Assessment of zygomatico-orbital complex fractures using ultrasonography

Twenty-two patients were referred to the maxillofacial surgical unit for as sessment and management of suspected fractures of the zygomatico-orbital co mplex. In each case, both routine plain radiographic and ultrasound examina tions were made. The aim of the study was to investigate the sensitivity an d reliability of ultrasound to detect such fractures. Imaging with ultrasou nd was carried out at five areas: the infraorbital margin; lateral wall of the maxillary sinus; zygomatic arch; frontozygomatic process; and orbital f loor. Both radiographic and ultrasound findings were correlated with the fi ndings at operation. An overall agreement of 85% between radiographs and ul trasound scans was found. Ultrasound imaging was most reliable at the later al wall of the maxillary sinus, where the sensitivity was 94% and specifici ty 100%. The positive predictive value at this area was 100% compared with radiographic findings. We conclude that ultrasound is a useful tool in imag ing facial trauma as an initial investigation, and can help to reduce the t otal number of radiographs required for the diagnosis of fractures of the z ygomatico-orbital complex. (C) 2000 The British Association of Oral and Max illofacial Surgeons.