ACCORDANCE BETWEEN CLINICAL AND RADIOLOGIC FINDINGS OF NASAL BONE FRACTURE

Yıl 2017, Cilt: 80 Sayı: 1, 33 - 37, 31.03.2017

Mehmet Çelik , Said Sönmez Mehmet Melih Çiçek Levent Aydemir Mehmet Serkan Alpaslan Şenol Çomoğlu

https://doi.org/10.18017/iuitfd.309229

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

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