PubMed · 13950727
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C M GROS, J P WALTER, P BLOCH, J BLOCH. 1962. [Pantomography].. https://pubmed.ncbi.nlm.nih.gov/13950727/
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We examined the impact of postoperative radiographs after repair of facial fractures on immediate postoperative management. This was completed in two parts: first we did a retrospective study from January to July 2001, and secondly a prospective observational study for the remainder of 2001. All patients who had a general anaesthetic for the treatment of a facial fracture were included. The intervention was postoperative radiographs before discharge. The outcome measure was whether the patient had to return to theatre within a month. A total of 257 patients were included of whom 3 (1.2%) returned to theatre for correction of the initial procedure. In each case this was based on the postoperative clinical findings. No patient was returned to theatre solely on the evidence of an immediate postoperative radiograph. In line with official guidelines, we suggest that postoperative radiographs must not be used routinely, but only when they are required clinically. This minimises the risk to patients, and may lead to speedier discharge and appreciable savings.
From July 1998 to December 2002, 42 patients (including 29 patients who had undergone radiation therapy) underwent a newly designed lateral nasal wall mucoperiosteal flap pedicled anteriorly on the lateral nasal artery of the angular artery to resurface a translocated facial bone segment during a facial translocation approach to the skull base to prevent its avascular necrosis. Of the 42 patients studied, 1 patient had full-thickness flap loss that resulted in bone graft necrosis. Another patient had marginal necrosis. The average length, width, and surface area of the flap was 30 mm, 45 mm, and 1350 mm measured on 5 patients. The mucoperiosteal flap tolerated radiation therapy well. The lateral nasal wall mucoperiosteal flap is a simple, reliable flap that provides ample vascularized tissue to resurface the nude translocated facial bone segment during a facial translocation approach to the skull base. It thus prevents its avascular necrosis even after radiation therapy.
OBJECTIVES: Radiation doses were determined to balance risks against usefulness of the different modalities available for the imaging of the facial skeleton. METHODS: An Alderson Rando Phantom, armed with lithium fluoride thermoluminescent dosemeters (TLDs) was exposed using a set of four conventional radiographs (orbital view, modified Waters view, orthopantomography, skull posterior--anterior 0 degrees ), two different cone beam computed tomography (CBCT) (NewTom 9000 and Siremobil Iso-C3D), and multislice computed tomography (CT) modalities (Somatom VolumeZoom and Somatom Sensation 16). TLDs from 14 well defined anatomical sites lying within the primary beam as well as the TLD corresponding to the thyroid gland were evaluated. RESULTS: Multislice CT showed the highest exposure values. Exposure levels of the CBCT systems lay between CT and conventional radiography. Dose measurement for the 16-slice CT revealed nearly the same radiation exposure as the 4-slice system when adapted examination protocols were used. CONCLUSIONS: Selection of the most appropriate imaging modality should be performed in view of the delivered doses, required image quality and information and the clinical circumstances.