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Lookup NU author(s): James AllisonORCiD
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Introduction and Aims:Facial trauma patients often receive CTs to exclude head injury, but these rarely include the orbits or facial bones. As CT is useful in managing orbital fractures, this service improvement project aims to examine practice and streamline the process for patients with likely fractures, already receiving a CT.Materials and Methods: We retrospectively searched hospital records over 9 months for patients who received a CT head following trauma, and were reviewed by OMFS, to look at the investigations they received.We also searched a separate 10 month period to identify from patients who received a facial CT for trauma, which signs and symptoms were predictive of an orbital fracture.Results: Of almost 80,000 patients seen in the ED, 45 received a CT of the head and were reviewed by OMFS for trauma. In 79% of cases the maxillofacial region was not included in the initial CT; of these, 48% received additional imaging, with 13% having a further CT.Of all signs and symptoms present at assessment, hypoglobus and reduced acuity had greatest sensitivity for diagnosing orbital fracture; ecchymosis, subconjunctival haemorrhage, diplopia and limitation of eye movement were also predictive. A median of 2 signs were present in patients with fractures, and 0 in those without.Conclusions/Clinical Relevance: Were able to implement a policy in the ED of including the orbits and facial bones, when signs and symptoms suggested a fracture. This will reduce radiation dose to patients where an additional CT scan would otherwise have been undertaken.
Author(s): Allison JR, Kearns A
Publication type: Article
Publication status: Published
Journal: British Journal of Oral and Maxillofacial Surgery
Print publication date: 01/12/2017
Online publication date: 14/12/2017
Acceptance date: 14/12/2017
ISSN (print): 0266-4356
ISSN (electronic): 1532-1940
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