J Rhinol.  2009 Nov;16(2):134-138.

Analysis on Effectiveness of Three Dimensional Facial Computed Tomography in Diagnosis of Nasal Fractures

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea. yhsljr@cau.ac.kr
  • 2Department of Otorhinolaryngology, Inje University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND AND OBJECTIVES
Accurate diagnosis of nasal fracture is difficult in many cases. Some reports showed that threedimensional facial computed tomography (3-D facial CT) is more effective than conventional facial computed tomography (conventional CT) in the diagnosis of nasal fracture. The purpose of this study is to prospectively evaluate the effectiveness of 3-D facial CT in diagnosis of nasal fracture.
MATERIALS AND METHODS
From July 1, 2006 to January 31, 2007, 85 patients (83 men and 2 women, ranging in age from 29 to 46 years) visited the Armed Forces Capital Hospital within 2 weeks from nasal trauma. All patients prospectively underwent physical examination, lateral nasal bone view, Water's view, conventional CT, and 3-D CT. If any of definite crepitus on physical examination, or if definite fracture line on simple X-ray, or on conventional CT or on 3-D CT was found according to Hwang's criteria, that patient was confirmed to have nasal bone fracture. The diagnostic values of conventional CT and 3-D CT methods were analyzed by Pearson's chi-square test.
RESULTS
Out of 85 trauma patients, 71 patients were diagnosed as having nasal bone fractures with the most common causes being, in the order of frequency of oc-currence, sports injuries and with other causes of blows, military training, works, and traffic accident. 28 patients showed nasal septal displace-ment or fracture. Conventional CT and 3-D CT were equally effective and had diagnosed 70 out of 71 fractures (98.6% of positive predictive value) and determined to be more effective than simple X-ray which had diagnosed only 50 fractures (70.4% of positive predictive value)(p=0.000). In the evaluation of nasal septum, conventional CT was proved to be more effective than 3-D CT since it diagnosed all 28 nasal deviation or fractures cases (100%) whereas 3-D CT diagonosed only 23 cases out of 28 (82.1%)(p=0.000).
CONCLUSION
3-D CT is not more effective than conventional CT in the diagnosis of nasal bone fracture. Moreover, conventional CT is better than 3-D CT in the diagnosis of nasal septal displacement or septal fracture.

Keyword

Nasal fracture; X-Rays; Computed tomography; Three dimensional imaging
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