Cone beam CT imaging of airgun injuries to the craniomaxillofacial region

In airgun injuries, the removal of the projectile is often recommended. The material properties of airgun projectiles make it difficult to determine their precise anatomical location using conventional radiological techniques. Conventional X-rays give only a two-dimensional representation of projectiles and do not allow a foreign object to be located precisely. Multi-slice computed tomography (CT) has become a standard tool in diagnosis. Metal objects can cause artefacts in CT scans and make it difficult to identify adjacent anatomical structures. By contrast, cone-beam CT (CBCT) provides three-dimensional images largely free from metal artefacts. The authors present three cases of airgun injuries and discuss the diagnostic and treatment approaches used. CBCT has proved to be a useful diagnostic tool in planning the treatment of craniofacial airgun injuries. It is superior to CT in detecting hard-tissue structural damage in the immediate vicinity of high-density metal projectiles.