title: Diagnostic value of ultrasonography in the diagnosis of nasal fractures.
abstract: BACKGROUND
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: From the *Department of Otolaryngology, Head and Neck Surgery, Rhinology Research Center, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd; †Department of Radiology, Shahid Sadoughi University of Medical Science and Health Services, Yazd; ‡Department of Otolaryngology, Head-Neck Surgery, Khatam Hospital, Shahid Sadoughi University of Medical Science and Health Services, Yazd; and §Rhinology Research Center, Shahid Sadoughi University of Medical Science and Health Services, Yazd, Iran.
authors.forename: Saied
authors.initials: S
authors.lastname: Atighechi
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Baradaranfar
authors.forename: Ghasem
authors.initials: G
authors.lastname: Karimi
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Dadgarnia
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Mansoorian
authors.forename: Najmeh
authors.initials: N
authors.lastname: Barkhordari
authors.forename: Batool Sadat
authors.initials: BS
authors.lastname: Sajadinejad
authors.forename: Nasim
authors.initials: N
authors.lastname: Behniafard
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009295:Nasal Bone / Q000000981:diagnostic imaging / Q000293:injuries*; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012887:Skull Fractures / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography; D055815:Young Adult