VRT in Traumatic Maxillo-Facial Injuries; Is it of an Added Value Compared to Axial and Reconstructed CT Images?

Abstract Background: Maxillo-facial fractures are very frequently seen as a result of increased incidence of road traffic accidents and aggressive fights. Due to new advances in multi-slice computed tomography and 3D VRT reconstructed images, accurateness of detection of occult fractures and outcome of maxilla-facial traumas has noticeably improved. Aim of Study: This study was conducted aiming at the description of different forms of maxillo-facial injuries, imaging criteria of different fractures of the maxilla and facial bones as well as the benefit of utilizing 3D VRT computed tomography with image reconstruction compared to axial CT images. Patients and Methods: Prospective study of 100 patients, coming to the Emergency Department with trauma and clinical evidence suggestive of maxillo-facial injuries. Multi-slice CT was done to all patients with coronal and sagittal as well as VRT reconstruction. All studies were assessed for presence of maxillo-facial fractures with detection of the types and extent of these fractures as well as associated soft tissue injuries. The findings missed or confirmed by the VRT image compared to those found by the axial images were assessed. Results: We detected that maxillo-facial fractures were more common in males (90%) than in females (10%). Road traffic accidents came first regarding the cause of these injuries followed by physical attack and fall from a height. The age group most affected was ranging from 18-35 years in 37% of the cases. Commonest fractures were seen at the maxillary sinuses (in 43% of the cases) followed by the nasal bones, zygomatic arches, mandible and orbital bony boundaries. Associated soft tissue injuries were very common. The extension of the complex fractures, occult fractures and bony displacements were more precisely assessed. VRT was superior to axial image in detection of fractures with others missed compared to the findings by the axial CT images. Conclusion: Multi-slice computed tomography offers excellent resolution needed for proper assessment of facial bones' difficult anatomy hence helping in the accurate assess-ment of facial bones' fractures needed for proper planning for surgery with VRT images adding more data compared to the axial and reconstructed images.