Diagnostic Performance of Plain Film, Ultrasonography, and Computed Tomography in Nasal Bone Fractures: A Systematic Review

Hwang, Kun; Jung, Joon Soo; Kim, Hun

doi:10.1177/2292550317749535

Cited by 18 publications

(13 citation statements)

References 18 publications

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“…11 The authors of each study mentioned that CR does not have high sensitivity in detecting nasal fractures, and that it specifically has difficulty detecting lateral nasal bone wall fractures. 8,20,[23][24][25] In our study, the sensitivity and specificity levels of CR were found to be 61.1% (95% CI: 35.8-82.7) and 69.2% (95% CI: 38.6-90.9), respectively.…”

Section: Discussionmentioning

confidence: 69%

Ability of Bedside Ultrasonography to Detect Pediatric Nasal Bone Fractures

et al. 2020

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Objectives/Hypothesis: The aims of this study were to evaluate the diagnostic test features of bedside ultrasonography in pediatric patients with nasal trauma and to investigate whether it is a preferable alternative method to conventional radiography (CR).Study Design: Cross-sectional prospective study.Methods: This prospective study was conducted from March 1, 2019, through November 1, 2019. Thirty-one patients under the age of 18 years who had nasal trauma were consecutively included. CR and ultrasonographic imaging tests were investigated in patients with clinical indications for nasal bone fracture. The sensitivity, specificity, and accuracy of ultrasonography and CR were calculated with respect to detecting nasal fractures according to the gold standard method.Results: Participants were between 3 and 16 years old and the median age was 8 (5-13) years. Nasal bone fracture was clinically detected in 18 patients. While 13 of these fractures were detected with ultrasonography, only 11 were also detected with CR. The sensitivity and specificity of ultrasonography and CR in detecting nasal fractures were 72.2% (95% confidence interval [CI]: 46.5-90.3) and 76.9% (95% CI: 46.2-95.0) for ultrasonography and 61.1% (95% CI: 35.8-82.7) and 69.2% (95% CI: 38.6-90.9) for CR.Conclusions: According to the results of this study, ultrasonography may be used with confidence as a first imaging method in the investigation of nasal fractures, particularly with consideration for avoiding the effects of radiation as much as possible. Our findings point to the next step of conducting trials with a greater number of patients in order to define the diagnostic test features of ultrasonography in pediatric patients.

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Section: Discussionmentioning

confidence: 69%

Ability of Bedside Ultrasonography to Detect Pediatric Nasal Bone Fractures

et al. 2020

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“…Computed tomography (89.3%±3.1%) and USG (87.2%±3.3%) were significantly more sensitive than PF ( P <0.001 and P <0.001, respectively). The specificity of CT (94.2%±2.3%) was significantly higher ( P =0.001) than that of USG (87.4%±3.3%), but the specificity of USG was significantly higher ( P <0.001) than that of PF (67.8%±4.7%) 3 . Therefore, we think that CT is necessary for diagnosing NBF.…”

Section: Discussionmentioning

confidence: 82%

Analysis of Nasal Bone Fractures: A 17-year Study of 3785 Patients

Hwang

Yoon

2023

Journal of Craniofacial Surgery

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In our previous study, we classified nasal bone fractures into 6 types based on computed tomography and the patterns of the nasal bone fractures (NBF) in 503 patients treated between 1998 and 2004. In the present study, we analyzed 3785 patients treated between 2005 and 2021. The age, sex, etiology, associated injuries, pattern of fractures, and treatments were reviewed, and radiographic studies were analyzed. The highest incidence was in the age group of 10 to 19 years (N=870, 23.0%), followed by 20 to 29 years (N=792, 20.9%) and 30 to 39 years (N=635, 16.8%). The most common causes of injury were slip or fall-down (42.3%), violence (24.3%), sports (19.2%), traffic accidents (8.9%), and work-related (5.3%). Most of the patients had tenderness (96.1%) and swelling (78.8%). Other findings were depression (27.1%) and nasal deviation (25.8%). Crepitus was heard in only 0.4% of the patients. The patterns of the NBFs classified by computed tomography findings were type IIA (unilateral simple fracture with displacement/without telescoping, 1283 cases, 33.9%), IIB (bilateral simple fracture with displacement/without telescoping, 786 cases, 20.8%), IIAs (unilateral simple fracture with septal fracture and displacement/without telescoping, 566 cases, 14.9%), IIBs (bilateral simple fracture with septal fracture and displacement/without telescoping 530 cases, 14.0%), I (simple fracture without displacement, 522 cases, 13.8%), and III (comminuted with telescoping or depression, 98 cases, 2.6%). In most of the cases (3,666, 96.9%), closed reduction was performed. The present analysis is one of the largest data sets on NBF in Korea, which could provide reference values for diagnosing and managing nasal bone fractures.

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“…The diagnosis of an orbital fracture is challenging because its clinical presentation usually varies and the anatomy of the region is complex [ 21 – 23 ]. Although the capability of a conventional non-contrast CT in providing multiplanar thin slices or 3D reconstruction of facial bone with good spatial resolution and 3D images in orbital fractures [ 24 – 26 ] makes it the imaging method of choice or accepted as gold standard [ 27 – 29 ], there is a significant concern regarding the hazard of radiation, and in some emergency situations clinical state of patient may not stable enough to be transferred to CT room. Financial issues could also be a matter of concern for some patients.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of linear-probe ultrasonography in diagnosis of infraorbital rim fractures

2023

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Background Maxillofacial fractures are a common cause of visits to emergency department, accounting for more than 400,000 annual visits in the United States. Gold standard diagnostic tool is conventional computerized tomography (CT) or 3DCT reconstruction. However, the disadvantages of CT are radiation exposure, unavailable in some hospital and expensiveness. Whereas the bony structures overlap is a problem in diagnostic when using plain film X-ray. The objective of this study is to show the accuracy of a linear-probe ultrasound compared to computed tomography and plain film X-ray in diagnosis of infraorbital rim fracture. Methods Patients clinically suspected of an inferior orbital rim fracture underwent linear-probe ultrasonographic investigation, plain film X-ray and CT. CT was used as gold standard in this diagnostic study. A radiologist and senior resident of plastic surgery were the examiner and interobserver for comparison. Result A total of 34 patients with suspected infraorbital rim fractures were investigated. Sensitivity of the linear-probe ultrasonography versus CT in the detection of infraorbital rim fracture was 92.9% (95% CI 66.1–99.8), specificity was 90.0% (95% CI 68.3–98.8), positive predictive value was 86.7% (95% CI 59.5–98.3), negative predictive value was 94.7% ( 95% CI 74.0–99.9), accuracy 91%. Conclusion Linear probe ultrasonography is a good diagnostic tool and has better reliability than the plain film X-ray and can be used as alternative to CT in inferior orbital rim fracture.

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Diagnostic Performance of Plain Film, Ultrasonography, and Computed Tomography in Nasal Bone Fractures: A Systematic Review

Abstract: Le rendement diagnostique des clichés sans préparation, de l'échographie et de la tomodensitométrie en cas de fractures de l'os nasal : une analyse systématique

Cited by 18 publications

References 18 publications

Ability of Bedside Ultrasonography to Detect Pediatric Nasal Bone Fractures

Ability of Bedside Ultrasonography to Detect Pediatric Nasal Bone Fractures

Analysis of Nasal Bone Fractures: A 17-year Study of 3785 Patients

Accuracy of linear-probe ultrasonography in diagnosis of infraorbital rim fractures

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