Utility of Routine Computed Tomography Angiogram Screening for Blunt Carotid Injury in Isolated Mandible Fractures

Purpose: Determine the incidence of blunt carotid injury (BCAI) in the blunt trauma induced isolated mandible fracture population and determine the utility of computed tomographic angiography (CTA) screening for BCAI in this population. Methods: A retrospective data review was performed on patients presenting to Boston Medical Center from January 2008 to January 2019 with a diagnosis of mandible fracture. Population selected utilizing ICD-9 and ICD-10 diagnosis codes for mandible fracture and BCAI. Excluded populations were pediatric (less than 18 years) and penetrating carotid injuries. Results: A total of 1,508 mandible fractures were identified, with 73% (n = 1,103) being isolated injuries. Five BCAIs were identified, and of these, 1 was associated with an isolated mandible fracture (incidence <0.01%). One of 110 isolated mandible fractures screened for BCAI with the use of CTA was positive (incidence 0.9%). Conclusions: BCAI is a rare finding in isolated mandible fractures. The inclusion of this population as an independent risk factor for BCAI should be questioned. Routine screening with CTA is not warranted. (C) 2020 American Association of Oral and Maxillofacial Surgeons

Automated summary

The study aimed to determine the incidence of blunt carotid injury (BCAI) in patients with isolated mandible fractures and assess the utility of computed tomographic angiography (CTA) screening for BCAI. Results showed a very low incidence of BCAI in isolated mandible fractures, questioning the inclusion of this population as an independent risk factor for BCAI. Therefore, routine screening with CTA is not recommended for isolated mandible fracture patients.