Conductor-assisted nasal sonography: an innovative technique for rapid and accurate detection of nasal bone fracture.

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.