Document Type : Original Article
Authors
1 Assistant Professor, Department of Otorhinolaryngology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
2 Assistant Professor, Department of Radiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
3 Associate professor, Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
4 Otorhinolaryngology Research Center, Department of Otolaryngology and Head and Neck Surgery, Guilan University of Medical Sciences, Rasht, Iran
Abstract
Introduction: Nasal bone fractures are one of the most common problems in patients who are referred to otolaryngology centers. We aimed to evaluate physical examination, sonography and conventional lateral nasal bone radiography in patients with nasal bone trauma and its relation to intra-operative findings.
Methods: This prospective study was performed on 200 patients with nasal trauma and those suspicious for nasal bone fracture. The results of physical examination, sonography and radiography were recorded in a check list and compared with intra-operative findings. Data were analyzed using SPSS software version 21.0 and the means of groups were compared using parametric or non-parametric tests according to the result of 1-sample K-S test for normal distribution. P-values less than 0.05 were considered statistically significant.
Results: Evaluation of 200 patients and their sonography revealed that the sensitivity and specificity of this method was higher than the conventional lateral nasal bone radiography. Sonography compared to physical examination in the diagnosis of dorsum and lateral nasal bone fractures had higher sensitivity and specificity. For septal fractures, the specificity of physical examination was higher and the sensitivity of both methods was the same.
Conclusion: Sonography with higher sensitivity and specificity is a useful method in the diagnosis of nasal bone fractures. In comparison to radiography it has no radiation; therefore, it is more useful for children and pregnant women.
Keywords
- Davis RE, Foulad AI. Treating the deviated or wide nasal dorsum. Facial Plast Surg 2017; 33(2):139-56.
- Das S, Ali MJ, Bansal S, Chugh M, Gupta N, Janaki V. Lacrimal Sac pneumatocele following blunt nasal trauma. Ophthalmic Plast Reconstr Surg 2017; 33(6):e150-1.
- Dogan S, Kalafat UM, Yüksel B, Karaboğa T, Basturk M, Ocak T. Use of radiography and ultrasonography for nasal fracture identification in children under 18 years of age presenting to the ED. Am J Emerg Med 2017; 35(3):465-8.
- Koh JH, Bhatti O, Mahmood A, Agar N. Traumatic nasal injuries in general practice. Aust Fam Physician 2016; 45(9):650-3.
- Lim H, Kang KR, Koh SH, Jung SW, Jung S. Postoperative changes after closed reduction of nasal fracture. J Craniofac Surg 2017; 28(7):1649-53.
- Atighechi S, Baradaranfar MH, Karimi G, Dadgarnia MH, Mansoorian HR, Barkhordari N, et al. Diagnostic value of ultrasonography in the diagnosis of nasal fractures. J Craniofac Surg 2014; 25(1):e51-3.
- Ardeshirpour F, Ladner KM, Shores CG, Shockley WW. A preliminary study of the use of ultrasound in defining nasal fractures: criteria for a confident diagnosis. Ear Nose Throat J 2013; 92(10-11):508-12.
- Kishibe K, Saitou S, Harabuchi Y. Significance of ultrasonography for nasal fracture. Nihon Jibiinkoka Gakkai Kaiho 2005; 108(1):8-14. [In Japanese].
- Javadrashid R, Khatoonabad M, Shams N, Esmaeili F, Jabbari Khamnei H.Comparison of ultrasonography with computed tomography in the diagnosis of nasal bone fractures. Dentomaxillofac Radiol 2011; 40(8):486-91.
- Chacko J, Brar G. Bedside ultrasonography-Applications in critical care: Part II.Indian J Crit Care Med 2014; 18(6): 376–381.
- Ashoor AJ, Alkhars FA. Nasal bone fracture. Saudi Med J 2000; 21(5):471-4.
- Mohammadi A, Ghasemi-Rad M. Nasal bone fracture--ultrasonography or computed tomography?. Med Ultrason 2011; 13(4):292-5.
- Fouad Youssef T, Ahmed M, Taha Madian Y, Abd Al-Hameed Gad A. Utilization of ultrasound imaging for diagnosis of fracture nasal bone. EJENTAS Egyptian Journal of Ear, Nose, Throat and Allied Sciences 2009; 10(2):54-7.
- Baek HJ, Kim DW, Ryu JH, Lee YJ. 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. Iran J Radiol 2013; 10(3):140-7.
- Clayton MI, Lesser TH. The role of radiography in the management of nasal fractures. J Laryngol Otol 1986; 100(7):797-801.
- Vilela F, Granjeiro R, Maurício C, Andrade P. Applicability and effectiveness of closed reduction of nasal fractures under local anesthesia. Int Arch Otorhinolaryngol 2014; 18(3):266-71.
- Farshchian N, Farshchian N, Farshchian F, Najafi F. Diagnostic value of ultrasound for identification of nasal fracture. J Kermanshah Univ Med Sci 2011; 15(3):173-7. [In Persian].
- Pérez-Guisado J, Maclennan P. Clinical evaluation of the nose: a cheap and effective tool for the nasal fracture diagnosis. Eplasty 2012; 12:e3.
- Ondik MP, Lipinski L, Dezfoli S, Fedok FG. The treatment of nasal fractures: a changing paradigm. Arch Facial Plast Surg 2009; 11(5):296-302.
- Moumoulidis I, Mani N, Patel H, Leong P. A novel use of photo messaging in the assessment of nasal fractures. J Telemed Telecare 2007; 13(8):387-90.
- Hong HS, Cha JG, Paik SH, Park SJ, Park JS, Kim DH, et al. High-resolution sonography for nasal fracture in children. AJR Am J Roentgenol 2007; 188(1):W86-92.
)