Simultaneous head and facial computed tomography scans for assessing facial fractures in patients with traumatic brain injury |
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| Affiliation: | 1. Department of Radiology, National Yang-Ming University Hospital, Yi-Lan, Taiwan;2. Department of Dentistry, National Yang-Ming University Hospital, Yi-Lan, Taiwan;3. Deparment of Radiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan;4. Department of Dentistry, Dental School, National Yang-Ming University, Taipei, Taiwan;5. Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Taiwan;6. Chang Gung University, Taiwan;1. Leibniz Universität Hannover, Institute of Mechatronic Systems, 30167 Hannover, Germany;2. Trauma Department, Hannover Medical School, 30625 Hannover, Germany;1. Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, United States;2. National Farm Medicine Center, Marshfield Clinic Research Foundation, United States;3. Division of Research, Essentia Institute of Rural Health, United States;4. Department of Medicine and Public Health, University of Washington and Veterans Administration Puget Sound Health Care System, United States;1. Orthopaedic and Trauma Surgery Department, Hospital Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Catalonia Spain;2. Department of Experimental and Health Sciences, Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain;1. Department of Pathology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran;2. Department of Anatomical Sciences, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran;3. Solid Tumor Research Center, Urmia University of Medical Sciences, Urmia, Iran;4. Department of Surgery and Diagnostic Imaging, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran |
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| Abstract: | IntroductionPatients 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.MethodsFrom 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.ResultsIn 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).ConclusionsTBI 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. |
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| Keywords: | Computed tomography Facial fracture Traumatic brain injury |
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