| Analysis on Effectiveness of Three Dimensional Facial Computed Tomography in Diagnosis of Nasal Fractures |
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Sang Yong Park, Jung Hwan Choi, Kwang Ho Lee, In Seok Moon, Hoon Shik Yang |
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. |
| 비골절의 진단에 있어서 3차원 컴퓨터 단층촬영의 유용성 고찰 |
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박상용, 최정환, 이광호, 문인석, 양훈식 |
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중앙대학교 의과대학 이비인후-두경부외과학교실,1 인제대학교 의과대학 이비인후과학교실2 |
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| 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. |
| Key Words:
Nasal fracture;X-Rays;Computed tomography;Three dimensional imaging |
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