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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
Rivista di Chirurgia Maxillo-Facciale
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2013 August;24(2):77-80
Experience in MRI and CT management of craniofacial malformed infants
Arangio P. 1, Passariello M. 3, Capriotti M. 1, Vellone V. 1, Rastelli E. 2, Martini S. 2, D’ambrosio F. 2, Cascone P. 1
1 Department of Maxillo-Facial Surgery “La Sapienza” University, Rome, Italy;
2 Department of Neuroradiology “La Sapienza” University, Rome, Italy;
3 Department of Anesthesia and Intensive Care “La Sapienza” University, Rome, Italy
Aim: Craniofacial malformations are usually identified during infancy (1st-12th month). Computed tomography (CT) and magnetic resonance imaging (MRI) are the common diagnostic approaches when necessary. In this target population, the need of sedation to obtain motionless images is often required but the lack of a protocol has generated confusion about its possible use. This retrospective study on sedation techniques and management in infants undergoing CT and MRI examinations aims to compare our sedation protocol studied to minimize the number of pharmacologic sedations with current literature evidence, indicating some guidelines on the issue.
Methods: We retrospectively reviewed, from 2005 until 2010, 36 infants affected by cranio-maxillo-facial malformation and craniosynostosis who underwent CT scan and/or MRI without contrast.
Results: Thirty-two patients (97%), who underwent CT scan, received only “feed and sleep”, while one patient (3%) was sedated in agreement with the literature. MRI exams were executed under sedation with chloral hydrate in 7 patients (50%) out of 14 (mean age 236 days) due longer mean time of performing the exams. There was no significant difference in exam quality group between CT and MRI without sedation group.
Conclusion: In conclusion, feed and scan had a success rate of 97% for CT while 50% for MRI without sedation. It is a simple method, costless and very effective for studying infants with craniomaxillofacial malformation.