Clin Exp Emerg Med.  2018 Jun;5(2):107-112. 10.15441/ceem.17.223.

Diagnostic performance of brain computed tomography to detect facial bone fractures

• Kim DH
• Choi YH
• Yun SJ
• Lee SH

• KMID: 2416923
• DOI: http://doi.org/10.15441/ceem.17.223

Abstract

OBJECTIVE
Most patients with head trauma require brain computed tomography (CT) in the emergency department. However, the requirement for facial CT remains controversial. The aim of this study was to evaluate the diagnostic value of brain CT alone for detection of facial fractures and its ability to determine the requirement for additional facial CT.
METHODS
This retrospective multicenter study was conducted in two tertiary hospitals in Seoul, Republic of Korea, between January 2014 and December 2015. Data were collected from the medical records of adult patients (aged over 18 years) who had undergone both brain and facial CT on the same day as their presentation to the emergency department with blunt trauma to the head and face. The same radiologist analyzed all brain and facial CT images.
RESULTS
Eight hundred and sixty patients (668 men, 192 women; mean age 48.60±18.2 years) were identified to have had facial fractures. There was a statistically significant predominance of men but not of any particular age group. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of brain CT were 83.72%, 98.87%, 97.17%, 92.92%, and 94.08%, respectively.
CONCLUSION
These findings suggest that brain CT has high diagnostic value for detection of upper facial bone fractures with high accuracy and can aid emergency physicians when determining the requirement for additional facial CT.

Keyword

Tomography; Diagnosis; Facial bones; Skull

MeSH Terms

Adult
Brain*
Craniocerebral Trauma
Diagnosis
Emergencies
Emergency Service, Hospital
Facial Bones*
Female
Head
Humans
Male
Medical Records
Republic of Korea
Retrospective Studies
Sensitivity and Specificity
Seoul
Skull
Tertiary Care Centers