2020; 11:30. [PMID: 32076873 PMCID: PMC7031477 DOI: 10.1186/s13244-020-0837-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/23/2020] [Indexed: 11/23/2022] Open
Abstract
Mandibular fractures are among the most common maxillofacial fractures observed in emergency rooms and are mainly caused by road accidents. The clinical features of mandibular fractures include malocclusion and loss of mandibular function. Panoramic radiography is usually limited to isolated lesions, whereas computed tomography is the tool of choice for all other facial traumatic events. No reference standard classification system for the different types of mandibular fractures is defined. Therapeutic options include a conservative approach or surgical treatment based on the anatomic area and the severity of fracture. The main purpose of this pictorial review is to illustrate a practical description of the pathophysiology of mandibular fractures and describe both the imaging techniques to recognise them and the therapeutic indications.
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Affiliation(s)
- Cosimo Nardi
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Chiara Vignoli
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Michele Pietragalla
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Paolina Tonelli
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Linda Calistri
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, University of Florence, Via del Ponte di Mezzo, 46-48, 50127, Florence, Italy.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, USA
| | - Lorenzo Preda
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, Italy. .,Diagnostic Imaging Unit, National Centre of Oncological Hadrontherapy (CNAO), Pavia, Italy.
| | - Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy
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Dougherty WM, Christophel JJ, Park SS. Evidence-Based Medicine in Facial Trauma. Facial Plast Surg Clin North Am 2017; 25:629-643. [PMID: 28941514 DOI: 10.1016/j.fsc.2017.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article provides the reader with a comprehensive review of high-level evidence-based medicine in facial trauma and highlights areas devoid of high-level evidence. The article is organized in the order one might approach a clinical problem: starting with the workup, followed by treatment considerations, operative decisions, and postoperative treatments. Individual injuries are discussed within each section, with an overview of the available high-level clinical evidence. This article not only provides a quick reference for the facial traumatologist, but also allows the reader to identify areas that lack high-level evidence, perhaps motivating future endeavors.
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Affiliation(s)
- William M Dougherty
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Virginia, 1215 Lee Street, Charlottesville, VA 22903, USA
| | - John Jared Christophel
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Virginia, 1215 Lee Street, Charlottesville, VA 22903, USA
| | - Stephen S Park
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Virginia, 1215 Lee Street, Charlottesville, VA 22903, USA.
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