The Effectiveness of Routine Cranial Computerized Tomography in the Evaluation of Facial Bone Fractures

Abstract

Aim: This study aimed to investigate the ability of routine cranial computed tomography (CT) to detect facial bone fractures, taking the maxillofacial, orbital, and temporal bones CT as reference. Materials and Methods: Patients who presented to the emergency department with head trauma and undergoing cranial CT were included in the study. Cases in the study group were also assessed using at least one of maxillofacial, orbital, or temporal CT. Results: Fracture was present in 155 patients who were examined by maxillofacial, orbital, or temporal CT. Moreover, 59 patients had a single fracture and 96 had more than one fracture. Fractures were determined completely and accurately in 71 patients using cranial CT. Cranial CT successfully provided the fracture diagnosis in 48 of 96 patients with multiple fractures, but all fracture lines in these patients were not shown. Eleven patients were reported as having false-positive results. The effectiveness of cranial CT was presented as a sensitivity of 45.8%, specificity of 93.1%, positive predictive value of 86.6%, negative predictive value of 63.8%, and kappa value of 0.39. Cranial CT identified 11 of 21 temporal, 33 of 50 nasal, 27 of 35 zygomatic, 3 of 4 occipital, 8 of 17 ethmoid, and 19 of 23 frontal bone fractures. Conclusion: CT assists in the detection of small, non-displaced fractures at the temporal, maxillofacial, and orbital bones owing to its advantages such as having thin slice thickness, use of a bone algorithm, and ability to reformat images.