Imaging Techniques for Assessment of Cranio-maxillofacial Complications of Covid-19, A Systematic Review

The aim of this review was to summarize and describe the reported imaging techniques used for COVID-19 patients who have developed cranio-maxillofacial complications.

A systematic review of the literature was conducted using MEDLINE/PubMed, Google Scholar, and Scopus databases. Included articles were case reports/series, clinical trials and cross-sectional studies on adult COVID-19 patients that were written in English. Excluded articles were those discussing the radiological assessment of COVID-19 complications manifested in the oral mucosa or the extra-maxillofacial areas. Combinations of the following keywords were used: “COVID-19”, “Maxillofacial,” “complications,” “imaging,” “radiological,” “Mandible,” “Jaw,” “Osteonecrosis,” “cavernous sinus thrombosis,” and “mucormycosis.”

A total of 13 articles were included. Imaging techniques used were: magnetic resonance imaging (MRI), computerized tomography (CT), multislice CT (MSCT), contrast-enhanced MRI, contrast-enhanced CT, and cone beam CT. These imaging techniques were used in the diagnosis of craniomaxillofacial complications of COVID-19, including sinusitis, cavernous sinus thrombosis, jaw osteomyelitis, cellulitis, vision loss, and mucormycosis. CT and its variants were the most commonly used techniques.

Within the limitations of the included studies, which were mainly case reports, it can be concluded that imaging techniques that were employed in the diagnosis of craniomaxillofacial complications of COVID-19 were limited to MRI, CT and their variants. Despite the efficiency of the utilized imaging techniques, clinicians worldwide should be aware of the most effective and least risk-associated methods used in such circumstances.