The radiology of nasal injuries: problems of interpretation and clinical relevance

Lacey, G. J. de; Wignall, Brian; Hussain, Shafqat; Reidy, J

doi:10.1259/0007-1285-50-594-412

Cited by 49 publications

(22 citation statements)

References 5 publications

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“…Many diagnostic methods, including clinical examination (crepitus, grossly apparent deviation of the nasal bones, swelling over the nasal bridge, and periorbital ecchymosis), conventional radiography, CT, and US, have been used to evaluate nasal trauma [13]. Although a physical examination is regarded as the gold standard for diagnosis, adequate imaging is often required to address legal implications [13,15]. Furthermore, physical examination cannot determine fracture complexity [10].…”

Section: Discussionmentioning

confidence: 99%

“…For many years, the standard imaging modality and the initial diagnostic step were considered to be conventional radiography. However, unlike injuries on the midline of nasal bone, it is difficult to evaluate lateral nasal wall injuries on conventional radiographs [1,15,16]. Furthermore, several studies have demonstrated that conventional radiography cannot be used routinely to evaluate nasal bone fractures [1,10,17].…”

Section: Discussionmentioning

confidence: 99%

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

Lee

Woo

et al. 2015

Eur Arch Otorhinolaryngol

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Lee

Woo

et al. 2015

Eur Arch Otorhinolaryngol

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“…1 The predictive value of periosteal thickness in estimating the time of nasal trauma [8]. Midline nasal suture, nasomaxillary suture, developmental defects or thinning of the nasal wall and short radiolucent lines reaching the anterior aspect of the nasal bone may erroneously be reported as fracture lines [9]. To date, only a few studies have been conducted to assess the diagnostic value of ultrasonography in nasal bone fracture.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography Findings in Nasal Bone Fracture; 6-Month Follow-up: Can We Estimate Time of Trauma?

Nemati

Jandaghi

Banan

et al. 2014

Eur Arch Otorhinolaryngol

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Differentiation of a recent nasal bone fracture from an old one may become of utmost importance, especially in medico-legal issues. The aim of this study was to demonstrate the value of high-resolution ultrasonography (HRUS) in determining the time of nasal bone fracture. A longitudinal, descriptive-analytic study was done on 45 patients with a clinical manifestation of acute unilateral nasal bone fracture. After a thorough rhinologic physical examination, HRUS was performed by an expert consultant who was blinded to the clinical data of the patients. All patients were followed-up for 6 months: in the first 5 days, 3rd, 6th, 12th and 24th weeks after the trauma. In each session, the ultrasonographic findings were recorded. Thirty-six cases (mean age, 27 years) completed the study course successfully. On HRUS, subperiosteal hematoma, with a mean thickness of 1.14 mm (0.79-1.31 mm) was highly sensitive (100 %) for the diagnosis of nasal bone fracture during the first few days after the trauma, but it was present in 13 cases in the 6th week, with a mean thickness of 0.71 mm (0.62-0.80 mm), and disappeared in all patients in the 24th week, with a mean thickness of 0.47 mm (almost equal to the non-traumatic side). According to the changes of subperiosteal reaction on the traumatic side and by means of generalized linear model and generalized estimating equations, we proposed an equation to estimate the time of nasal bone trauma. In conclusion, HRUS is a reliable diagnostic tool for estimating the time of nasal bone fracture.

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“…De Lacey and co-workers [23] concluded from a study of 100 patients with nasal bone trauma that it is an unnecessary procedure and should be carried out only upon specific request by an ENT surgeon.…”

Section: Nasal Fracturesmentioning

confidence: 99%

“…Magnetic resonance imaging is helpful in evaluating carotid-cavernous sinus fistulas (Figs. 23,24,25) [39].…”

Section: Complex Facial Featuresmentioning

confidence: 99%

Traumatic injuries: imaging of facial injuries

Salvolini

2002

Eur Radiol

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Facial injuries are common and require radiologic evaluation to plan treatment. The role of imaging is to detect fractures, describe their morphology and topography, and evaluate adjacent soft tissue damage. Computed tomography is the imaging method of choice for an accurate diagnosis and for depicting the complex anatomic structures of the maxillo-facial region. Magnetic resonance imaging plays a limited role, mainly in the assessment of lesions of orbital soft tissues. This paper reviews the most common traumatic injuries of facial bones, paranasal sinuses, orbits and mandible.

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The radiology of nasal injuries: problems of interpretation and clinical relevance

Cited by 49 publications

References 5 publications

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

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

Ultrasonography Findings in Nasal Bone Fracture; 6-Month Follow-up: Can We Estimate Time of Trauma?

Traumatic injuries: imaging of facial injuries

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