ABSTRACT
Introducción. Los traumatismos maxilofaciales (TMF) representan un motivo de consulta común en los servicios de Urgencias. La compleja anatomía del macizo facial requiere de métodos de imágenes multiplanares para su correcta evaluación. Objetivos. Describir la frecuencia y tipos de fracturas en una serie de pacientes con TMF evaluados mediante tomografía computada multislice (TCMS) con reconstrucciones multiplanares y tridimensionales. Materiales y Métodos. Se revisaron en forma retrospectiva las tomografías de macizo facial, solicitadas por TMF a través del servicio de Emergencias durante el período junio 2008- diciembre 2009. Se recabaron los siguientes datos: edad, sexo, causa del traumatismo, presencia y tipo de fracturas. Los pacientes fueron evaluados utilizando un TCMS de 8 filas de detectores. En todos los casos se realizaron reconstrucciones multiplanares con ventana de alta resolución para hueso y con ventana para partes blandas, así como reconstrucciones tridimensionales. Resultados. Fueron realizadas 137 tomografías por TMF, de las cuales 78 (57%) presentaron 131 fracturas. De estos 78 pacientes, 52 (66%) eran hombres y 26 (34%) mujeres. Edad promedio: 33 años (rango 14-90 años). Causas: 58% accidentes de tránsito; 24% lesiones por enfrentamientos o peleas; 13% lesiones deportivas; y 7% causas varias. Tipo y frecuencia de fracturas: de piso de órbita 18,3%; de senos maxilares 16%; nasales 15,3%; de mandíbula 13%; orbitarias 9,2%; del complejo zigomático- malar 12,3%; y dos fracturas Le Fort tipo II-III. Conclusiones. Las fracturas fueron más frecuentes en hombres y en el grupo etario de 15 a 35 años. La mayor cantidad, así como las más complejas, fueran causadas por accidentes de tránsito; la más común, aislada o asociada a otras, fue la del piso orbitario.
Introduction. Maxillofacial trauma (MFT) is a common reason for attendance at Emergency Departments. The complex anatomy of the facial bones requires multiplanar imaging techniques for a proper evaluation. Objectives. To describe frequency and types of fractures in a series of patients with MFT evaluated by multi-slice computed tomography (MDCT) with multiplanar and 3D reconstructions. Materials and Methods. Facial bone CTs ordered for MFT by the Emergency Department from June 2008 to December 2009 were retrospectively reviewed. The following data were obtained: age, gender, cause of trauma, presence and type of fractures. Patients were evaluated with an 8-channel MDCT. Multiplanar reconstructions were performed in all cases using high resolution bone window and soft tissue window, as well as 3D reconstructions. Results. One-hundred and thirty-seven CTs were performed for MFT: 78 (57%) showed 131 fractures. Of these 78 patients, 52 (66%) were males and 26 (34%) were females; mean age 33 years old (range: 14-90 yrs.). Causes: 58 % were injuries from traffic accidents; 24% were injuries from fights; 13% were sport injuries; and 7% were due to miscellaneous etiologies. Type and frequency of fractures: 18.3% were orbital floor fractures, 16% were maxillary sinus fractures, 15.3% were nasal fractures, 13% were jaw fractures, 9.2% were orbital fractures, and 12.3% were fractures of the zygomatic-malar complex; two cases of Le Fort II-III fractures were also observed. Conclusions. Fractures were more common in males, in the age range from 15 to 35 years old. Most fractures, and the most complex ones, were caused by traffic accidents. The most common fracture, either isolated or associated with other fractures, was the orbital floor fracture.