Correlation of computerized tomography and flat film radiographic findings with clinical examination in patients sustaining periorbital trauma

Background and Objectives. When patients arrive at an emergency center with periorbital trauma, flat film radiographs are taken routinely - they are less costly than computerized tomography (CT) scans. When flat film radiographs are combined with preoperative CT scans, a complete representation is obtained preoperatively, enabling the selection of optimal treatment. A retrospective review of the data in patient charts was performed in a large city hospital center in order to evaluate the results. Methods and Materials. Charts of 164 patients who received trauma-related CT scans were evaluated, using the following procedures: ophthalmologic evaluation, examination of hard and soft tissues, examination of the cranial nerves, and neurologic examination. Results and/or Conclusions. In the group in whom flat film had recorded negative findings, 21 of 32 patients had positive CT findings. Orbital fractures were the most commonly involved. The lamina papyracea and orbital floor fractures received the most benefit from the use of CT scans, followed by lateral sinuses and nasoethmoidal fractures. The authors concluded that patients with periorbital trauma benefit from preoperative CT scans.