Ability of Bedside Ultrasonography to Detect Pediatric Nasal Bone Fractures

ABSTRACT Background and objectives Road traffic crashes are reported to be the leading cause of maxillofacial fractures in developing countries. The large variability in reported incidence and etiology is due to a variety of contributing factors, including environmental, cultural and socioeconomic factors. The study aims at describing the patterns of maxillofacial fractures in road traffic crashes by clinical and radiological methods and to study the complications associated with these fractures. Materials and methods The study included 100 road traffic crash patients with maxillofacial injuries. Patients were evaluated for any maxillofacial fracture by clinical assessment and, radiologically, using plain radiographs and computed tomography scan. Results Midfacial skeleton was more prone to fractures. Isolated fractures of the maxilla was the commonest (58%) followed by nasal bone fractures (43%). Among the complex fractures, Le Fort type II was the commonest. Mandibular fractures were seen in 33% of the patients, parasymphysis being the commonest site. Majority of the patients had associated soft tissue injuries. The incidence of complications associated with maxillofacial fractures was 11%, malocclusion being the commonest. Conclusion Maxillofacial fractures are commoner in the mobile population in the most productive age group, more so in two wheeler riders causing significant morbidity and mortality. Midface region is more prone to fractures and is most of the time associated with complications. How to cite this article Jayaraju RM, Sagayaraj A, Reddy MP, Harshitha KR, Majety P. Patterns of Maxillofacial Fractures in Road Traffic Crashes in an Indian Rural Tertiary Center. Panam J Trauma Crit Care Emerg Surg 2014;3(2):53-58.

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Is Ultrasonography Efficient for the Detection of the Zygomatic Arch, Nasal Bone and Cartilage Fractures?

The Open Dentistry Journal ◽

10.2174/1874210602014010178 ◽

2020 ◽

Vol 14 (1) ◽

pp. 178-183

Author(s):

Amir Eskandarloo ◽

Atena karimi ◽

Abbas Shokri ◽

Jalal Poorolajal ◽

Mohammad Hosseinipanah

Keyword(s):

Bone Fractures ◽

Imaging Modality ◽

Nasal Bone ◽

Kappa Coefficient ◽

Zygomatic Arch ◽

Nasal Cartilage ◽

Specificity And Sensitivity ◽

Wide Range ◽

Linear Probe ◽

And Cartilage

Background: The high incidence of nasal and zygomatic arch fractures highlights the need for an accurate imaging modality for their detection. The superimposition of structures is a major problem in conventional radiography. Ultrasonography is a low-cost imaging modality with a wide range of applications, that does not employ ionizing radiation. This study aimed to assess the efficacy of ultrasonography for the detection of the zygomatic arch and nasal bone fractures. Materials and Methods: This study was conducted on 16 sheep heads. Artificial fractures were created in some parts of the zygomatic arch, dorsum and lateral wall of the nose, and nasal cartilage. All sheep heads underwent Cone-Beam Computed Tomography (CBCT) to ensure the presence of a fracture. Next, the lateral nasal and submentovertex radiographs were obtained, and ultrasonography was performed with a 12-15 MHz linear probe. Ultrasonography and radiography were repeated after 1 week to assess their reproducibility by calculating the kappa coefficient. Data were analyzed using Stata 11 software and Chi-square test. Results: The specificity and sensitivity of ultrasonography ranged from 87% to 100%, and 50% to 75%, respectively. The specificity and sensitivity of radiography ranged from 87% to 100%, and 62% to 87%, respectively. The differences between the two imaging modalities were not statistically significant (p>0.05). The kappa coefficient ranged from 46% to 100% for ultrasonography and 44% to 87% for radiography. Conclusion: Ultrasonography seemed useful for the detection of displaced bone and cartilage fractures. For non-displaced fractures, US is not recommended.

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Effects of COVID-19 Pandemic on Otolaryngology Surgery in Italy: The Experience of Our University Hospital

Otolaryngology ◽

10.1177/0194599820928970 ◽

2020 ◽

Vol 163 (1) ◽

pp. 86-88 ◽

Cited By ~ 6

Author(s):

Massimo Ralli ◽

Antonio Minni ◽

Francesca Candelori ◽

Fabrizio Cialente ◽

Antonio Greco ◽

...

Keyword(s):

Head And Neck ◽

Bone Fractures ◽

Malignant Tumors ◽

Nasal Bone ◽

Upper Airway ◽

Neck Surgery ◽

University Hospital ◽

Outpatient Procedures ◽

Therapeutic Procedures ◽

Adults And Children

Otolaryngology and head and neck surgery underwent drastic changes during the COVID-19 pandemic. Since March 10, the first day of the lockdown in Italy, diagnostic and therapeutic procedures were limited to emergency and oncology cases, while outpatient procedures and clinical examinations were temporarily suspended to limit virus diffusion and to reallocate personnel into wards dedicated to COVID-19. In our otolaryngology unit, between March 10 and April 28, 2020, we performed 96 surgical procedures; they mainly consisted in diagnosis and treatment of malignant tumors of the head and neck (77%), management of acute upper airway obstruction in adults and children (14.7%), drainage of abscesses of the head and neck (6.2%), and treatment of nasal bone fractures (2.1%). When comparing these data with those of the same period in 2019 for emergency and oncology procedures, we noticed a drastic reduction of head and neck abscesses and nasal bone fractures, while oncology surgery remained stable.

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In Regard to Local Versus General Anesthesia for the Management of Nasal Bone Fractures: A Systematic Review and Meta-Analysis

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2016.01.045 ◽

2016 ◽

Vol 74 (6) ◽

pp. 1105-1106

Author(s):

Eoin Kelly

Keyword(s):

Systematic Review ◽

General Anesthesia ◽

Bone Fractures ◽

Meta Analysis ◽

Nasal Bone

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Demographic Factors of Nasal Bone Fractures and Social Reflection

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000006065 ◽

2020 ◽

Vol 31 (1) ◽

pp. 169-171

Author(s):

Il Hwan Byun ◽

Won Jai Lee ◽

Tai Suk Roh ◽

Jong Won Hong

Keyword(s):

Bone Fractures ◽

Nasal Bone ◽

Demographic Factors

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External Fixation of Unstable, “Flail” Nasal Fractures

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0032-1313359 ◽

2012 ◽

Vol 5 (2) ◽

pp. 99-105 ◽

Cited By ~ 5

Author(s):

George E. Anastassov ◽

Ali Payami ◽

Zain Manji

Keyword(s):

External Fixation ◽

Closed Reduction ◽

Nasal Septum ◽

Bone Fractures ◽

Nasal Bone ◽

Facial Fractures ◽

Kirschner Wires ◽

Nasal Bones ◽

External Stabilization ◽

Nasal Fractures

Nasal bone fractures are the most common among facial fractures. Usually these are adequately treated with closed reduction and internal and/or external stabilization with splints. However, there are clinical situations where the nasal bones are severely displaced, the nasal septum fractured and displaced, or there are external drape lacerations which preclude the use of nasal splints. If the nasal bones are reducible but unstable we consider them “flail” and in this case transmucosal, endonasal Kirschner wires are used for dorsal support until sufficient healing occurs. The technique is simple, quick, and predictable and causes minimal discomfort to the patients.

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Comparison of Ultrasonography and Conventional Radiography in the Diagnosis of New Nasal Bone Fractures in Adults

Biosciences Biotechnology Research Asia ◽

10.13005/bbra/1598 ◽

2015 ◽

Vol 12 (SEMAR) ◽

pp. 01-06

Author(s):

Abdolhosayn Masoomi ◽

Mohamad Momen Gharibvand ◽

Hossien Rekabi ◽

Mohsen Zakaeifar ◽

Elahe khorami ◽

...

Keyword(s):

Bone Fractures ◽

Nasal Bone ◽

Conventional Radiography

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Changes in nasal aesthetics following nasal bone manipulation

The Journal of Laryngology & Otology ◽

10.1017/s0022215107008225 ◽

2007 ◽

Vol 122 (1) ◽

pp. 38-41

Author(s):

S C L Leong ◽

M Abdelkader ◽

P S White

Keyword(s):

Bone Fractures ◽

Nasal Bone ◽

Post Treatment ◽

Facial Injury ◽

Nasal Fracture ◽

Initial Injury ◽

Nasal Trauma ◽

The Aesthetic

AbstractNasal bone fractures are the commonest type of bony facial injury causing aesthetic deformity. The aim of this study was to identify the effect of nasal trauma and fracture manipulation on the aesthetic proportions of the nose, by comparing pre- and post-treatment nasal aesthetics. Thirty-two patients (26 men and 6 women) underwent aesthetic assessment prior to treatment of the injury by closed nasal manipulation, 7 to 10 days after the initial injury. Standard facial aesthetic photographic assessments were performed prior to and following manipulation. Assessment involved measurement of standard nasal aesthetic parameters. In the nasal trauma cohort, the main anomalies in nasal aesthetics were nasal deviation and differences in the nasal aesthetic profile. Nasal fracture manipulation successfully reduced deviation from an average of 35° pre-manipulation to an average of 9° post-manipulation.

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