Image Diagnosis of Nasal Bone Fracture

Hirota, Yoshiharu; Yayoi, Shimizu; Iinuma, Toshitaka

doi:10.3950/jibiinkoka.91.539

Cited by 4 publications

(9 citation statements)

References 9 publications

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“…Several studies have suggested that CT is very useful for the diagnosis of nasal bone fracture (6-9, 11). In cases of very severe injuries, a higher detection rate and better clinical correlation were achieved with CT (8).…”

Section: Discussionmentioning

confidence: 99%

“…However, some investigators have reported the limitations of conventional radiography for the evaluation of nasal bone fractures (2, 4-6). Computed tomography (CT) has been shown to be a more accurate diagnostic tool than conventional radiography for evaluating nasal bone fractures and combined facial injuries (3, 6-11). The use of reformatted CT images, which reconstruct the original CT images to view different angles than the ones imaged, is important for the assessment of nasal bone and other facial bone fractures (3).…”

Section: Introductionmentioning

confidence: 99%

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Identification of Nasal Bone Fractures on Conventional Radiography and Facial CT: Comparison of the Diagnostic Accuracy in Different Imaging Modalities and Analysis of Interobserver Reliability

et al. 2013

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BackgroundThere has been no study to compare the diagnostic accuracy of an experienced radiologist with a trainee in nasal bone fracture.ObjectivesTo compare the diagnostic accuracy between conventional radiography and computed tomography (CT) for the identification of nasal bone fractures and to evaluate the interobserver reliability between a staff radiologist and a trainee.Patients and MethodsA total of 108 patients who underwent conventional radiography and CT after acute nasal trauma were included in this retrospective study. Two readers, a staff radiologist and a second-year resident, independently assessed the results of the imaging studies.ResultsOf the 108 patients, the presence of a nasal bone fracture was confirmed in 88 (81.5%) patients. The number of non-depressed fractures was higher than the number of depressed fractures. In nine (10.2%) patients, nasal bone fractures were only identified on conventional radiography, including three depressed and six non-depressed fractures. CT was more accurate as compared to conventional radiography for the identification of nasal bone fractures as determined by both readers (P <0.05), all diagnostic indices of an experienced radiologist were similar to or higher than those of a trainee, and κ statistics showed moderate agreement between the two diagnostic tools for both readers. There was no statistical difference in the assessment of interobserver reliability for both imaging modalities in the identification of nasal bone fractures.ConclusionFor the identification of nasal bone fractures, CT was significantly superior to conventional radiography. Although a staff radiologist showed better values in the identification of nasal bone fracture and differentiation between depressed and non-depressed fractures than a trainee, there was no statistically significant difference in the interpretation of conventional radiography and CT between a radiologist and a trainee.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Identification of Nasal Bone Fractures on Conventional Radiography and Facial CT: Comparison of the Diagnostic Accuracy in Different Imaging Modalities and Analysis of Interobserver Reliability

et al. 2013

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“…Annals of Plastic Surgery • Volume 53, Number 6, December 2004 X-ray and CT Evaluation in Acute Nasal Fracture Classifications of nasal fracture by clinical findings 1,2 or by CT 7,9 have been reported previously, but there has not been any report of classification based on both x-ray and CT findings. CT examination is very important for diagnosing nasal fracture, but in some depressed nasal fractures, lateral x-ray view is more useful than CT. Analyzing 156 surgically treated cases, nasal fracture was classified into 5 types.…”

Section: Figurementioning

confidence: 93%

“…[7][8][9] This remains true postoperatively. To understand the postoperative condition, not only x-ray but also CT evaluation is needed.…”

Section: Yabe Et Almentioning

confidence: 95%

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Pre- and Postoperative X-ray and Computed Tomography Evaluation in Acute Nasal Fracture

Yabe

Ozawa²,

Sakamoto³

et al. 2004

Annals of Plastic Surgery

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Between January 1997 and July 2003, 156 acute nasal fractures were treated by closed reduction in Ishikiri-Seiki Hospital. For all patients, x-ray and computed tomography (CT) taken pre- and postoperatively were used to classify fractures and evaluate postoperative conditions. Acute nasal fractures requiring surgery were classified into the following 5 types. Unilateral type (U), bilateral type (B), frontal type (F), laterofrontal type (L), and comminuted type (C). Postoperative conditions were classified as good, fair, or poor. On statistical analysis, it was found that reduction is easier in the U, F, B, L, and C types in order. Furthermore, it was found that in the U, B, and F types, reduction can be performed after swelling has subsided, but in the L and L+C types, reduction should be performed earlier. On follow-up x-ray and CT, there was no significant difference between the postoperative evaluation and follow-up evaluation. A few overreduced cases improved, but correct reduction was preferable to overreduction. Accurate preoperative understanding of the fracture type and postoperative evaluation by x-ray and CT are necessary to obtain good results and to decrease secondary deformity caused by poor primary reduction.

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Clinical Utility of Three-Dimensional Facial Computed Tomography in the Treatment of Nasal Bone Fractures: A New Modality Involving an Air-Bone View with a Volume Rendering Technique

Song

Jun

Chae

et al. 2011

Indian J Otolaryngol Head Neck Surg

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To evaluate the utility of three-dimensional (3D) reconstruction when planning the surgical treatment of nasal bone fractures. The axial scan of high-resolution facial bone CT was reconstructed in 3D using the program V-works 4.0 (CyberMed, Seoul, Korea) with a volume and surface rendering technique. For detailed stereoscopic examination of the nasal valve area, an air-bone view with the volume rendering technique was obtained using thresholds for air, cartilage, and bone. In most nasal bone fractures, 2D and 3D CT had similar detection rates. However, to determine the fracture angle and dimpled area, and identify multiple fractures, surgeons can get better information to help with the reduction of the fractured bone from 3D reconstruction images. Additionally, with a septal deformity, this view helps in deciding on the need for septal surgery during nasal reduction. The air view of the nasal passage provides clues to obstruction of the nasal cavity. We could identify the contour and location of the fracture site accurately from 3D CT images. The detection rate of fractures was similar to that of 2D CT. However, 3D CT enabled the accurate determination of the distance and direction of the fractured bony fragment from normal bone structure. Additionally, a stereoscopic image of the fracture site facilitated an understanding of the location and range of reduction. The air-bone view gave more information about the pathological obstruction of the nasal air passage.

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Image Diagnosis of Nasal Bone Fracture

Cited by 4 publications

References 9 publications

Identification of Nasal Bone Fractures on Conventional Radiography and Facial CT: Comparison of the Diagnostic Accuracy in Different Imaging Modalities and Analysis of Interobserver Reliability

Identification of Nasal Bone Fractures on Conventional Radiography and Facial CT: Comparison of the Diagnostic Accuracy in Different Imaging Modalities and Analysis of Interobserver Reliability

Pre- and Postoperative X-ray and Computed Tomography Evaluation in Acute Nasal Fracture

Clinical Utility of Three-Dimensional Facial Computed Tomography in the Treatment of Nasal Bone Fractures: A New Modality Involving an Air-Bone View with a Volume Rendering Technique

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