The study about availability of variable radiographic techniques in evaluating maxillofacial trauma patients

응급실에 내원한 환자의 악안변 골절환자는 일반적인 방사선 사진을 촬영하는 것이 통례적이다. 안면 중앙부 골절중 하나인 상악관골 복합체 골절을 진단하는데 가장 유효한 방사선 촬영기법은 무엇인가? 하악골 골절을 진단하는데 가장 유효한 방사선 촬영기법은 무엇인가? 상악관골 복합체 골절은 협골 전두골 봉합, 협골 측두골 봉합, 상악 관골 기주, 하안궁, 4부위에 대해 Skull P-A, Water s, Zygomatic arch view의 적합성에 관하여 연구하였고, 하악골 골절은 하악 과두부, 하악지부, 하악 우각부, 하악체, 하악 정중부에 대해 Towne s, Oblique lateral, Mandibular lateral, Mandibular P-A의 적합성에 관하여 연구하였다. 방사선 사진 판독이 유용했던 상악관골 복합체 골절환자 14명과 하악골 골절환자 49명을 대상으로 2인이 시행하여 상이한 의견이 있을 경우 제3자를 통한 골절부의 진단 적중률을 조사하였으며, 통계처리는 SPSS/PC plus package version 2.0을 사용하여 적합도 검정중 Chi-square 분석법을 사용하여 다음과 같은 결론을 얻었다. 1. 협골 전두골 봉합부는 Water s(71.4%), Skull P-A(71.4%), Zygomatic arch view(28.6%) 순이었다. (Chi-square : 7.0, P<0.05). 2. 협골 측두골 봉합부는 Zygomatic arch view(92.9%), Waters(71.4%), Skull P-A(14.3) 순이었다. (Chi-square : 19.1 P<0.05). 3. 상악 관골 기주부위는 Waters(92.9%), Skull P-A(78.6%) 순이었다. 4. 하안궁은 Waters(100%), Skull PA(28.6%) 순이었다(Chi-square, 18.1, P<0.05). 5. 하악과두부위는 Towne s(l00%), OL(85.7%), Lateral view, PA 순이었다(Chi square, 18.7 P<0.05). 6. 하악우각부위는 PA(88.9%), OL(82.6%), Towne s(66.7%) 순이었으나 유의성 있는 차이는 없었다(Chi-square 7.2, P>0.05). 7. 하악정중부위는 PA(95.1%), Lateral view(34.8%), Townes(l6.7%) 순이었다(Chi-square 68.8, P<0.05).

We usually perform a routine radiographic examination on the maxillofacial trauma patients that visit the emergency room. What is the most effective technique of radiographics in diagnosis of a zygomaticomaxillary complex fracture, or one of the midfacial bone fracture? What is the most effective technique of radiographics in diagnosis of a mandibular fracture? We performed three radiographic imaging techniques such as Water s, Skull PA, and the Zygomatic arch view to diagnose the zygomaticomaxillary complex fracture. We performed four radiographic imaging techniques such as Townes , Oblique lateral, Mandibular lateral, Mandibular PA to diagnose the mandibular fracture. In the 14 patients with a ZMC fracture and 49 patients with a mandibular fracture, useful radiographics were examined by two independent investigators. If the two investigators had different opinions, the final diagnosis was determined by a third investigator. We used Chi-square analysis with SPSS/PC plus statistic package program.(version 2.0) 1. The accuracy of Water s(71.4%) and the Skull P-A(71.4%)was the highest for the Zygomaticofrontal suture. (Chi-square : 7.0, P<0.05) 2. The accuracy of the Zygomatic arch view(92.9%) was the highest ofr the Zygomaticotemporal suture. (Chi-square : 19.1 P<0.05) 3. The accuracy of Waters(92.9%) was the highest for the Zygomaticomaxillary buttress. (Chi-square 28.5, P<0.05) 4. The accuracy of Watere(100%) was the highest for the Infraorbital rim.(Chi-square, 18.1, P<0.05) 5. The accuracy of Townes (100%) was the highest for the mandibular condyle (Chi square, 18.7 P<0.05) 6. The accuracy of the Mandibular P-A(88.9%) was the highest for the mandibular angle, but there was no significant difference. (Chi-square 7.2, P>0.05) 7. The accuracy of the mandibular P-A(95.1%) was the highest for the mandibular symphysis. (Chi-square 68.8, P<0.05)