Background: Globally, much has changed in the imaging modalities available to investigate maxillofacial trauma. Nevertheless, the regional practice patterns are highly influenced by availability, affordability and accessibility of imaging services as well as competence in interpreting radiological images and the practice of defensive medicine. The aim was to assess the use of maxillofacial trauma imaging modalities as well as to document patterns of skeletal injuries at selected government-sponsored health facilities in Kenya. Material and Methods: A cross sectional study, done in three health facilities. Results: There were 137 (81.5%) males and 31 (18.5%) females with a mean of 27.73 ± 9.86 years. Commonest aetiology of trauma was interpersonal violence (80, 47.62%) and road traffic crashes (63, 37.50%). The total number of radiological examinations was 250 with a mean of 1.49 ± 0.99 examinations per patient. Plain film radiographs were more (210, 84%) than computed tomographic scans (39, 15.6%). Dental panoramic technique was the most (104, 61.9%) popular. Most participants experienced isolated fractures to the mandible (99, 58.9%) and midface (28, 16.7%). Conclusion: Dental panoramic radiography remained the imaging of choice for mandibular fractures which had the commonest occurrence. There is a shift from the traditional conventional skull radiography to computed tomography in the diagnosis of midfacial fractures. Judicious utilization and prompt provision of affordable services in dental panoramic and computed tomographic scanning at the study centers and other upcoming health facilities are paramount in ensuring timely diagnosis and management of maxillofacial injuries in Kenya.
References
[1]
Gelesko, S., Markiewicz, M.R. and Bell, R.B. (2013) Responsible and Prudent Imaging in the Diagnosis and Management of Facial Fractures. Oral and Maxillofacial Surgery Clinics of North America, 25, 545-560. https://doi.org/10.1016/j.coms.2013.07.001
[2]
Boffano, P., Benech, R., Gallesio, C., Arcuri, F. and Benech, A. (2014) Current Opinions on Surgical Treatment of Fractures of the Condylar Head. Craniomaxillofacial Trauma & Reconstruction, 7, 92-100. https://doi.org/10.1055/s-0034-1371772
[3]
Schuknecht, B. and Graetz, K. (2005) Radiologic Assessment of Maxillofacial, Mandibular, and Skull Base Trauma. European Radiology, 15, 560-568. https://doi.org/10.1007/s00330-004-2631-7
[4]
Singh, M., Ricci, J.A. and Caterson, E.J. (2015) Use of Intraoperative Computed Tomography for Revisional Procedures in Patients with Complex Maxillofacial Trauma. Plastic and Reconstructive Surgery-Global Open, 3, e463. https://doi.org/10.1097/GOX.0000000000000455
White, S.C. and Pharoah, M.J. (2004) Oral Radiology: Principles and Interpretation. 5th Edition, Mosby, St Louis, 71-265.
[8]
Brant-Zawadzki, M.N., Minagi, H., Federle, M.P. and Rowe, L.D. (1982) High Resolution CT with Image Reformat Ion in Maxillofacial Pathology. American Journal of Roentgenology, 138, 477-483. https://doi.org/10.2214/ajr.138.3.477
[9]
Kreipke, D.L., Moss, J.J., Franco, J.M., Maves, M.D. and Smith, D.J. (1984) Computed Tomography and Thin-Section Tomography in Facial Trauma. American Journal of Roentgenology, 142, 1041-1045. https://doi.org/10.2214/ajr.142.5.1041
[10]
Weber, A. (2001) History of Head and Neck Radiology: Past, Present and Future. Radiology, 218, 15-24. https://doi.org/10.1148/radiology.218.1.r01ja2715
[11]
Boeddinghaus, R. and Whyte, A. (2008) Current Concepts in Maxillofacial Imaging. European Journal of Radiology, 66, 396-418. https://doi.org/10.1016/j.ejrad.2007.11.019
[12]
Scarfe, W.C. (2005) Imaging of Maxillofacial Trauma: Evolutions and Emerging Revolutions. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 100, 75-96. https://doi.org/10.1016/j.tripleo.2005.05.057
[13]
Hassfeld, S., Muhling, J. and Zoller, J. (1995) Intraoperative Navigation in Oral and Maxillofacaial Surgery. International Journal of Oral and Maxillofacial Surgery, 24, 111-119. https://doi.org/10.1016/S0901-5027(05)80871-9
[14]
Laine, F.J., Conway, W.F. and Laskin, D.M. (1993) Radiology of Maxillofacial Trauma. Current Problems in Diagnostic Radiology, 22, 145-188. https://doi.org/10.1016/0363-0188(93)90019-P
[15]
Forrest, C.R., Lata, A.C., Marcuzzi, D.W. and Bailey, M.H. (1993) The Role of Orbital Ultrasound in the Diagnosis of Orbital Fractures. Plastic and Reconstructive Surgery, 92, 28-34. https://doi.org/10.1097/00006534-199307000-00004
[16]
Friedrich, R.E., Heiland, M. and artel-Friedrich, S. (2003) Potentials of Ultrasound in the Diagnosis of Midfacial Fractures. Clinical Oral Investigations, 7, 226-229. https://doi.org/10.1007/s00784-003-0232-5
[17]
Kleinheinz, J., Anastassov, G.E. and Joos, U. (1997) Ultrasonographic versus Conventional Diagnostic Procedures in Dislocated Subcondylar Mandibular Fractures. Craniomaxillofacial Trauma, 3, 40-42.
[18]
Lone, P., Singh, A.P., Kour, I. and Kumar, M. (2014) A 2-Year Retrospective Analysis of Facial Injuries in Patients Treated at Department of Oral and Maxillofacial Surgery, IGGDC, Jammu, India. National Journal of Maxillofacial Surgery, 5, 149-152. https://doi.org/10.4103/0975-5950.154817
[19]
Natu, S.S., Pradhan, H., Gupta, H., Alam, S., Gupta, S., Pradhan, R., Mohammad, S., Kohli, M., Sinha, V.P., Shankar, R. and Agarwal, A. (2012) An Epidemiological Study on Pattern and Incidence of Mandibular Fractures. Plastic Surgery International, 2012, Article ID: 834364. https://doi.org/10.1155/2012/834364
[20]
Al Ahmed, H.E., Jaber, M.A., Fanas, S.H.A. and Karas, M. (2004) The Pattern of Maxillofacial Fractures in Sharjah, United Arab Emirates: A Review of 230 Cases. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 98, 166-170. https://doi.org/10.1016/j.tripleo.2004.01.020
[21]
Ascani, G., Cosimo, F., Costa, M., Mancini, P. and Caporale, C. (2014) Maxillofacial Fractures in the Province of Pescara, Italy: A Retrospective Study. Otolaryngology, 2014, Article ID: 101370. https://doi.org/10.1155/2014/101370
[22]
Udeabor, S.E., Akinbami, B.O., Yarhere, K.S. and Obiechina, A.E. (2014) Maxillofacial Fractures: Etiology, Pattern of Presentation, and Treatment in University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. Journal of Dental Surgery, 2014, Article ID 850814. https://doi.org/10.1155/2014/850814
[23]
Seife, H. and Teffera, E. (2015) Epidemiology of Road Traffic Accidents: A Prospective Study at a Tertiary University Hospital in Addis Ababa Ethiopia. East and Central African Journal of Surgery, 20, 3-9.
[24]
Nyameino, S., Butt, F., Guthua, S.W., Macigo, F. and Akama, M. (2018) Occurrence and Pattern of Maxillofacial Injuries Caused by Motorcycle Crashes Presenting at Two Major Referral Hospitals in Nairobi, Kenya. Craniomaxillofacial Trauma & Reconstruction Open, 2, e9-e14. https://doi.org/10.1055/s-0038-1660434
[25]
Odhiambo, W.A., Guthua, S.W., Macigo, F.G. and Akama M.K. (2002) Maxillofacial Injuries Caused by Terrorist Bomb Attack in Nairobi, Kenya. International Journal of Oral and Maxillofacial Surgery, 31, 374-377. https://doi.org/10.1054/ijom.2001.0199
[26]
Whaites, E. (1996) Essentials of Dental Radiography and Radiology. 3rd Edition, Churchill Livingstone, London.
[27]
Kaeppler, G., Cornelius, C., Ehrenfeld, M. and Mast, G. (2013) Diagnostic Efficacy of Cone-Beam Computed Tomography for Mandibular Fractures. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 116, 98-104. https://doi.org/10.1016/j.oooo.2013.04.004
[28]
Barde, D., Mudhol, A. and Madan, R. (2014) Prevalence and Pattern of Mandibular Fracture in Central India. National Journal of Maxillofacial Surgery, 5, 153-156. https://doi.org/10.4103/0975-5950.154818
[29]
Ogura, I., Sasaki, Y. and Kaneda, T. (2014) Multidetector Computed Tomography of Maxillofacial Fractures. Japanese Dental Science Review, 50, 86-90. https://doi.org/10.1016/j.jdsr.2014.05.002
[30]
Kihara, E.N., Opondo, F., Ochola, T.J., Chindia, M.L. and Wagaiyu, E.G. (2012) 5-Year Audit of the Range and Volume of Diagnostic Radiographic Services at the University of Nairobi Dental Hospital. Open Journal of Stomatology, 2, 234-236. https://doi.org/10.4236/ojst.2012.23041
[31]
Shah, N., Bansal, N. and Logani, A. (2014) Recent Advances in Imaging Technologies in Dentistry. World Journal of Radiology, 6, 794-807. https://doi.org/10.4329/wjr.v6.i10.794
[32]
Kihara, E., Chindia, M., Ochola, T. and Parker, M. (2014) Clinical Significance of Pathological and Anatomical Findings in Cone Beam CT Scans of the Maxillary Sinus. Open Journal of Stomatology, 4, 285-290. https://doi.org/10.4236/ojst.2014.46040
[33]
Macleod, L. and Heath, N. (2008) Cone-Beam Computed Tomography (CBCT) in Dental Practice. Dental Update, 35, 590-598. https://doi.org/10.12968/denu.2008.35.9.590
[34]
Sidebottom, A.J. (2013) The TN Chawla Lecture—The Current Management of Midfacial Trauma. Journal of Oral Biology and Craniofacial Research, 3, 120-122. https://doi.org/10.1016/j.jobcr.2013.07.006
[35]
Van Hout, W.M.M.T., Van Cann, E.M., Marvick, S.M., Frank, M.H. and Koole, R. (2014) Intraoperative Imaging for the Repair of Zygomaticomaxillary Fractures: A Comprehensive Review of the Literature. Journal of Cranio-Maxillofacial Surgery, 42, 1918-1923. https://doi.org/10.1016/j.jcms.2014.07.012
[36]
Xing, L., Duan, Y., Zhu, F., Shen, M., Jia, T., Liu, L., Tao, J., Chen, Y., Gao, Z. and Zhang, H. (2015) Computed Tomography Navigation Combined with Endoscope Guidance for the Removal of Projectiles in the Maxillofacial Area: A Study of 24 Patients. International Journal of Oral and Maxillofacial Surgery, 44, 322-328. https://doi.org/10.1016/j.ijom.2014.12.018
