An Algorithmic Approach Using Ultrasonography in the Diagnosis of Pediatric Nasal Bone Fracture

Tamada, Ikkei; Mori, Takaaki; Inoue, Nobuaki; Shido, Hirokazu; Aoki, Miki; Nakamura, Yukie; Kamogawa, Ruri

doi:10.1097/scs.0000000000003217

Cited by 10 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The US sensitivity and specificity values for the diagnosis of pediatric nasal bone and skull fractures were variable. They seem to be higher in children younger than 2 years old 281 282 .…”

Section: Pediatric Applicationsmentioning

confidence: 80%

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part II: Joint Pathologies, Pediatric Applications, and Guided Procedures

et al. 2021

View full text Add to dashboard Cite

The second part of the Guidelines and Recommendations for Musculoskeletal Ultrasound (MSUS), produced under the auspices of EFSUMB, following the same methodology as for Part 1, provides information and recommendations on the use of this imaging modality for joint pathology, pediatric applications, and musculoskeletal ultrasound-guided procedures. Clinical application, practical points, limitations, and artifacts are described and discussed for every joint or procedure. The document is intended to guide clinical users in their daily practice.

show abstract

Section: Pediatric Applicationsmentioning

confidence: 80%

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part II: Joint Pathologies, Pediatric Applications, and Guided Procedures

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The inclusion criteria across studies typically involved participants aged ≤ 18 with isolated nasal trauma, excluding cases with multiple traumas. The reference tests in all included studies relied on physical examination; however, the testing protocols varied between examinations conducted by emergency physicians [ 8 ] and those carried out by otolaryngologists [ 1 , 6 ] and plastic surgeons [ 9 ]. Additional information regarding the studies, characteristics of the patients, and details of the ultrasound examinations can be found in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, two studies [ 6 , 8 ] in the review did not clearly specify sonographic criteria for diagnosing nasal fractures. Additionally, one study [ 9 ] exclusively employed CT scans as a reference test for patients with suspected nasal fractures in ultrasound results, rather than uniformly applying it to all patients. In summary, the review suggests a moderate overall quality of the included studies.…”

Section: Resultsmentioning

confidence: 99%

“…This requirement is accentuated in pediatric cases, where the inherent challenges of patient non-compliance further complicate the efficacy of physical examinations [ 4 – 6 ]. Traditional imaging methods, including X-rays and computed tomography (CT) scans, present limitations in sensitivity, specificity, and concerns about radiation exposure [ 8 , 9 ]. In this context, ultrasonography emerges as a promising method for evaluating pediatric nasal bone fractures.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic utility of ultrasound in pediatric nasal bone fractures: a systematic review and meta-analysis

Hassankhani,

Amoukhteh,

Jannatdoust

et al. 2024

Emerg Radiol

View full text Add to dashboard Cite

Ultrasonography, a radiation-free and cost-effective modality, stands out as a promising tool for evaluating nasal bone fractures. Despite limited literature on its pediatric application, there is an increasing recognition of its potential to enhance diagnostic precision. To evaluate the diagnostic efficacy of ultrasound in detecting pediatric nasal bone fractures. Employing established guidelines, a systematic review and meta-analysis were conducted through a comprehensive literature search in PubMed, Scopus, Web of Science, and Embase databases until December 5, 2023. Inclusion criteria encompassed studies reporting diagnostic accuracy measures of ultrasound in pediatric patients with nasal bone fractures. Data extraction and analysis were undertaken for the selected studies. Involving four studies with 277 patients, ultrasound demonstrated a pooled sensitivity of 66.1% (95% CI: 35.1-87.5%) and specificity of 86.8% (95% CI: 80.1-91.4%) in diagnosing pediatric nasal fractures. The area under the receiver operating characteristic curve (AUC) was 0.88 (95% CI: 0.72–0.93). After excluding an outlier study, sensitivity and specificity increased to 78.0% (95% CI: 65.6-86.9%) and 87.8 (95% CI: 78.1-93.6%), respectively, with an AUC of 0.79 (95% CI: 0.75–0.94). Pooled positive and negative likelihood ratios were 5.11 (95% CI: 2.12–9.15) and 0.40 (95% CI: 0.14–0.77) before exclusion and 6.75 (95% CI: 3.47–12.30) and 0.26 (95% CI: 0.15–0.40) after exclusion of an outlier study, respectively. This study highlighted ultrasonography’s utility in diagnosing pediatric nasal bone fractures with high accuracy and specificity. However, caution is advised in relying solely on ultrasound due to suboptimal overall diagnostic performance, evident in likelihood ratios.

show abstract

“…Therefore, Tamada et al recently Here, we identify some potential to reduce irradiation for the young patients proposed an algorithm including repetitive US for pediatric nasal bone fractures. The algorithm was able to detect the majority of fractures [28]. Moreover, US would be an appropriate modality to assess intraoperative success of closed nasal bone reposition.…”

Section: Discussionmentioning

confidence: 99%

Blunt nasal trauma in children: a frequent diagnostic challenge

Borner

Anschuetz

Kaiser

et al. 2018

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Objective The clinical challenge in blunt nasal trauma in children, is to identify cases requiring specialized care among frequently encountered banalities, whilst trying to minimize the exposure to diagnostic procedures. We aim to evaluate the related diagnostic and therapeutic pathways and its outcome during follow-up. Methods This retrospective cohort study includes children up to 16 years presenting at the emergency department with blunt nasal trauma of our tertiary reference center. ResultsThe incidence of blunt nasal injuries was estimated 1750 cases in 7 years. A total of 459 consecutive cases with suspected complications were enrolled. Univariate comparison between age groups revealed a statistically significant diminution of downfall related injuries with growing up, whereas blows (including violence) significantly increased with age (p < 0.001 each). The logistic regression model identified male sex as an independent risk factor for soft tissue lesions (OR 1.699, p = 0.017) and for frontobasal fractures (OR 2.415, p = 0.050). Age was not identified to play a significant role regarding localization of injuries. Delayed septorhinoplasties became necessary in 2 cases only (0.4%). The logistic regression model identified nasal bone fracture (OR 17.038, p < 0.001) and mandibular fracture (OR 4.753, p = 0.004) as independent risk factor for a surgical intervention. Conclusions Blunt trauma to the nose is frequent in children. Trauma mechanisms differ significantly between age groups, whereas localization and concomitant injuries do not. Male sex was identified as an independent risk factor for soft tissue lesions and frontobasal fractures. In our experience, initial triage by the pediatric department with consecutive involvement of the ENT specialists in case of suspected complications is safe and effective and may help to reduce unnecessary diagnostic procedures/irradiation to the young patients.

show abstract

An Algorithmic Approach Using Ultrasonography in the Diagnosis of Pediatric Nasal Bone Fracture

Cited by 10 publications

References 23 publications

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part II: Joint Pathologies, Pediatric Applications, and Guided Procedures

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part II: Joint Pathologies, Pediatric Applications, and Guided Procedures

Diagnostic utility of ultrasound in pediatric nasal bone fractures: a systematic review and meta-analysis

Blunt nasal trauma in children: a frequent diagnostic challenge

Contact Info

Product

Resources

About