Multidetector computed tomography in evaluation of orbital injuries in complex facial fractures

Abstract

Background: Complex facial fractures were usually associated with orbital fractures.  Multidetector computed tomography allows rapid detection of post-traumatic orbital and ocular injuries. Aim: to evaluate orbital and ocular injuries in complex facial fractures using multidetector computed tomography. Methods: This study is a retrospective observational study where 38 male patients with complex facial fractures and orbital injuries due to motor vehicle accident were referred to the Emergency Unit, Radiodiagnosis department, Kasr Alainy Hospital, Cairo University. Multidetector computed tomography of the face was performed to all patients. Multidetector computed tomography and multiplanar images were analyzed for patterns of complex facial fractures and associated orbital and ocular injuries. Statistics: Odds ratios and relative risk were calculated to determine risk of occurrence of orbital and ocular injuries in patients with complex facial fractures. Results: the commonest orbital injury in complex facial fractures were periorbital hematoma. Right sided eye injuries (34.2 %) were more common than left ones (31.5%). Extra-ocular intraconal orbital complications (71%) were more common than ocular complications (7%) in patients with complex facial fractures with associated mandibular trauma. The risk of occurrence of ocular injuries in complex facial fractures without mandibular fractures (OR: 2.6, P-value: 0.38) was twice that in complex facial trauma with mandibular fractures. Conclusion: multidetector computed tomography and multiplanar reformatted images were essential in evaluation of orbital complications in complex facial trauma. Orbital and ocular injuries were more common in multiple complex facial fractures than single types.