Comparison of Ultrasonography and Conventional Radiography in the Diagnosis of Nasal Fractures

Abstract

To compare the diagnostic findings of ultrasonography and radiography in nasal fractures. Design and Main Outcome Measures:In this prospective study, 63 patients (23 female and 40 male; mean age, 26.8 years) with clinical signs of a nasal bone fracture were investigated. All patients underwent radiography (lateral view of the nose plus occipitomental view) and ultrasonography (10-MHz ultrasound scanner) of the nasal dorsum and the lateral nasal walls and a clinical examination by 2 consultants. Thirty-six patients underwent nasal fracture reduction. Two radiographs and 3 ultrasound images of each patient were analyzed by 2 experienced readers at different times. After assessing the nasal dorsum and lateral nasal walls in radiographs and ultrasound images, they decided whether the nose was fractured or not or whether the results were uncertain.The results were analyzed by various statistical testing methods (for sensitivity, specificity, positive and negative predictive value, and accuracy).Results: Assessment of the lateral nasal walls revealed that ultrasonography was statistically superior (P=.04) to radiography. In contrast, assessment of the nasal dorsum showed radiography to be statistically superior (P=.01) to ultrasonography. Assessment of the nasal pyramid revealed no statistical difference between radiography and ultrasonography (P =.91). Conclusion:In assessment of the nasal pyramid, ultrasonography can be considered an alternative to radiography, with equivalent diagnostic performance.

Comparison of ultrasonography with computed tomography in the diagnosis of nasal bone fractures

“…A nasal fracture can involve any part of the nasal pyramid but the lateral nasal walls, the nasal dorsum and the nasal septum generally require the most attention when assessing a nasal pyramid fracture. 2 Although clinical examinations are considered standard procedure in the diagnosis of nasal fractures, haematoma and oedema of adjacent tissues make it difficult to diagnose them. Imaging procedures in midface traumas are also needed for forensic reasons.…”

“…Ultrasonography is a non-invasive, inexpensive technique that has been shown to reveal fractures of different areas of the face, such as the nasal bone, 2,3,6 orbital floor, 7,11 anterior wall of the frontal sinus 6 and zygomatic fractures. 8,12 Previous studies have evaluated the use of ultrasonography in detecting nasal bone fractures in cases where a fracture had already been diagnosed.…”

“…8,12 Previous studies have evaluated the use of ultrasonography in detecting nasal bone fractures in cases where a fracture had already been diagnosed. 2,3 However, the sensitivity and specificity of ultrasonography has not been tested in the diagnosis of nasal bone fractures. The aim of this study was to evaluate the diagnostic value of ultrasonography in detecting nasal bone fractures compared with CT as the reference method in a single-blind study.…”

Nazal Fraktürlerin Değerlendirilmesi ve Adli Tıp Yaklaşımı

“…Çal›flmam›zda tüm olgularda radyolojik görüntüleme yöntemleri kullan›l-m›flt›r (resim 1-3). Yap›lan çal›flmalarda nazal grafinin h›zl› ve ucuz bir yöntem olmakla birlikte yanl›fl pozitif ve negatif sonuçlara yol açabildi¤ini, BT ve USG kullan›m›n daha güvenli oldu¤unu bildirilmifltir (6,22).…”

Sonography of the nasal cartilage: technique and normal anatomy

“…Because the cartilage is located superficial sonography could be such an imaging test. Sonography of the bony parts of the nose in trauma is an established method [2,3]. But, until now, to the best of our knowledge, sonography of the nasal cartilage has not been described.…”