Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Nov;26(4):286-292.
doi: 10.1177/2292550317749535. Epub 2018 Jan 9.

Diagnostic Performance of Plain Film, Ultrasonography, and Computed Tomography in Nasal Bone Fractures: A Systematic Review

Kun Hwang  1 , Joon Soo Jung  2 , Hun Kim  1
Affiliations
Review

Diagnostic Performance of Plain Film, Ultrasonography, and Computed Tomography in Nasal Bone Fractures: A Systematic Review

Kun Hwang et al. Plast Surg (Oakv). 2018 Nov.

Abstract
in English, French

Purpose: The aim of this study was to compare the diagnostic performance (accuracy, sensitivity, specificity, positive predictive value, and negative predictive value) of plain film (PF), ultrasonography (USG), and computed tomography (CT) in diagnosing nasal bone fractures (NBFs).

Methods: In a search of PubMed and Scopus, "nasal bone fracture" AND "X-ray OR CT OR USG OR MRI" were searched. Among the 369 titles from PubMed and 379 titles from Scopus, 257 duplicate titles were excluded and 491 titles were reviewed. Among them, 36 full articles were reviewed. From these, 21 were excluded and 1 mined article was added; thus, 16 articles were reviewed.

Results: The accuracy of CT (94.4% ± 2.3%) was significantly higher (P < .001) than that of USG (85.0% ± 3.6%). The accuracy of USG was significantly higher (P < .001) than that of PF (67.7% ± 4.7%). Computed tomography (89.3% ± 3.1%) and USG (87.2% ± 3.3%) were significantly more sensitive than PF (P < .001 and P < .001, respectively). The specificity of CT (94.2% ± 2.3%) was significantly higher (P = .001) than that of USG (87.4% ± 3.3%). The specificity of USG was significantly higher (P < .001) than that of PF (67.8% ± 4.7%). Among the PF techniques, combining a lateral view and the Water's view (71.8% ± 4.5%) had significantly higher accuracy than a lateral view alone (62.4% ± 4.8%) or the Water's view alone (61.0% ± 4.9%). In USG, there was no significant difference (P = .300) in accuracy among lateral and dorsal views (95.8% ± 2.0%), a lateral view alone (84.2% ± 3.7%), and a dorsal view alone (84.2% ± 3.6%).

Conclusion: The results of this review might be helpful in choosing the most appropriate diagnostic tool in patients suspected having NBF.

Objectif: La présente étude visait à comparer le rendement diagnostique (précision, sensibilité, spécificité, valeur prédictive positive et valeur prédictive négative) du film radiographique (FR), de l’échographie (ÉG) et de la tomodensitométrie (TDM) pour diagnostiquer les fractures de l’os nasal (FON).

Méthodologie: Les auteurs ont cherché les termes nasal bone fracture ET X-ray OU CT OU USG OU MRI dans PubMed et Scopus. Parmi les 369 articles tirés de PubMed et les 379 articles tirés de Scopus, ils ont exclu 257 articles dédoublés et examiné 491 articles. De ce nombre, ils ont revu 36 articles intégraux. Ils en ont exclu 21, ont ajouté un article extrait des précédents et ont analysé 16 articles.

Résultats: La TDM (94,4 % ± 2,3 %) était considérablement plus précise (P < 0,001) que l’ÉG (85,0 % ± 3,6 %). L’ÉG était considérablement plus précise (P < 0,001) que le FR (67,7 % ± 4,7 %). La TDM (89,3 % ± 3,1 %) et l’ÉG (87,2 % ± 3,3 %) étaient considérablement plus sensibles que le FR (P < 0,01 et P < 0,001, respectivement). La TDM (94,2 % ± 2,3 %) était considérablement plus spécifique (P = 0,001) que l’ÉG (87,4 % ± 3,3 %). L’ÉG était considérablement plus spécifique (P < 0,001) que le FR (67,8 % ± 4,7 %). Parmi les techniques de FR, la combinaison de la vue latérale et de la vue de Water (71,8 % ± 4,5 %) était considérablement plus précise que la vue latérale seule (62,4 % ± 4,8 %) ou que la vue de Water seule (61,0 % ± 4,9 %). La précision des vues latérale et dorsale (95.8 % ± 2.0 %), de la vue latérale seule (84,2 % ± 3,7 %) et de la vue dorsale seule (84,2 % ± 3,6 %) de l’ÉG n’était pas statistiquement significative (P = 0,300).

Conclusion: Les résultats de la présente analyse peuvent être utiles pour choisir l’outil diagnostique le mieux adapté aux patients susceptibles d’avoir une FON.

Keywords: X-ray computed; X-ray film; bone; diagnosis; fractures; nasal bone; sensitivity and specificity; tomography; ultrasonography.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Selection process of the articles included in this study.
Figure 2.
Figure 2.
Diagnostic performance of each method. CT indicates computed tomography; NPV, negative predictive value; PF, plain film; PPV, positive predictive value; USG, ultrasonography. *P < .05.
Figure 3.
Figure 3.
Diagnostic performance of plain film. NPV indicates negative predictive value; PPV, positive predictive value. *P < .05.
Figure 4.
Figure 4.
Diagnostic performance of ultrasonography. NPV indicates negative predictive value; PPV, positive predictive value. *P < .05.
See this image and copyright information in PMC

References

    1. Hwang K, You SH, Kim SG, Lee SI. Analysis of nasal bone fractures; a six-year study of 503 patients. J Craniofac Surg. 2006;17(2):261–264. - PubMed
    1. Becker OJ. Nasal fractures. Arch Otolaryngol. 1948;48(3):344–361. - PubMed
    1. Dorobisz H, Voegeli E, Hardt N. Conventional radiology and computed tomography in facial fractures. Rontgenblatter. 1983;36(12):428–433. - PubMed
    1. Thiede O, Krömer JH, Rudack C, Stoll W, Osada N, Schmäl F. Comparison of ultrasonography and conventional radiography in the diagnosis of nasal fractures. Arch Otolaryngol Head Neck Surg. 2005;131(5):434–439. - PubMed
    1. Gürkov R, Krause E, Clevert D. Sonography versus plain X rays in diagnosis of nasal fractures. Am J Rhinol. 2008;22(6):613–616. - PubMed

LinkOut - more resources