Radiological assessment of facial fractures: a comparative study between surgeon and radiologist.

BACKGROUND

The authors aimed to examine the differences in CT facial bone interpretation by the faciomaxillary surgeon and the radiologist, in order to improve communication gaps and subsequently, the quality and consistency of patient care.

METHODS

This study was conducted at a level I tertiary trauma centre. Patients with facial trauma who were referred to the faciomaxillary unit following a facial CT examination from August 2017 to September 2018 were eligible for inclusion. The inclusion period was extended to 5 years for panfacial trauma patients. All consecutive patients that fulfilled the study inclusion criteria for each type of injury were included in the study (a total of 120 patients assigned to the following six categories: orbits, skull and skull base, zygomaticomaxillary complex, Le Fort pattern, mandible and pan-facial fractures). Faciomaxillary surgeons, blinded to the radiology report, were asked to provide a verbal description of the fractures. The surgical interpretation was compared to the radiology report and further analysed.

RESULTS

Of the 120 cases, the same fractures were reported in 43 cases (35.8%). Both types of specialists noted the predominant and clinically relevant fractures in 106 cases (88.3%). The reports did not match in 14 cases (11.7%) and different terminology was used in 76 cases (63.3%), with agreement in 25% (95% CI: 18-34%), partial agreement in 11.7% (95% CI: 5.9-17.4%) and no agreement in 63.3% (95% CI: 54.7-72.0%) cases.

CONCLUSION

Radiologists and faciomaxillary surgeons frequently differ in their assessment of facial fractures.