 Hello everyone, I am Dr. Sanjana Sati from Mysore Medical College and Research Institute. I would like to thank CTBus for providing me the platform, the present Mike paper on the topic of evaluation of mazalo-facial fractures using MDCT with multi-planar and 3D reconstruction. Coming to the introduction, mazalo-facial fractures are one of the most frequently encountered cases in emergency departments as isolated injury or as a part of fall trauma. The face area is one of the anatomically complex regions of the human body, so fractured morphology is usually complex. If not properly managed, it can negatively influence the basic functional and psychosocial activities of the patient. CTB is the imaging soil to display the multiplicity of the fracture fragments, the rotation and the view of dislocation for any cell-base involvement. Multi-planar reconstruction and multi-planar re-formation in coronal and keratin veins are the added benefit of MDCT that are extremely helpful in evaluating the bony architecture in large, combinatorial, misplaced and complex fractures involving multiple planes and thereby allowing the surgeons to plan and treat appropriately. Some of the claims of this particular study to describe and classify the mazalo-facial fractures describe the importance of multi-planar reconstruction in the accuracy of detection of mazalo-facial fractures and to describe the advantages of using 3D reconstructed images over 2D images in patients with facial fractures. Come to the materials and methods, a descriptive cross-sectional hospital-based study was done at the Department of Rural Diagnostics in the tertiary care hospital attached to mytometrical college and research institute for a duration of one year. A total of 620 patients who had history of trauma and suspected mazalo-facial injury were referred to our department in the study period, but among them, only 500 patients had positive MDCT findings of mazalo-facial fractures and rest of the 120 patients had no fracture. The study was done using 128 slides dual-energy statements from a term-definition-edge helical CT scan. Some of the inclusion criteria, patients with clinical consummation of mazalo-facial fractures who undergo multi-slide CT examination and are shown to be positive for fractures and patients with all age group and both sex group are included. In criteria being unstable patients who needed emergency management, pregnant patients with mazalo-facial fractures and patients having passes to a surgical intervention in a mazalo-facial region. Things we met the criteria for inclusion was updated to MDCT evaluation and fields to call the selected. The patient in supine position, scan with perform and axial sections were taken at 0.625 mm columnation with a field of view extending from the top of the tonsil sinus to the chin. The axial 1 mm reconstructed images were transferred to the syngovia workstation where it was analyzed using various post-processing techniques like the axial multi-planar reconstruction in coronal and satiety plane for examination and the volume rendering technique. The images were reviewed for the following, that is to look for the presence of facial fractures, the extent of the fractures and the evaluation of the related top fractures. In our study, facial fractures were categorized as following, the frontal bone fractures, nasal bone fractures, orbital fractures, naso-orbito-ethmodus fractures, isolated zygomatic arch fractures, zygomatic omalar complex fractures, mazalo-facial sinus wall fractures, depot fractures, mandible fractures and skull-based fractures. The frontal bone fractures were further classified into five subgroups wherein we have site 1, that is anterior wall fracture with minimal combination, site 2, anterior wall fracture with combination, site 3, anterior and posterior wall fracture, site 4 included anterior and posterior wall fracture with dural injury and CSF-RE, and site 5, similar to type 4 with additional soft tissue or bone loss or severe dysfunction of anterior cranial coarser. The mandibular fractures were also classified based on the AOC-MS classification as fractures involving the symphysis, parasymphiases, body, mangle, ramus, coronal joint process and the congelal process. From the results of our study, out of the 500 patients evaluated, majority of patients who had trauma came into the age group of 21 to 40 years and these minimum were under the age of 20 years. Out of the different fractures, nasal bone fractures were more common, followed by the naso-orbito-ethmod fractures, followed by the maxillary sinus wall fractures and the lead common bone to be involved was the mandible, constituting about 2.7% of the fractures. The lead bone fractures constituted about 20% of the total fractures out of which lead bone type 1 was most common. Coming to the distribution of mandibular fractures, the congelal process was the most commonly involved site, followed by the body of the mandible, lead commonly involved site was the symphysis. In the strontal bone fractures, majority were type 2, constituting about 50% of the fractures, lead being type 2. And also, this table depicts the importance of each plane in the accuracy of detection of manzillofacial fractures. For example, angular section is best for evaluating the fractures of body of mandible, the postolateral wall of mandible sinus, tericoid plates, zygomatic arch, lateral wall of orbit and anterior and posterior wall of the frontal sinus. Whereas the coronal section is important in identifying the default fractures, fractures of the cribriform plate, naso-frontal recess, lamina paperasia, medial wall of the maxillary sinus, ramus and body of mandible and tricorps fractures. The diagonal section will be helpful to look at the fractures of the basal skull, the rule and sore of the orbit and also assessment of nasal fractures and degree of physical pain. And BRT images will be helpful for accurate detection and extension of fracture fragments. And in our study, each of the different types of fractures, 2D and 3D images were compared and out of it all the fractures, except for the naso-orbital etymodal fractures, all of the fractures show the 3D images to be superior in evaluation of fractures compared to the 2D images. Some of the few cases in our study, here is the case number one wherein we have a 22-year-old male with history of RTA, the anvil images show the fracture of the anterior wall of the maxillary sinus on the right side, fracture of the right zygomatic arch and in the coronal image, fracture of the lateral wall of the right orbit. And this constitutes a tripod fracture, VRT image depicting the tripod fracture on the right side. So, in the case number two, wherein we have a 40-year-old female with history of RTA, here the anvil images depicting the leaport type I fracture, also we can appreciate the fracture of bilateral zygomatic arches and VRT images showing type I leaport fracture on the left side and bilateral type III leaport fracture. Here we have one more case of a 35-year-old female with history of RTA, the axial images showing fracture of bilateral nasal bones and also fracture of the orbit and the maxillary sinus on the anterior wall and also the coronal image showing the fracture of lower orbit with herniation of the orbital fat into the maxillary sinus and the VRT image showing the different fracture fragments on the extension of the fracture. Coming to the discussion, mazlo facial trauma can occur as an isolated injury or a part of colitrauma. These are clinically important as disruption of soft tissues and bones of the face called facial disc the government because of emotional and cosmetic concerns. Multi-slice CT and latest technological advance in CT imaging, resulting in the opportunity to greatly increase the speed of data acquisition and reconstruction. A study conducted by Floor et al. had mentioned that facial injuries are predominantly an affliction of young men. Similarly, in our study, majority of patients were males, among them 58% were less than 40 years. So the high incidence in young males can be attributed to their deliberate risk-taking and carelessness. The most common isolated bone fracture was found to be the nasal bone fracture in our study and the same result was found in the study conducted by Phanganu. The leopold fractures were predominant among complex fractures and diagnosis of leopold fractures were as follows, invariably there will be involvement of the teregor plate. In type 1 leopold fracture, there will be involvement of the angiolateral margin of the nasal fossa. In type 2, there is involvement of the inferior rim of the orbit. In type 3, there is involvement of the zygomatic arch. The mandibular injuries were most common in the condy and the body of the mandible and this was related to the study conducted by Hall Arcade. And the prawn-tail bone fractures were also commonly encountered during manzolo-facial injuries, most common being type 2 fracture, correlated to the study conducted by Solonel et al. Multiplanar reconstructed images were found to be beneficial in localizing and identifying manzolo-facial fractures in detail. Coarse H. Monset et al. in the literature revealed 46.7% of fractures detected by coronal scams, while 30% of fractures were detected by azale scams. Rest were detected by combined azale and coronal sections. Many studies have noted that 3D reconstructed images are helpful in evaluation of fracture, combination, displacement confidence and complex fractures involving multiple things. The MDCT is the best imaging modality available for evaluation of manzolo-facial injuries and our study was done on the same modality, hence no significant limitations were entered, sample size and study design were adequate and satisfactory. According to the conclusion, MDCT is the investigation of cause and evaluation of patients with maximum facial form of 3D images are useful, although variable for different bones and assessment of complex fractures involving the face. Coronal images are useful adjunct in detection of facial fractures. As there is no additional scanning or radiation involved in the reconstruction of images, 3D VR images and NPR is a valuable tool for a radiologist interpreting manzolo-facial fractures. Continued advances in computer software algorithm and enhanced accuracy in radiographic data acquisition would allow 3D reformative CT imaging a necessary complement to conventional 2D CT imaging in complex facial trauma management. These are my references. Thank you.