CBCT in ENT/Maxillofacial
The main clinical applications of CBCT in maxillofacial surgery may be summarized as dental implantology, impacted and supernumerary tooth, OMF pathology, maxillofacial trauma, temporomandibular joint (TMJ) disorders, dentofacial discrepancies, and cleft palate.
CBCT provides the 3D visualisation of the alveolar bone height, width, and thickness, and spatial proximity of inferior alveolar and incisive canals, maxillary sinus, and nasal cavity. It is the contemporary method used for planning dental implant surgery and bone augmentation procedures.
The CBCT is also used for pre-surgical evaluation of impacted teeth, supernumerary teeth, and their relations with neighbouring anatomic structures (adjacent teeth, inferior alveolar nerve, mental nerve, and maxillary sinus).
All kinds of pathologic lesions which affect bone tissue in the OMF region including infection, cysts, tumours, and osteonecrosis can be monitored by CBCT imaging.
The CBCT technology can be used in combination with specific computer software for preoperative virtual planning and fabrication of patient-specific reconstruction plates for mandibular fractures. When CBCT and multi-detector CT were compared in diagnostic imaging of mid-face, it was concluded that CBCT provided better image quality at lower doses, comparable image quality at higher doses, and superior spatial resolution in standard- and reduced-dose settings.
A CBCT imaging for TMJ complex requires less time and lower radiation doses, it provides the multi-planar views for both TMJs from a single 360° rotation scan, and it simplifies positioning of the patient. The TMJ is often involved in patients with multiple maxillofacial fractures. CBCT enables us to meet the patient’s needs by providing adequate information regarding the nature of fracture, its extent and relative locations of important anatomic structures.
The treatment planning and success of the surgical treatments of alveolar cleft patients can be assessed with CBCT imaging. Moreover, 3D measurement of cleft area including volume of bone defect and outcomes after alveolar grafting in cleft lip and palate patients can also be assessed by CBCT imaging. The dentofacial discrepancies can be visualized, and virtual planning of orthognathic surgeries can be performed with CBCT imaging and special software.
In terms of ENT, CBCT imaging can be used to assess airway, paranasal sinus pathologies, nasal polyps, temporal and frontal bone anatomy, middle ear, and cochlear implantation.
We have invested into 3D ENT imaging programs and protocols together with Planmeca as well as using our internal expertise. The Planmeca CBCT unit offers a minute voxel size of just 75 μm (micrometers). This super-fine voxel displays an amazing level of clarity enabling a comprehensive examination. The imaging area is cylindrical and covers the majority of the head and neck region, suitable for specialised medical applications in ENT and the maxillofacial field.
We have listed below some of the indications, which would warrant a CBCT investigation in ENT
- Ossicular chain form
- Cochlear implant (CI)
- Semi-circular canal dehiscence syndrome
- Congenital abnormalities of the middle ear
- Patulous Eustachian tube (PET)
- Temporal bone fracture
- Acute/Chronic Sinusitis
- Vacuum cephalgia
- Osseous defects in the paranasal sinus
- Planning surgical procedures in the paranasal sinus
- Image acquisition of IGS for FESS
Endoscopic trans-nasal approach for skull base surgery with image guidance system
- Diagnosis of foreign body larynx (in the case of X-ray opaque)
- Ptyalolith (in the case of X-ray opaque)
- Form of epiglottis
- Mid-facial fractures
- Blow-out fractures
- Zygomatic arch fractures
- Nasal bone fractures
- Petrous bone fractures