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High-Resolution Sonography for Nasal Fracture in Children

Hyun Sook Hong1, Jang Gyu Cha1, Sang Hyun Paik1, Seong Jin Park1, Jai Soung Park1, Dae Ho Kim1 and Hae Kyung Lee1

1 All authors: Department of Radiology, Soonchunhyang University Hospital, 1174 Jung-Dong, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do 420-021, South Korea.


Figure 1
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  		Fig. 1A —Examples of normal sonographic findings. Images illustrate defined positions of head on longitudinal (A) and axial (B) sonographic scans. Upper, middle, and lower levels of nasal bone are shown in yellow, blue, and pink, respectively.

 

Figure 2
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  		Fig. 1B —Examples of normal sonographic findings. Images illustrate defined positions of head on longitudinal (A) and axial (B) sonographic scans. Upper, middle, and lower levels of nasal bone are shown in yellow, blue, and pink, respectively.

 

Figure 3
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  		Fig. 2A —Normal sonographic findings in 3-year-old girl with nasal contusion after falling down stairs. Longitudinal sonograms show midline (A) and lateral wall (B) of nose.

 

Figure 4
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  		Fig. 2B —Normal sonographic findings in 3-year-old girl with nasal contusion after falling down stairs. Longitudinal sonograms show midline (A) and lateral wall (B) of nose.

 

Figure 5
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  		Fig. 2C —Normal sonographic findings in 3-year-old girl with nasal contusion after falling down stairs. Axial sonograms show upper level of nose (C) and M-shaped nasal septum (D).

 

Figure 6
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  		Fig. 2D —Normal sonographic findings in 3-year-old girl with nasal contusion after falling down stairs. Axial sonograms show upper level of nose (C) and M-shaped nasal septum (D).

 

Figure 7
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  		Fig. 2E —Nor mal sonographic findings in 3-year-old girl with nasal contusion after falling down stairs. Sonogram at level of alar cartilage shows hyperechoic wing-shaped cartilage.

 

Figure 8
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  		Fig. 3A —3-year-old girl with nasal pain after fall down stairs. Axial scan shows linear fracture line in upper portion of nasal bone in left paramedian location (arrow).

 

Figure 9
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  		Fig. 3B —3-year-old girl with nasal pain after fall down stairs. Sonogram shows hypoechoic M-shaped normal nasal septum.

 

Figure 10
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  		Fig. 4A —15-year-old boy with painful swelling of nose after blunt trauma. Axial sonogram shows multiple fracture lines (arrows) in mid nasal bone.

 

Figure 11
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  		Fig. 4B —15-year-old boy with painful swelling of nose after blunt trauma. Sonogram shows anterior portion of nasal septum (arrow) is deviated to left.

 

Figure 12
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  		Fig. 4C —15-year-old boy with painful swelling of nose after blunt trauma. CT scan obtained at same level as A and B shows anterior portion of cartilaginous septum is deviated to left. However, associated soft-tissue swelling and hypoechoic fluid are more clearly seen on sonography.

 

Figure 13
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  		Fig. 4D —15-year-old boy with painful swelling of nose after blunt trauma. Postoperative follow-up sonogram shows normal cartilaginous septum with no deviation and shape of nasal septum.

 

Figure 14
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  		Fig. 5A —11-year-old boy with painful nasal swelling after fall. Sonogram shows septal cartilage (arrow) is deviated to right.

 

Figure 15
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  		Fig. 5B —11-year-old boy with painful nasal swelling after fall. Longitudinal scan of left nasal bone shows depressed fracture line (arrows).

 

Figure 16
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  		Fig. 6A —9-year-old boy with painful nasal swelling after fall. Axial sonogram of upper portion of nose shows separation of pyriform aperture of maxilla and nasal bone (arrow).

 

Figure 17
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  		Fig. 6B —9-year-old boy with painful nasal swelling after fall. Sonogram shows marked soft-tissue edema and hypoechoic hematoma (arrows) near depressed fracture lines.

 

Figure 18
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  		Fig. 7A —5-year-old boy with blunt nasal trauma. Radiograph shows radiolucent fracture line (arrow) on lateral nasal view.

 

Figure 19
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  		Fig. 7B —5-year-old boy with blunt nasal trauma. On axial sonogram of upper nasal bone, focal bone disruption (arrow) is seen, but there is no soft-tissue edema or hypoechoic hematoma near bone gap. On physical examination, there is bump on nasal dorsum, but neither crepitation nor pain, so plastic surgeon regarded bump as old fracture.

 

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