Pattern of radiological imaging modalities for maxillofacial skeletal injuries in Nairobi

Abstract

INTRODUCTION:A review of 200 patients who presented in three major hospitals in Nairobi for maxillofacial skeletal trauma (MFST) imaging in a five- year period from Jan. 1998to Dec. 2000. OBJECTIVES:To show the pattern of radiological imaging utilization in the diagnosis of MFST in Nairobi, and to determine the number of plain films and particular projections required for the diagnosis of MFST in the different hospitals. DESIGN:A retrospective descriptive study. SETTING:Kenyatta National Hospital, Aga Khan Hospital and Nairobi Hospital. SUBJECTS:200 cases of MFST seen in these hospitals. METHODS:Review of patients' files and radiological reports. MAIN OUTCOME MEASURE:Variation in utilization of imaging modalities in the three hospitals. RESULTS:There were 168 males and 30 females investigated (for 2 patients the gender was not indicated). The age group that was most commonly affected was 31 to 35 years. The most frequent indication for imaging was a suspected facial fracture (97%). Plain radiography was the most frequent examination performed in the primary investigation (71%). Under- utilization of CT scan as an imaging modality was demonstrated, where it was not performed in 69.3% of the cases. There was a wide variation in the use of radiographic views of the face among the hospitals with a p-value of 0.01 (the statistical measure of effect was the chi-squared test). In many of the cases an average of one to two films were used (43.5%)with an extreme finding of four patients for whom more than eight films were used. The predominant cause of injury was assault (48.7%), with mandibular fractures appearing commonest among all the facial fractures investigated (33.7%). CONCLUSION:The variation observed among the hospitals with regard to the imaging of facial skeletal injuries require further investigation in order to determine what the basic standard radiographic images may be necessary for the average case of MFST.