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83rd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

16.05. - 20.05.2012, Mainz

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Intraoperative digital volume tomography in the management of midfacial fractures

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  • corresponding author presenting/speaker Boris A. Stuck - Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany
  • author Tilo J. Barth - Clinic and Practice on Oral and Maxillofacial Surgery, Diakoniekrankenhaus Mannheim, Mannheim, Germany
  • author Roland Huelse - Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 83rd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Mainz, 16.-20.05.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12hno08

doi: 10.3205/12hno08, urn:nbn:de:0183-12hno081

Published: July 23, 2012

© 2012 Stuck et al.
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Outline

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Introduction: Computed tomography (CT) is currently the gold standard in the preoperative and postoperative evaluation of facial fractures, although digital volume tomography (DVT) appears to be a promising alternative. The availability of mobile DVT-scanners allows intraoperative scanning which offers advantages compared to postoperative assessment of facial reconstruction.

Methods: Intraoperative DVT was performed with the xCAT ENT system (Xoran Technologies, Ann Arber, USA) at 42 patients with facial fractures. The system allows the evaluation of the entire facial skeleton. Feasibility and consequences of intraoperative scanning was assessed.

Results: With the help of intraoperative DVT sufficient reduction of the facial fractures could be monitored intraoperatively in all cases. In 14 cases (complex zygomatic fractures, orbital floor and orbital wall fractures, Le-Fort and panfacial fractures) intraoperative DVT lead to immediate consequences for the intervention. In 12 cases intraoperative DVT revealed suboptimal fracture reduction that lead to immediate revision / optimisation, in one case extensive exposure of the fracture sites could partly be avoided and in one case a displaced fragment was detected and could be removed.

Conclusion: Intraoperative DVT can reliably be performed and offers potential advantages over postoperative scanning in the management of facial fractures. Immediate consequences for the intervention may result from intraoperative DVT, leading to an optimised fracture reduction and may avoid surgical revision by a second intervention.