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Int J Oral Maxillofac Surg ; 50(4): 471-476, 2021 Apr.
Article in English | MEDLINE | ID: mdl-32980217

ABSTRACT

The aim of this study was to evaluate the sensitivity, accuracy, and reliability of two-dimensional computed tomography (2D-CT) scans (axial, coronal, sagittal planes) and three-dimensional computed tomography (3D-CT) reconstructions in diagnosing midfacial fractures in relation to actual fractures identified clinically and during surgery (gold standard). The imaging diagnosis was performed by a radiologist and an oral and maxillofacial surgeon. Sixty-two patients with a total of 429 midfacial fractures were included. Frontal sinus and nose fractures were easily diagnosed. For the three CT planes, there was a statistically significant difference between the CT examination and the gold standard for five to seven of the nine bones evaluated, while for 3D-CT, a difference was observed only for fractures of the orbital floor. The inter-observer agreement between the oral and maxillofacial surgeon and the radiologist was 75.5%. In conclusion, in this study 3D-CT reconstructions showed significantly the best sensitivity, accuracy, and reliability for the diagnosis of midfacial fractures. The sagittal reconstructions were the least diagnostic of the 2D-CT images. For areas where the parameters studied showed less agreement and hence a more difficult diagnosis, we recommend a combination of 3D and 2D-CT images to improve diagnostic accuracy.


Subject(s)
Frontal Sinus , Orbital Fractures , Skull Fractures , Facial Bones/diagnostic imaging , Humans , Imaging, Three-Dimensional , Orbital Fractures/diagnostic imaging , Orbital Fractures/surgery , Reproducibility of Results , Skull Fractures/diagnostic imaging , Skull Fractures/surgery , Tomography, X-Ray Computed
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