Three Dimensional CT Imaging For Surgical Planning And Evaluation Of Treatment Of Mid Face Fractures

Abstract

The study included ten adult patients sustaining mid facial trauma (injury to the middle 1/3 of the facial skeleton).The series comprised 6 males and 4 females their age ranged from 20-50 years. A. comprehensive history, clinical examination was performed for each patient before radiographic assessment is performed, in which conventional plain radiographs (occipitomental, submento vertix, orthopantomogram and occipitofrontal view) were do·ne as well as CT. coronal· and transaxial scans.

Lastly a 30 CT. reformation from the axial and coronal scans was performed. All the data gathered from the conventional radiography, CT. and 30 CT. was recorded and compared under the heading of detection extension, displacement as well as representation of the main facial buttresses upon which open reduction and fixation of fracture sites was performed to all patient with limitation to the sites in which the main facial buttresses are restored following biomechanical principles RtF by miniplates and screws were used to fix the fracture segments.

The study revealed the following results :

• Conventional radiography could not give the whole real picture of the fractured segments due to the super imposition of structures as well as it depends upon changing a three dimensional structure into a two dimensional image. • CT. proved to be the most accurate method of radiographic examination in detecting fractures specially those with minor displacement, and in areas of thin bone. CT. examination must be done both transaxially and coronally in order not to miss any fracture lines. • Unlikely CT. did not give a good representation of the whole picture of the traumatized fracture as it depends upon the experience of the surgeon in interpreting the series of cuts in order to get the traumatized facial skeleton mentally conceptualized.