Division of Traumatology, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Trauma Acute Care Surg. 2012 Jan;72(1):306-11. doi: 10.1097/TA.0b013e318227a239.
Nasal bone is frequently involved in craniofacial trauma. We sought to investigate the role of conductor-assisted nasal sonography (CANS) in patients with nasal trauma.
In all, 71 patients sustaining midfacial trauma who underwent CANS examination with simultaneous facial computed tomography (CT) scans were reviewed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of nasal bone fracture identified by CANS and other plain films versus nasal bone fracture evidenced by CT scan, taken as the gold standard, were measured.
Of these patients (52 males and 19 females; mean age, 40 years ± 19.8 years), 52 of 71 were diagnosed with nasal fractures by facial CT scans. No demographic difference was found in fracture and nonfracture groups. In addition to nasal sonography and facial CT scan, 23 patients also received nasal X-ray examination, 17 experienced skull X-rays, and 12 underwent Waters' view survey. The sensitivity, specificity, PPV, and NPV of nasal X-ray were 89%, 25%, 85%, and 33%, respectively. The skull X-ray showed a poor sensitivity of 50%, with 100% specificity, 100% PPV, and 30% NPV. The Waters' view survey gave the worst sensitivity of 13% and a high specificity of 100%, with a PPV of 100% and a NPV of 36%. CANS proved to be the most reliable in detection of nasal fracture, with 100% sensitivity and 89% specificity, 96% PPV, and 100% NPV.
CANS technique could detect nasal bone fracture more accurately compared with conventional methods. We recommend it as a new standard of diagnostic tool for nasal fracture.
鼻骨经常参与颅面外伤。我们旨在研究导体辅助鼻超声（CANS）在鼻外伤患者中的作用。
共回顾了 71 例接受 CANS 检查和同时进行面部计算机断层扫描（CT）扫描的中面部外伤患者。测量了 CANS 和其他平片与 CT 扫描（作为金标准）所证实的鼻骨骨折的灵敏度、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
这些患者中（52 名男性和 19 名女性；平均年龄 40 岁±19.8 岁），71 例中有 52 例经面部 CT 扫描诊断为鼻骨折。骨折组和非骨折组在性别上无差异。除了鼻超声和面部 CT 扫描外，23 例还接受了鼻 X 线检查，17 例进行了颅骨 X 线检查，12 例进行了 Waters 位检查。鼻 X 线的灵敏度、特异性、PPV 和 NPV 分别为 89%、25%、85%和 33%。颅骨 X 线的灵敏度较差，为 50%，特异性为 100%，PPV 为 100%，NPV 为 30%。Waters 位检查的灵敏度最差，为 13%，特异性为 100%，PPV 为 100%，NPV 为 36%。CANS 在检测鼻骨折方面被证明是最可靠的，灵敏度为 100%，特异性为 89%，PPV 为 96%，NPV 为 100%。
与传统方法相比，CANS 技术可以更准确地检测鼻骨骨折。我们建议将其作为鼻骨折的一种新的诊断工具标准。
