Diagnostic Accuracy of Maxillofacial Trauma Two-Dimensional and Three-Dimensional Computed Tomographic Scans: Comparison of Oral Surgeons, Head and Neck Surgeons, Plastic Surgeons, and Neuroradiologists
| Autor: | Hurig V. Katchikian, James P. Bradley, Victoria Vo, Clifton Meals, Reza Jarrahy, Christina J. Tabit, Anand Kumar, Haig A. Goenjian |
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| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Oral Surgeon Diagnostic accuracy Computed tomographic Imaging Three-Dimensional medicine Humans Diagnostic Errors Surgery Plastic Neuroradiology Observer Variation Frontal sinus business.industry Surgery Oral Plastic surgery medicine.anatomical_structure Neuroradiography Maxillofacial Injuries Surgery Zygomatic arch Clinical Competence Radiology Tomography Tomography X-Ray Computed business Head Neck |
| Zdroj: | Plastic and Reconstructive Surgery. 127:2432-2440 |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0b013e318213a1fe |
| Popis: | Background: The authors' objectives were to study differences in diagnostic accuracy between two- and three-dimensional computed tomographic scans and among the specialties of plastic surgery, head and neck surgery, oral surgery, and neuroradiology, since this had not previously been done. Methods: Four groups of subspecialists completed time-proctored tests of 20 maxillofacial trauma scans with zygomatic arch, zygomatic complex, orbital, Le Fort I, II, III, mandibular and panfacial fractures from five institutions (n = 40). Accuracy of diagnosis and indication for surgery, efficiency, and preference were assessed. Comparison between two- and three-dimensional scans, between expert (experienced attending) versus novice (resident/fellow), and among the four subspecialties was performed. Results: For two- and three-dimensional scans, two-dimensional was more accurate for orbital floor/medial wall (40 percent and 34 percent) and frontal sinus (26 percent for diagnostic) fractures. Two-dimensional examinations took 2.3 times longer but were preferred (85 percent). Experts and novices had similar accuracy with three-dimensional scanning, but experts were more accurate with the two-dimensional scanning. Experts were 3.3 times faster with two-dimensional scanning but not with three-dimensional scanning. Accuracy of diagnosis among subspecialists was similar, except that oral surgery was less accurate with orbitozygomatic fractures (79 percent versus 90 to 92 percent); neuroradiology was less accurate with indications for surgery (65 percent versus 87 to 93 percent). Conclusions: Differences in diagnostic accuracy exist between two- and three-dimensional maxillofacial scans and between expert and novice readers but not between subspecialties. Combined modalities are preferred. |
| Databáze: | OpenAIRE |
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