A number of recent studies have looked at whether a single view (either OM15 or OM30) is sufficient to identify a midfacial fracture.
OM15
This x-ray shows a normal OM15 view of the face.
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OM30
This x-ray shows a normal OM30 view of the face.
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A review found that although a single view will save time, cost and radiation, a low sensitivity meant that occasionally fractures would be missed [8]. The review suggested that two views should be taken.
In a separate study, analysing midfacial fractures in 104 patients, the lateral facial view failed to identify a single midface fracture seen in either the OM15 or OM30 view [9].
Therefore, the recommended optimum combination of facial views to maximise pick-up rate and minimise radiation exposure is the OM15 and OM30.
In patients where clinical findings suggest a zygomatic arch fracture, a specific arch view such as the submentovertical, will facilitate identification of the fracture.
Submentovertical
This x-ray shows a submentovertical view of a depressed right zygomatic arch fracture.
Click on the x-ray to enlarge.
Learning bite
Two facial views – the OM15 and OM30 – provide the best combination of accuracy in identifying midfacial fractures whilst minimising radiation exposure.