비골골절의 진단에 있어 3차원 전산화 단층촬영의 유용성

Backgound and Objectives: The accurate diagnosis of nasal bone fracture by means of simple radiographs and physical examination is difficult in cases of severe soft tissue swelling or minimally displaced fracture. The purpose of this study is to evaluate the practical effectiveness of three dimensional computed tomography (3D- CT) for the diagnosis of nasal bone fracture and to compare accuracy of 3D-CT with it of simple radiograph. Material and Methods: The authors reviewed 3D-CT and simple radiographs of 19 patients with nasal bone injury who were suspected to have nasal bone fracture after history taking and physical examinations. The nasal bone fracture was classifed as one of three types on 3D-CT : type I (simple fracture), type II (simple fracture with displacement) and type III (comminuted fracture). Associated facial bone injuries were also evaluated and simple radiographs of nasal bone were reviewed for comparison. Results: Fifteen out of 19 patients was done closed reduction of nasal bone. Only four cases out of 15 cases has obvious nasal bone fracture evidence showed fracture lines on simple radiography. Then all 15 cases showed fracture lines on 3D-CT. The most common cause of nasal bone fracture is accidental blow as 10 cases. Compare to simple radiography not to showed associated facial bone fracture, it was showed at 7 cases by 3D-CT. Conclusion: Three dimensional computed tomography is a useful method for diagnosis of nasal bone fracture. It provides accurate identification of fracture line and associated facial bone injury such as nasal septal fracture. It helps to proper management for nasal bone fracture. (J Clinical Otolaryngol 2005;16:84–88)