Computed Tomography of Facial Fractures

Facial skeletal fractures are common, and severe cases usually result from motor vehicle accidents, interpersonal violence, sports, or accidental falls. Precise visualization of the location, magnitude, and extent of fractures provides clinicians with a clearer picture of likely complications and associated soft-tissue or sensory system damage, as well as details needed to plan surgical interventions. There are alternative imaging modalities for assessing facial trauma, but multidetector computed tomography (MDCT) imaging has become the standard choice for quick and accurate assessment of head and face trauma. This modality has revolutionized the detection and assessment of complex fracture patterns and the prediction of complications associated with specific types, locations, and patterns of fractures. CT or MDCT of the face, head, and neck are now routine imaging examinations for patients with severe facial trauma. Although MDCT offers superior visualization of fractures and other trauma associated with high-velocity impact injuries to the face and head, it is not superior to other imaging modalities for assessing minor damage to bones such as minimally displaced nasal bone fractures. In such cases, and particularly for children, MDCT is not recommended because of its relatively high radiation doses. The bones of children are not just smaller versions of the adult bones. Because of differences in the biology of bones, craniofacial morphology, and risk behaviors throughout the human lifespan, the patterns and associations of facial fractures vary importantly with age.