Evaluation Of Nasal Fractures Research Articles

Using telemedicine to facilitate social distancing in otolaryngology: A systematic review

Objectives As the coronavirus 2019 pandemic puts strains on current models of otolaryngology practice, telemedicine is an attractive way for otolaryngologists to reduce in-person appointments while still addressing the health of their patients. This systematic review of the literature aims to identify the evidence basis for using telemedicine in otolaryngology practice to limit person-to-person interactions while achieving comparable quality to in-person services. Methods The authors gathered articles from three databases (Embase, PubMed and Web of Science), performed a comprehensive literature review of articles published on telemedicine since 2002, and selected articles for inclusion based on their relevance to otolaryngology and the potential of the intervention to improve patient social distancing. Results A total of 7153 articles were identified from the initial query. After review, 35 met the inclusion criteria. Of the included articles, 32 (91%), found their specific telemedicine intervention to be effective when compared to in-person services. Twenty articles (57%) were related to remote otoscopy. Other telemedical interventions included videoconferencing for peri-operative visits, diagnosis of peritonsillar abscess, telephone-based voice evaluations and evaluation of nasal fractures. Conclusions Video-otoscopy is the most well-supported telemedical intervention which limits physical contact between otolaryngologists and their patients. Other interventions have also demonstrated efficacy but have yet to be as widely validated as video-otoscopy. Telehealth facilitators play a key role in providing high-quality telehealth services. More invasive procedures, such as laryngoscopy, require further evidence to demonstrate definite benefits in a telemedicine setting.

The accuracy of bedside USG in the diagnosis of nasal fractures

A comparison of the sensitivity and specificity of bedside ultrasonography with conventional radiography for the evaluation of nasal fractures. Introduction - purposeThere is increasing use of ultrasonography in the Emergency Dept (ED) and other areas. The purpose of the present study was to evaluate the sensitivity and specificity of bedside ultrasonography with conventional radiographs in the evaluation of nasal fractures in the ED. MethodPatients admitted to ED with maxillofacial trauma were evaluated in this prospective study. Ultrasonography scans of the patients were taken by the emergency physician at the bedside. The images were obtained from both laterals and parallel to the nasal dorsum. The nasal radiography scans were evaluated by an experienced radiologist blinded to the study. The ultrasonography and radiography results were compared statistically. ResultsThe study included 103 patients. In showing the presence of nasal fracture, the sensitivity of ultrasonography was determined to be 84.8% (95% CI 71.13%–93.66%), specificity was 93.0% (95% CI 83.00%–98.05%), positive predictive value (PPV) was 90.7% (95% CI 77.86%–97.41%), negative predictive value (NPV) was 88.3% (95% CI 77.43%–95.18%). ConclusionUltrasonography can be used in ED as an alternative method to conventional radiography with high rates of sensitivity and specificity in the evaluation of nasal fractures.

1306 Nazal Kırıklı Olgunun Adli Rapor Sürecinin Değerlendirilmesi

Amaç: Yüz bölgesine gelen travmalarda anatomik yapısı veyerleşimi nedeniyle en sık burun kemiği kırıkları görülmektedir. Adli tıp şube müdürlüklerine yansıyan nazal kırıklı olgularda, rapor düzenleme aşamasında sıkıntılar yaşanmaktadır. Bu çalışmada, burun kemik kırıklarının adli travmatoloji açısından değerlendirilmesi ve raporlama aşamasında yaşanan aksaklıkların vurgulanması amaçlanmıştır.Gereç ve Yöntem: 01 Haziran 2011-31 Mayıs 2014 tarihleri arasında Eskişehir Adli Tıp Şube Müdürlüğü’nce düzenlenen 24306 adli rapordan, burun kemiği kırığı saptanan 1306 olgu retrospektif olarak incelenerek değerlendirme kapsamına alındı.Bulgular: 1306 olguya, travma ağırlığı açısından rapor düzenleyebilmek için toplam, 2104 yazışma yapılmıştır. 764 olguda 1 kez, 17 olguda 2 kez olmak üzere ek belge, grafi veya konsültasyon istenilmiştir. Olguların yaş ve cinsiyetleri literatürle uyumlu bulunmuştur.Sonuç: Uzun vadede, sağlık kuruluşlarında adli tıp uzmanı istihdamının artırılması, kısa vadede ise illerde sağlık kuruluşlarına ait veri sistemlerine adli tıp şube müdürlüklerinin de entegre edilmesi gerektiği sonucuna varılmıştır.Anahtar kelimeler: Nazal kırık, Adli rapor, Travma.

Sonography versus Plain x Rays in Diagnosis of Nasal Fractures

The standard imaging procedure for suspected nasal fractures has been radiography (XR). However, its usefulness for clinical decision making is highly controversial. High-resolution ultrasonography now offers a promising new diagnostic imaging option. In this study we compared the diagnostic value of high-resolution ultrasonography and conventional XR in the evaluation of suspected nasal fractures. A prospective single-blinded study was performed. Ultrasound (US) and XR findings in 80 patients with suspected nasal fractures were compared with the definite clinical diagnosis with respect to sensitivity, specificity, and accuracy. For detection of fractures of the nasal dorsum, both modalities had high sensitivity (98 and 88% for US and XR, respectively) and specificity (95% for both US and XR). In lateral nasal wall fractures, specificity was higher for XR (75% versus 94%). Sensitivity was significantly higher for the US examination (98% versus 28%). In summary, the accuracy was higher for US. When available, US should be the first-line imaging procedure in the evaluation of nasal fractures.