안면골골절에 대한 방사선학적 고찰

Abstract

[한글]본 연세의료원에서 1964년부터 10년간 안면골골절로 진단을 받은 113예에 대하여 연령, 성별분포 및 사고의 원인을 분류 고찰하였으며 이들중 두개골 정면 및 측면상을 얻을 수 있었던 101예에 대하여 방사선학적 고찰을 하였다.

1. 안면골골절은 남자에게서 현저히 많아 81.4%를 차지하였고 특히 20대의 남자에게서 가장 많은 빈도를 나타냈다.

2. 사고의 원인은 자동차사고 자체에 의한 것이 19.5%, 산업재해에 의한 것이 15.9%, 폭행에 의한 것이 14.3%의 순으로 나타났다.

3, 안면골골절중에서는 하악골골절이 가장 많아 53.4%에서 발생하였으며 안와골골절이 32.6%, 비골골절이 29.7%, 협궁골절이 25..7%, 상악골골절이 24.7%에서 나타났다.

4. 두개골 정면 및 측면상에서 나타난 안면골골절수와 여러가지상을 종합하여 얻은 안면골골절수를 비교하여 보면 하악골골절은 54..3%중 52.5%에서 나타나 거의 대부분이 발견되었고 사골골절은 8.9%중 7.9%에서, 전두골 상악돌기골절은 7.9%중 6.9%에서, 비골전

두봉합선분리는 8.9%중 7.9%에서 나타나 이골절은 두개골 정면 및 측면상에서 잘 보였다.

5. Water 씨상은 하악골골절, 사골골절, 비골골절 및 비골전두봉합선분리를 제외하고서는 거의 모든 안면골골절들이 잘 발견되는 상임을 확인하였다.

6. 단층촬영상은 안면골골절의 범위와 연관성을 잘 나타내어주고 하악골의 오탁돌기와 과상돌기의 골절 및 안와골의 Blow Out골절을 확인하는데 많은 도움이 되었다.

7. 상악동의 음영증가는 그편에 안면골골절의 가능성을 의미하는 매우 중요한 증후임을 확인하였다.

[영문]Radiological Evaluation of Facial Bone Fracture

Ho Kyun Kim

Department of Medical Science, The Graduate School, Yonsei University

(Directed by Professor Byung Sook Choi, M.D.)

On the basis of radiological positive findings of 101 cases, facial bone fractures are analysed according to the location and predilection of fracture site with the other adjoining facial bone fractures by force being observed, as follows;

1. The incidence of facial bone fracture is markedly prominent in the males, 81.4%, compare with the females, and the most frequent age group is 3rd decade, 26.6%

2. Among the causes of accident, the car accidents are most frequent, of which percentage is 19.5% and the other causes of accidents are as follows ; read users and pedestrians is 18.6%, falls 17.7%, industrial 15.9%, assualt 14.3% and motor and bicycles 8.8%.

3. Among the facial bone fractures, visible on various view, the mandibular fractures are most common, of which percentage is 53.4% and the other facial bone fractures in order of frequency, as follows ; orbital wall fracture is 32.6%, nasal bone fracture 29.7%, fracture of zygomatic arch 26.6% and maxillar fracture 24.7%.

4. Comparing the percentage of visible facial bone fracture on skull AP and lateral view with that of the facial bone fracture taken on various views ; the mandibular fracture is found in 52.5% on skull AP and lateral view out of 53.4% on various views, ethmoid fracture in 7.9% out of 8.9%, maxillary process fracture of frontal bone in 6.9% out of 7.9% and the nasofrontal suture separation in 5.9% out of 6.9%, and the skull AP and lateral view are most helpful for detection of above fractures.

5. On Water's view most of the facial bone fractures are detected, except the fractures of the mandible, ethmoid and nasal bones and nasofrontal suture separations. One of the two cases of the maxillary bone fractures which is not visualized on Water's view is the alveolar portion of the maxillary bone, which is

however visualized on the skull lateral view.

6. Tomography is necessary to evaluate the continuity and extensibility of facial bone fracture, and confirm the fractures of coronoid and condyloid process of mandible and orbital blow out fracture.

7. The maxillary bone fracture are frequently associated with the facial bone fractures on the same side, such as inferior wall of orbit in 84.0%, zygomatic arch in 56.0%, malar part of zygoma in 56.0% and frontozygomatic suture separation in 48.9%.

8. Among the subsequent case of increased haziness in the maxillary antrum, the incidence of facial bone fractures are markedly increased on the same side and the haziness may be from post traumatic edema, exudate and hemorrhage in the maxillary

sinus.

9. By the skull AP, lateral and Water's view, the most of the facial bone fractures are detected except nasal bone fracture due to improper angle of central beam and different densities, however the accurate location and extension of various facial bone fractures, such as the fractures of zygomatic arch, coronoid

and condyloid process of mandible, maxillary bone and orbital wall and blow out fractures may only be definitely visualized on the special view, such as zygomatic arch view, TM joint view of the mandible, optic foramen view and tomography.