S Li1, B Papsin, D H Brown. 1. Department of Otolaryngology, Toronto Hospital, Ontario.
Abstract
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.
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.