When compared with radiographs, CT is more sensitive in confirming the clinical suspicion of nasal bone fracture [93]. Several classification systems exist for nasal bone fractures, and one classification system created by Rhee et al [95] relies solely on CT to determine the degree of septal deviation. CT allows for a quicker acquisition time compared with other modalities such as radiography and MRI. Also, it is less reliant on patient positioning than radiography. CT is useful as the first-line of imaging to identify penetrating foreign bodies and the subsequent determination of their trajectory and extent of the injury [47,48]. A novel volume visualization tool, cinematic rendering, is a promising technique to illustrate maxillofacial fractures [41]. CT with IV contrast does not aid in detection of facial injury. MRI Maxillofacial There is no relevant literature to support the use of MRI of the face in the initial imaging evaluation of suspected nasal bone injury. Variant 4: Trismus or malocclusion or gingival hemorrhage or mucosal hemorrhage or loose teeth or fractured teeth or displaced teeth. Suspect mandibular injury. Initial imaging following primary survey. Fractures of the mandible comprise a large proportion of facial fractures because it is vulnerable to low-energy forces. In the setting of assaults and ballistic trauma, the mandible is the most common maxillofacial fracture site [6,96]. Mandibular fractures are classified according to the degree of comminution, location, and the presence of displaced fragments [22]. The mandible is a U-shaped bone forming an incomplete ring that articulates with the calvaria via the temporomandibular joints. Secondary to this ring-like configuration, two separate fractures occur in the mandible in approximately 67% of cases [22,31]. Thus, a second fracture must be sought and excluded after the first fracture is detected.
Imaging of Facial Trauma Following Primary Survey. When compared with radiographs, CT is more sensitive in confirming the clinical suspicion of nasal bone fracture [93]. Several classification systems exist for nasal bone fractures, and one classification system created by Rhee et al [95] relies solely on CT to determine the degree of septal deviation. CT allows for a quicker acquisition time compared with other modalities such as radiography and MRI. Also, it is less reliant on patient positioning than radiography. CT is useful as the first-line of imaging to identify penetrating foreign bodies and the subsequent determination of their trajectory and extent of the injury [47,48]. A novel volume visualization tool, cinematic rendering, is a promising technique to illustrate maxillofacial fractures [41]. CT with IV contrast does not aid in detection of facial injury. MRI Maxillofacial There is no relevant literature to support the use of MRI of the face in the initial imaging evaluation of suspected nasal bone injury. Variant 4: Trismus or malocclusion or gingival hemorrhage or mucosal hemorrhage or loose teeth or fractured teeth or displaced teeth. Suspect mandibular injury. Initial imaging following primary survey. Fractures of the mandible comprise a large proportion of facial fractures because it is vulnerable to low-energy forces. In the setting of assaults and ballistic trauma, the mandible is the most common maxillofacial fracture site [6,96]. Mandibular fractures are classified according to the degree of comminution, location, and the presence of displaced fragments [22]. The mandible is a U-shaped bone forming an incomplete ring that articulates with the calvaria via the temporomandibular joints. Secondary to this ring-like configuration, two separate fractures occur in the mandible in approximately 67% of cases [22,31]. Thus, a second fracture must be sought and excluded after the first fracture is detected.