Radiological evaluation of mid-third facial fractures

Clinical assessment of patients with facial injuries can be difficult, particularly if there is extensive soft tissue swelling. The maxillofacial surgeon frequently must rely on radiographic images to confirm and delineate the presence of fractures. In particular, the mid-third of the face is a notoriously difficult area in which to delineate fracture lines in the severely injured patient. In this study, three radiographic techniques were compared for the evaluation of patients with mid-facial fractures treated in a major trauma center: plain films; panoramic zonography; and computed axial tomography. The results indicate that quality plain films are frequently difficult to obtain in the severely injured patient. In selected cases, panoramic zonography and computed axial tomography are important complementary methods for accurate assessment of mid-third facial fractures.