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Oliver Thiede, MD; Jan-Hendrik Krömer, MD; Claudia Rudack, MD; Wolfgang Stoll, MD; Nani Osada, MD; Frank Schmäl, MD

Arch Otolaryngol Head Neck Surg. 2005;131:434-439.

Objective  To compare the diagnostic findings of ultrasonography and radiography in nasal fractures.

Design and Main Outcome Measures  In this prospective study, 63 patients (23 female and 40 male; mean age, 26.8 years) with clinical signs of a nasal bone fracture were investigated. All patients underwent radiography (lateral view of the nose plus occipitomental view) and ultrasonography (10-MHz ultrasound scanner) of the nasal dorsum and the lateral nasal walls and a clinical examination by 2 consultants. Thirty-six patients underwent nasal fracture reduction. Two radiographs and 3 ultrasound images of each patient were analyzed by 2 experienced readers at different times. After assessing the nasal dorsum and lateral nasal walls in radiographs and ultrasound images, they decided whether the nose was fractured or not or whether the results were uncertain. The results were analyzed by various statistical testing methods (for sensitivity, specificity, positive and negative predictive value, and accuracy).

Results  Assessment of the lateral nasal walls revealed that ultrasonography was statistically superior (P = .04) to radiography. In contrast, assessment of the nasal dorsum showed radiography to be statistically superior (P = .01) to ultrasonography. Assessment of the nasal pyramid revealed no statistical difference between radiography and ultrasonography (P = .91).

Conclusion  In assessment of the nasal pyramid, ultrasonography can be considered an alternative to radiography, with equivalent diagnostic performance.

Author Affiliations: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital (Drs Thiede, Krömer, Rudack, Stoll, and Schmäl), and Department of Medical Informatics and Biomathematics, University of Münster (Dr Osada), Münster, Germany.

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