New methods for CT data analysis in patients with posttraumatic defects and deformations of the midface
Objective. To improve radiological diagnosis in patients with traumatic injuries of the midface, to develop the methods for post-processing of CT data in patients with orbital injury in order to obtain additional diagnostic information and choose treatment strategy. Material and methods. There were 107 patients (100%) with traumatic midface injuries for the period 2014-2018. All patients were examined within 24-48 hours after admission. CT was performed using Aquilion One 640 scanner («Canon», Japan) with a slice thickness of 0.5 mm. Bone and soft tissue reconstructions were used. Examination was accompanied by multiplanar and three-dimensional reconstructions. Vitrea workstation was used for subsequent processing of CT data. Results. In 51 (48%) patients, the volume of injured orbit was not increased. Orbital enlargement was detected by visual assessment and confirmed by CT in 35 (33%) patients. In 21 (19%) cases, no visual changes in the orbit were observed. However, additional data processing revealed enlargement of the orbit over critical value (2 ml). Defect type was determined using the developed classification considering the volume and area of inferior orbital wall defects. Small defect of inferior orbital wall was diagnosed in 18 (17%) patients, medium - in 31 (29%) patients, large - in 38 (35%) patients, total - in 20 (19%) patients. Conclusion. CT is preferred for examination of patients with midface injuries. The developed methods for measurement of orbital volumes and assessment of defects of inferior orbital wall ensure additional diagnostic information about the patient’s condition. Moreover, this approach is valuable for personalized approach and preoperative planning in each patient with orbital injury.