CT of the facial massif
When is this exam indicated?
In the maxillofacilal area, CT allows to highlight anatomical and phlogistic alterations of the nasosinusal structures, such as deviation of the nasal septum, the presence of hypertrophy of the turbinates, phlogistic involvement of the paranasal sinuses (allowing also to assume the etiology), the presence of bone erosion or neoplastic lesions (in the latter case contrast medium is generally indicated).
It also provides indispensable information for a correct surgical planning, in fact, it is one of the key pre-operative exams in this area.
How is it performed?
It is generally performed by placing the patient on a sliding table, which then passes inside a "ring" where X-rays are emitted and captured. The acquisition process lasts from a few tens of seconds to a few minutes; in case of contrast medium use, a venous access is made to the patient, and, at the end of the first acquisition, the contrast medium is administered intravenously and the image acquisition is repeated.
For the success of the examination the patient must be cooperative, but the rapidity of execution and the total absence of pain make it very well tolerated. If the examination is performed with contrast medium, fasting and recent creatinineemia (a blood test that evaluates renal function) are required.
The exam is generally well tolerated even by claustrophobic patients. Unlike MRI, CT uses ionizing radiation, although in reduced quantity compared to the old one; for this reason it is always necessary to evaluate the risk-benefit balance of this examination, especially in pediatric patients. The quality of the examination can be reduced by the presence of metallic objects, including dental implants, but this is not an absolute contraindication to the execution of the examination. On the other hand, it is a complicated examination in patients who are completely uncooperative, or who are unable to remain supine even for a short time. The possibility of using contrast medium should be carefully evaluated for patients with chronic renal insufficiency or allergy to such medication, but in some cases the examination is still performed, after proper preparation.