Evaluation of Maxillofacial Injuries Using Multi-Planar and Three- Dimensional Computed Tomography

Author(s): Sukanya S, Cherukara Nihil, Kasiviswanathan M, Lihil CK, Karthika Aravindakshan.

Abstract Background: Maxillofacial injuries, comprising 20%–50% of emergency cases, often result from trauma. This study assesses the role of 2D multiplanar and 3D CT reconstruction in their evaluation. Le Fort’s classification, later refined, emphasizes the facial skeleton’s reinforced structure, enhancing resistance to mechanical forces. Objectives: To assess and compare three-dimensional volume rendering (3D) and two dimensional (2D) multiplanar CT images in maxillofacial injuries. Methods: A prospective study was conducted on 100 patients with maxillofacial fractures who underwent CT evaluation over nine months. Results: MDCT is a noninvasive, accurate tool for evaluating maxillofacial injuries, offering shorter scan times in acute trauma. This study assessed 100 patients using 128-slice MDCT to compare 2D and 3D CT in detecting fractures and Le Fort classifications. While 2D CT was superior in detecting fractures in the medial maxillary wall, orbit, and frontal sinus, 3D CT provided better spatial visualization for surgical planning. The difference in detection rates was statistically significant (p < 0.05), confirming 2D CT as the preferred diagnostic tool for most facial fractures. Conclusion: 2D CT serves as the foundation for diagnosing facial fractures, accurately detecting tiny and deep fractures. 3D CT acts as a complementary tool, providing a clearer visualization of Le Fort fractures. It is particularly useful for preoperative planning and treatment design.