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KMID : 0900220090160020134
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대한비과학회지
2009 Volume.16 No. 2 p.134 ~ p.138
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Analysis on Effectiveness of Three Dimensional Facial Computed Tomography in Diagnosis of Nasal Fractures
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Park Sang-Yong
Choi Jeong-Hwan
Lee Kwang-Ho
Moon In-Seok
Yang Hun-Sik
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Abstract
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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.
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KEYWORD
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Nasal fracture, X-Rays, Computed tomography, Three dimensional imaging
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