A novel technique for the quantitative examination of nasal tip support.

OBJECTIVE: We proposed a novel technique for the quantitative examination of tip recoil. The technique measures nasal tip strain as an objective measure of tip recoil. We used the term tip recoilometry to refer to this measurement technique. DESIGN: We performed case studies in two phases. Phase 1 included 30 candidates with normal tip recoil and 30 candidates with weak tip recoil. Phase 2 included 40 patients who had undergone open rhinoplasty surgery by either columella strut or caudal extension graft methods. We evaluated tip support of patients 1 year after the surgery. RESULTS: The nasal tip strain of normal target group before any surgery was 0.158 and that of the patients with nasal tip ptosis was 35% more than that of the normal target group. The methods columella strut and caudal extension graft achieved 43% and 74% nasal tip strain reduction, respectively. CONCLUSION: The proposed technique can help a surgeon to select a proper plan and to evaluate the success of the surgery.

Diagnostic value of ultrasonography in the diagnosis of nasal fractures.

INTRODUCTION: This study examined the diagnostic value of ultrasound and radiography compared with clinical examinations as the gold standard method to determine whether ultrasound can be used for early diagnosis of nasal fracture. METHODS: This prospective study was conducted on 128 patients with clinical signs of nasal fracture. Radiography in all patients was performed by 2 different radiologists on Waters and lateral view with a 10-MHz ultrasound probe, and clinical examinations were done by an ENT specialist. Radiography and ultrasound findings were recorded and compared with the final diagnosis which was based on clinical examinations. Results were analyzed with different statistical methods to determine sensitivity, specificity, accuracy, positive predictive value, and negative predictive value. RESULTS: In the assessment of fracture with ultrasound, sensitivity was 84%, specificity 75%, accuracy 82%, positive predictive value 91%, and negative predictive value 61%. In the assessment of fracture on lateral view radiography, sensitivity was 50%, specificity 72%, accuracy 55%, positive predictive value 84%, and negative predictive value 32%. On Waters view radiography, sensitivity was 53%, specificity 65%, accuracy 56%, positive predictive value 82%, and negative predictive value 31%. On lateral-waters view radiography, sensitivity was 64%, specificity 58%, accuracy 62%, positive predictive value 82%, and negative predictive value 34%. Fracture diagnosis by ultrasound was significantly better as compared with radiography (P = 0.04). CONCLUSION: The nasal bone ultrasound study is a useful method in determining the nasal fracture and radiography can be replaced with ultrasound in early diagnosis of fracture.