Sonographic Evaluation of Nasal Bone Fractures

ABSTRACT

PURPOSE: To describe the sonographic findings of nasal bone fracture and evaluate the diagnostic value of sonography (US). MATERIALS AND METHODS: Thirty-six patients with sustained nasal trauma underwent plain radiography, US and CT, and the CT findings were used as the gold standard. The sonographic findings were retrospectively reviewed and compared with those of radiography and CT. Twelve patients underwent follow-up US within 3 months of reduction. RESULTS: Sonographic findings of nasal bone fractures were irregularity (n=7), discontinuity (n=25) and dis-placement with discontinuity (n=28) of the thin smooth echogenic line formed by the ventral cortex of the nasal bone. Sixty-five nasal bone fractures (36 patients) were identified by CT; 60 of these were revealed on US but only 41 by plain radiographs. CT demonstrated unilateral involvement of nasal bone fractures in seven bones and bilateral involvement in 58, while US revealed unilateral involvement in 12 and bilateral involvement in 48. Plain radiographs, unilat-eral involvement in 21 bones and bilateral fractures in 20. Plain radiographs were more limited in detecting the location of nasal bone fractures than was US. On follow-up US in 12 patients, normal alignment without residual abnormality was observed in seven patients, residual cortical irregularities in four, and minimal cortical depression in one. CONCLUSION: The sonographic findings of nasal bone fractures were similar to those of CT in detecting the location and degree of depression or displacement of nasal bone fractures. We believe that US is very useful for the evaluation of such fractures, especially in cases in which plain radiographs reveal equivocal abnormality, or postreduction status is uncertain.