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Value of nasal radiographs in nasal trauma management
Objective:
To assess the value of routinely acquiring plain nasal radiographs in patients following nasal trauma both clinically and cost effectively.
Design:
A questionnaire was devised to determine the factors that influence physicians to order nasal x-rays and whether or not the results of these radiographs influence management.
Setting:
The questionnaire was distributed to the otolaryngology staff and residents, emergency physicians, and family physicians affiliated with the University of Toronto.
Methods:
Descriptive statistics were employed.
Main Outcome Measures:
Percentages of reasons for ordering nasal x-rays and their part in treatment management.
Results:
The commonest reasons for ordering nasal x-rays in these cases included perceived severity of injury and detection of unsuspected facial fractures, as well as presumed need for medicolegal documentation.
Conclusions:
Nasal x-rays are not of substantial medicolegal value and do not play a role in the treatment of the patient. Nasal radiographs are not a cost-effective investigation in the management of trauma to the nose, and their routine use should be abandoned.