ULTRASONOGRAPHY IN ORBITAL FLOOR FRACTURE S - AN ALTERNATIVE TO COMPUTED-TOMOGRAPHY

Background: Plain radiography of the paranasal sinuses (Water's view) may fail to demonstrate typical signs of orbital floor fractures. To r esolve questionable cases, computed tomography (CI) is performed. B-mo de ultrasonography (US) is investigated concerning its reliability and as a possible alternative to CT. The replacement of standard radiolog ical techniques in primary evaluation will be discussed. Methods: A sk ull was used to assess the visualization of the bony floor in the ultr asound-technique. Fifteen patients with suspected fractures of the orb ital floor were investigated with plain radiographs, ultrasound of bot h orbits in dosed-eyelid technique, and CT scans. The findings were co mpared, Results: Thirteen patients were found to have apparent fractur es in CT scans. These fractures were also diagnosed on ultrasound. In three patients, ultrasonographic localization was unprecise. These fra ctures were located behind the lower orbital rim or far posteriorly. P lain radiographs showed positive Fracture signs only in five patients, Localization was not possible, The application of the ultrasound prob e was well tolerated. Conclusions: B-mode ultrasonography is a valuabl e and inexpensive technique to visualize orbital floor fractures, it s hould be employed in primary evaluation in patients with suspected iso lated orbital floor fractures prior to taking plain radiographs of the paranasal sinuses. Computed tomography should be used in suspected co mplex fractures and questionable orbital fractures.