Li-Kuo Huang1, Hsueh Han Wang2, Hsi-Feng Tu3, Chih-Yuan Fu4. 1. Department of Radiology, National Yang-Ming University Hospital, Yi-Lan, Taiwan; Deparment of Radiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan. 2. Department of Radiology, National Yang-Ming University Hospital, Yi-Lan, Taiwan. 3. Department of Dentistry, National Yang-Ming University Hospital, Yi-Lan, Taiwan; Department of Dentistry, Dental School, National Yang-Ming University, Taipei, Taiwan. 4. Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Taiwan; Chang Gung University, Taiwan. Electronic address: drfu5564@yahoo.com.tw.
Abstract
INTRODUCTION: Patients with traumatic brain injury (TBI) may have concomitant facial fractures. While most head injury patients receive head computed tomography (CT) scans for initial evaluation, the objective of our study was to investigate the value of simultaneous facial CT scans in assessing facial fractures in patients with TBI. METHODS: From January 1, 2015 to December 31, 2015, 1649 consecutive patients presenting to our emergency department (ED) with a TBI who received CT scans using the protocol for head and facial bones were enrolled. The clinical data and CT images were reviewed via a standardized format. RESULTS: In our cohort, 200 patients (12.1%) had at least one facial fracture shown on the CT scans. Patients with facial fractures were more likely to have initial loss of consciousness (ILOC; p<0.001), a Glasgow coma scale of 8 or less (p<0.001), moderate or severe degrees of head injury severity scale (p<0.001), positive physical examination findings (p<0.001), and positive CT cranial abnormalities (p<0.001). A total of 166 (83.0%) patients with facial fractures required further facial CT scans instead of conventional head CT scans alone. Surgical intervention was mandatory in 73 (44.0%) of the 166 patients, who more frequently exhibited fractures of the lower third of the face (p<0.001) and orbital fractures (p=0.019). CONCLUSIONS: TBI patients with risk factors may have a higher probability of concomitant facial fractures. Fractures of the lower third of the face and orbit are easily overlooked in routine head CT scans but often require surgical intervention. Therefore, simultaneous head and facial CT scans are suggested in selected TBI patients.
INTRODUCTION:Patients with traumatic brain injury (TBI) may have concomitant facial fractures. While most head injurypatients receive head computed tomography (CT) scans for initial evaluation, the objective of our study was to investigate the value of simultaneous facial CT scans in assessing facial fractures in patients with TBI. METHODS: From January 1, 2015 to December 31, 2015, 1649 consecutive patients presenting to our emergency department (ED) with a TBI who received CT scans using the protocol for head and facial bones were enrolled. The clinical data and CT images were reviewed via a standardized format. RESULTS: In our cohort, 200 patients (12.1%) had at least one facial fracture shown on the CT scans. Patients with facial fractures were more likely to have initial loss of consciousness (ILOC; p<0.001), a Glasgow coma scale of 8 or less (p<0.001), moderate or severe degrees of head injury severity scale (p<0.001), positive physical examination findings (p<0.001), and positive CT cranial abnormalities (p<0.001). A total of 166 (83.0%) patients with facial fractures required further facial CT scans instead of conventional head CT scans alone. Surgical intervention was mandatory in 73 (44.0%) of the 166 patients, who more frequently exhibited fractures of the lower third of the face (p<0.001) and orbital fractures (p=0.019). CONCLUSIONS: TBI patients with risk factors may have a higher probability of concomitant facial fractures. Fractures of the lower third of the face and orbit are easily overlooked in routine head CT scans but often require surgical intervention. Therefore, simultaneous head and facial CT scans are suggested in selected TBI patients.
Authors: Zachary Gala; Di Bai; Jordan Halsey; Haripriya Ayyala; Kristin Riddle; Julien Hohenleitner; Ian Hoppe; Edward Lee; Mark Granick Journal: Eplasty Date: 2022-06-20
Authors: Romke Rozema; Michiel H J Doff; Konstantina Delli; Frederik K L Spijkervet; Baucke van Minnen Journal: Clin Oral Investig Date: 2022-03-17 Impact factor: 3.573
Authors: Romke Rozema; Mostafa El Moumni; Gysbert T de Vries; Frederik K L Spijkervet; René Verbeek; Jurrijn Y J Kleinbergen; Bas W J Bens; Michiel H J Doff; Baucke van Minnen Journal: Eur J Trauma Emerg Surg Date: 2022-02-24 Impact factor: 2.374