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Congress: ECR25
Poster Number: C-11800
Type: Poster: EPOS Radiologist (educational)
Authorblock: M. Régil Guerrero1, A. Goikoetxea Zubeldia2, M. Irizar Dorronsoro1, M. Q. Caballero Lladó3, A. Aramburu4, I. E. Roteta5, O. Iñarra6, P. G. Aguinagalde Vives1, M. I. Blanco1; 1Donostia/San Sebastián/ES, 2Lazkao/ES, 3Aretxabaleta/ES, 4Anoeta/ES, 5Oiartzun/ES, 6Hondarribia/ES
Disclosures:
Mónica Régil Guerrero: Nothing to disclose
Ainhoa Goikoetxea Zubeldia: Nothing to disclose
Mikel Irizar Dorronsoro: Nothing to disclose
Maria Queralt Caballero Lladó: Nothing to disclose
Ainara Aramburu: Nothing to disclose
Irati Elizasu Roteta: Nothing to disclose
Oihane Iñarra: Nothing to disclose
Paula Gabriela Aguinagalde Vives: Nothing to disclose
Marina Isabel Blanco: Nothing to disclose
Keywords: Emergency, Head and neck, Trauma, CT, Complications, Diagnostic procedure, Structured reporting, Acute, Trauma
Learning objectives To briefly review facial anatomy, fracture types and clinically and/or surgically relevant spots that should be assessed and reported on urgent computed tomography (CT) scan.
Read more Background Facial trauma often presents itself in a high-energy polytraumatic context, with severe soft tissue lesions that limit physical examination of the bony structures underneath, thus making the diagnosis almost entirely dependent on urgent CT scan. Besides, facial fractures tend to be complex and, thus, a challenge to assess, classify and report for the Radiologist. Therefore, basic knowledge of facial anatomy, fracture types and potentially affected surrounding key structures is required to deliver an optimal radiology report.
Read more Findings and procedure details ANATOMY REVIEWThe facial region is comprised by 5 unpaired and 6 paired bones. These bones are distributed in: 3 facial thirds. [fig 1] 7 facial subunits. [fig 2] 8 facial buttresses. [fig 3]  OPTIMAL IMAGING TECHNIQUEThe CT scan images should be acquired in a parallel plane to the hard palate and include every structure comprised between the frontal sinuses and the mandibular symphysis. Two sets of images should be acquired: Bony-window axial images, no more than 1 mm thick: these allow for optimal sagital and coronal multiplanar reconstructions. Soft tissue-window axial thicker...
Read more Conclusion Facial fractures’ imaging is challenging, but the CT scan is usually the only path to diagnosis in politraumatic or unconscious patients or in case of severe soft tissue lessions. Certain clinically and/or surgically relevant structures should be beared in mind and assesed. Multiplanar and volume rendering reconstructions must be sistematically revised.
Read more References  Winegar BA, Murillo H, Tantiwongkosi B. Spectrum of Critical ImagingFindings in Complex Facial Skeletal Trauma. RadioGraphics. 2013; 33(1): 3–19. DOI: 10.1148/rg.331125080 Dreizin D, Nam AJ, Diaconu SC, Bernstein MP, Bodanapally UK, Munera F. Multidetector CT of Midfacial Fractures: classification Systems, Principlesof Reduction, and Common Complications. RadioGraphics. 2018; 38(1):248-74. DOI: 10.1148/rg.2018170074 Dualde-Beltrán D, Cervera-Miguel JI. El informe estructurado del traumatismo facial. Radiología. 2022; 64: 134-41. DOI:10.1016/j.rx.2022.01.010 Boscà-Ramon A, Dualde-Beltrán D, Marqués-Mateo M, Nersesyan N. Tomografía computarizada multidetector en el traumatismo facial: informe estructurado y...
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