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Screening of Pediatric Facial Fractures by Brain Computed Tomography: Diagnostic Performance Comparison With Facial

JongChan Ryu1, Seong Jong Yun2, Sun Hwa Lee3

  • 1From the Department of Emergency Medicine, Ewha Womans University Hospital.

Pediatric Emergency Care
|January 26, 2018
PubMed

Insights

Brain computed tomography (CT) effectively detects facial bone fractures in pediatric patients, showing high accuracy. Emergency physicians should consider facial fractures when reviewing brain CT scans for children with head and face trauma.

Area of Science:

  • Pediatric Radiology
  • Emergency Medicine
  • Trauma Imaging

Background:

  • Facial bone fractures are common in children after head trauma.
  • Multidetector row computed tomography (CT) is preferred over radiography for diagnosing these injuries.
  • Previous studies on brain CT for facial fractures focused solely on adults.

Purpose of the Study:

  • To assess the diagnostic performance of brain CT in detecting facial bone fractures in pediatric emergency patients.
  • To determine the necessity of additional facial CT when brain CT is already performed.

Main Methods:

  • Retrospective multicenter study involving pediatric patients (<8 years) from two tertiary hospitals.
  • Patients underwent both brain and facial CT on the same day in the emergency department.
  • CT scans were independently reviewed by a radiologist and an emergency medicine physician.

Main Results:

  • Brain CT demonstrated high diagnostic accuracy for facial bone fractures in pediatric patients.
  • Emergency physician sensitivity: 92.31%, specificity: 100%, PPV: 100%, NPV: 99.31%, accuracy: 99.36%.
  • Radiologist achieved 100% for all diagnostic parameters.

Conclusions:

  • Brain CT is a highly accurate tool for identifying facial bone fractures in children.
  • Emergency physicians should remain vigilant for facial fractures when interpreting pediatric brain CT scans.
  • Consideration of facial bone fractures is crucial in pediatric blunt head and face trauma evaluations.
Abstract

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