Rendimiento de la evaluación clínica en el diagnóstico de fractura de huesos propios nasales

Abstract

Clinical assessment in the diagnosis of bone fractures in patients with nasal trauma Introduction: The aim of this study was to evaluate the performance of clinical assessment in the diagnosis of bone fractures in patients with nasal trauma. Methods: Retrospective review of medical records of 220 patients with nasal trauma treated at the Maxillofacial Surgery Department of Hospital Workers in Santiago was performed. Eight clinical criteria were evaluated: epistaxis, ecchymosis, swelling, nasal injury, airway obstruction, nasal deviation, irregular nasal dorsum, and acute septal injury. The gold standard for diagnosis of nasal fracture was the radiological evaluation. The sensitivity, specifi city, and positive/negative predictive value (PPV/NPV) were calculated for each separate clinical criteria (8), for all possible combinations of 2 clinical criteria (28) and 3 clinical criteria (56). Results: For any of the 8 criteria, the average sensitivity and negative predictive values for nasal fracture was very low (< 35%). However, the specifi city and positive predictive values were relatively high (> 90%) and increased, respectively, when at least one criterion was present (92% and 94% respectively), when 2 clinical criteria were present (98% and 96%, respectively), and when at least 3 clinical criteria were present (100% for both). Conclusion: The presentation of the clinical criteria can be a valuable method for diagnosis of nasal fracture, however, when these clinical criteria are absent, the possibility of nasal fracture cannot be excluded, although the possibility is remote.

Productividad y calidad metodológica de artículos clínicos en cirugía oral y maxilofacial en Chile: Período 2001-2012

“…Respecto a la CM de los artículos analizados, se verificó que ésta es baja; aunque con una tendencia a la mejoría en los últimos tres años representado en los 4 artículos con puntuación mayor a 18 puntos de la escala MINCIR-terapia [16][17][18][19] . En general, todo esto implica que el aporte al conocimiento y desarrollo de la COMF en nuestro país es limitado y se acota básicamente a la publicación de artículos de NE tipo 4 de Sackett.…”