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Ultrasonography in the diagnosis of nasal bone fractures: a comparison with conventional radiography and computed tomography

  • Rhinology
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Abstract

The purpose of this study was to evaluate and compare the diagnostic efficacy of ultrasonography (US) with radiography and multi-detector computed tomography (CT) for the detection of nasal bone fractures. Forty-one patients with a nasal bone fracture who underwent prospective US examinations were included. Plain radiographs and CT images were obtained on the day of trauma. For US examinations, radiologist used a linear array transducer (L17-5 MHz) in 24 patients and hockey-stick probe (L15-7 MHz) in 17. The bony component of the nose was divided into three parts (right and left lateral nasal walls, and midline of nasal bone). Fracture detection by three modalities was subjected to analysis. Furthermore, findings made by each modality were compared with intraoperative findings. Nasal bone fractures were located in the right lateral wall (n = 28), midline of nasal bone (n = 31), or left lateral wall (n = 31). For right and left lateral nasal walls, CT had greater sensitivity and specificity than US or radiography, and better agreed with intraoperative findings. However, for midline fractures of nasal bone, US had higher specificity, positive predictive value, and negative predictive value than CT. Although two US evaluations showed good agreements at all three sites, US findings obtained by the hockey-stick probe showed closer agreement with intraoperative findings for both lateral nasal wall and midline of nasal bone. Although CT showed higher sensitivity and specificity than US or radiography, US found to be helpful for evaluating the midline of nasal bone. Furthermore, for US examinations of the nasal bone, a smaller probe and higher frequency may be required.

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References

  1. Illum P (1991) Legal aspects in nasal fractures. Rhinology 29:263–266

    PubMed  CAS  Google Scholar 

  2. Staffel JG (2002) Optimizing treatment of nasal fractures. Laryngoscope 112:1709–1719

    Article  PubMed  Google Scholar 

  3. Park CH, Joung HH, Lee JH, Hong SM (2009) Usefulness of ultrasonography in the treatment of nasal bone fractures. J Trauma 67:1323–1326

    Article  PubMed  Google Scholar 

  4. Javadrashid R, Khatoonabad M, Shams N, Esmaeili F, Jabbari Khamnei H (2011) Comparison of ultrasonography with computed tomography in the diagnosis of nasal bone fractures. Dentomaxillofac Radiol 40:486–491

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  5. Nigam A, Goni A, Benjamin A, Dasgupta AR (1993) The value of radiographs in the management of the fractured nose. Arch Emerg Med 10:293–297

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  6. Logan M, O’Driscoll K, Masterson J (1994) The utility of nasal bone radiographs in nasal trauma. Clin Radiol 49:192–194

    Article  PubMed  CAS  Google Scholar 

  7. Friedrich RE, Heiland M, Bartel-Friedrich S (2003) Potentials of ultrasound in the diagnosis of midfacial fractures. Clin Oral Investig 7:226–229

    Article  PubMed  CAS  Google Scholar 

  8. Jank S, Emshoff R, Etzelsdorfer M, Strobl H, Nicasi A, Norer B (2004) Ultrasound versus computed tomography in the imaging of orbital floor fractures. J Oral Maxillofac Surg 62:150–154

    Article  PubMed  Google Scholar 

  9. Nezafati S, Javadrashid R, Rad S, Akrami S (2010) Comparison of ultrasonography with submentovertex films and computed tomography scan in the diagnosis of zygomatic arch fractures. Dentomaxillofac Radiol 39:11–16

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  10. Hong HS, Cha JG, Paik SH, Park SJ, Park JS, Kim DH et al (2007) High-resolution sonography for nasal fracture in children. AJR Am J Roentgenol 188:W86–W92

    Article  PubMed  Google Scholar 

  11. Hauger O, Bonnefoy O, Moinard M, Bersani D, Diard F (2002) Occult fractures of the waist of the scaphoid: early diagnosis by high-spatial-resolution sonography. AJR Am J Roentgenol 178:1239–1245

    Article  PubMed  Google Scholar 

  12. Paik SH, Chung MJ, Park JS, Goo JM, Im JG (2005) High-resolution sonography of the rib: can fracture and metastasis be differentiated? AJR Am J Roentgenol 184:969–974

    Article  PubMed  Google Scholar 

  13. Thiede O, Krömer JH, Rudack C, Stoll W, Osada N, Schmäl F (2005) Comparison of ultrasonography and conventional radiography in the diagnosis of nasal fractures. Arch Otolaryngol Head Neck Surg 131:434–439

    Article  PubMed  Google Scholar 

  14. Gürkov R, Clevert D, Krause E (2008) Sonography versus plain x rays in diagnosis of nasal fractures. Am J Rhinol 22:613–616

    Article  PubMed  Google Scholar 

  15. de Lacey GJ, Wignall BK, Hussain S, Reidy JR (1997) The radiology of nasal injuries: problems of interpretation and clinical relevance. Br J Radiol 50:412–414

    Article  Google Scholar 

  16. Mondin V, Rinaldo A, Ferlito A (2005) Management of nasal bone fractures. Am J Otolaryngol 26:181–185

    Article  PubMed  Google Scholar 

  17. Daly BD, Russell JL, Davidson MJ, Lamb JT (1990) Thin section computed tomography in the evaluation of naso-ethmoidal trauma. Clin Radiol 41:272–275

    Article  PubMed  CAS  Google Scholar 

  18. Mohammadi A, Ghasemi-Rad M (2011) Nasal bone fracture—ultrasonography or computed tomography? Med Ultrason 13:292–295

    PubMed  Google Scholar 

  19. Atighechi S, Baradaranfar MH, Karimi G, Dadgarnia MH, Mansoorian HR, Barkhordari N et al (2014) Diagnostic value of ultrasonography in the diagnosis of nasal fractures. J Craniofac Surg 25:e51–e53

    Article  PubMed  Google Scholar 

  20. Nemati S, Jandaghi AB, Banan R, Aghajanpour M, Kazemnezhad E (2014) Ultrasonography findings in nasal bone fracture; 6-month follow-up: can we estimate time of trauma? Eur Arch Otorhinolaryngol [Epub ahead of print]

  21. Hirai T, Manders EK, Nagamoto K, Saggers GC (1996) Ultrasonic observation of facial bone fractures: report of cases. J Oral Maxillofac Surg 54:776–779

    Article  PubMed  CAS  Google Scholar 

  22. Lee MH, Cha JG, Hong HS, Lee JS, Park SJ, Paik SH, Lee HK (2009) Comparison of high-resolution ultrasonography and computed tomography in the diagnosis of nasal fractures. J Ultrasound Med 28:717–723

    PubMed  Google Scholar 

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The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Correspondence to Kyu-Sup Cho.

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Lee, I.S., Lee, JH., Woo, CK. et al. Ultrasonography in the diagnosis of nasal bone fractures: a comparison with conventional radiography and computed tomography. Eur Arch Otorhinolaryngol 273, 413–418 (2016). https://doi.org/10.1007/s00405-015-3595-8

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  • DOI: https://doi.org/10.1007/s00405-015-3595-8

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