ACCORDANCE BETWEEN CLINICAL AND RADIOLOGIC FINDINGS OF NASAL BONE FRACTURE

Öz

Objective: The goal of our study was to compare physical examination with plain X-ray findings in patients with a suspected nasal bone fracture (NBF).

Methods: The study included 403 patients who received a suspected NBF between 2014 and 2016; the files of these patients were retrospectively reviewed. In our tertiary hospital, patients with nasal bone trauma are principally admitted to the trauma and emergency department. Patients are first examined by a general surgeon for suspected NBF. Afterwards, lateral nasal radiography and otorhinolaryngology (ORL) consultations are requested. Presence of crepitation, radiologic findings, swelling, deviation of nasal axis, septal hematoma/fracture, and cause of trauma are all documented. 
Results: The 403 patients who presented to the trauma and emergency department for suspected NBF included 274 males and 129 females, the median age was 25±18.7 years (range, 2-106 years). When the correlation between positive clinical and radiologic findings was analyzed, crepitation was correlated with radiologic data in 155/156 (99.3%) cases, deviation of nasal axis in 135/142 (95%), septal hematoma 4/5 (80%), swelling in 103/134 (76.8%), laceration in 60/93 (64.5%), and epistaxis in 7/14 (50%). The correlation of crepitation, deviation of nasal axis, and swelling with radiologic evaluation were found statistically significant.

Conclusion: Crepitation of nasal bone, deviation of nasal axis and swelling of the nasal dorsum were significantly correlated with plain X-ray imaging that had a positive finding of fracture. We believe that these results might have practical potential for diagnostic management and save time especially in crowded emergency departments.

Keywords: Crepitation; epistaxis; nasal; nasal bone fracture; plain X-ray; septal hematoma; trauma.

Anahtar Kelimeler

• Crepitation,epistaxis,nasal,nasal bone fracture,plain X-ray,septal hematoma,trauma

NAZAL KEMİK KIRIĞININ KLİNİK VE RADYOLOJİK BULGULARI ARASINDAKİ UYUMU

Öz

Amaç: Çalışmamızın amacı nazal kemik kırığı (NKK) olan hastalarda fizik muayene ile düz grafi bulgularını karşılaştırmaktı.

Yöntem: Çalışmada, 2014-2016 yılları arasında şüpheli nazal kemik fraktürü tanısı alan 403 hastanın dosyaları retrospektif olarak incelendi. Üçüncü basamak hastanemizde, burun kemiği travması olan hastalar Travmatoloji ve Acil Cerrahi başvurusunun ardından, NKK şüphesiyle lateral burun radyografisi ile Kulak Burun Boğaz Servisi’ne konsülte edilmektedir. Hastaların bulguları krepitasyon, şişlik, aks devisyonu ve septal hematom/kırık varlığına; radyolojik bulgulara ve travmanın nedenine göre kategorize edildi.

 Bulgular: Nazal kemik kırığı şüphesi nedeniyle değerlendirilen 403 hastanın 274 ü erkek ve 129 u kadın olup; medyan yaş 25 ± 18.7 idi. (aralık; 2-106 yaş) Pozitif klinik ve radyolojik bulgular arasındaki korelasyonu analiz ettiğimizde radyolojik verilerde; krepitasyon 155/156 (% 99.3), aks deviasyonu 135/142 (%95), septal hematom 4/5 (% 80), şişlik 103/134 (% 76.8), laserasyon 60/93 (%64.5) ve burun kanaması 7/14(% 50) oranında tespit edildi.

Krepitasyon, aks deviasyonu ve şişlik ile radyolojik değerlendirme arasındaki korelasyon istatistiksel olarak anlamlı bulundu.

Sonuç: Fizik muayene ile burun kemiğinin krepitasyonu, aks deviasyonu ve burun dorsumunun şişmesi ile kırık bulgusu pozitif olan düz X-ray görüntüleme arasında anlamlı korelasyon göstermiştir. Bu sonuçların, özellikle kalabalık acil servislerde tanı yöntemleri için pratik bir potansiyele sahip olabileceğine ve zaman kazandıracağına inanıyoruz.

Anahtar kelimeler: Burun; krepitasyon; epistaksis; nazal; nazal kemik kırığı; direk grafi; septal hematom; travma.

Anahtar Kelimeler

• Burun,krepitasyon,epistaksis,nazal,nazal kemik kırığı,direk grafi,septal hematom,travma

Kaynakça

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