Ultrasonographic Images of Nasal Bone Fractures with Water Used as the Coupling Medium.

Background: Ultrasonography can show local and superficial fractures of the nasal bone. However, it is difficult to see the whole nasal bone. We used water as the coupling medium for ultrasonography. Methods: This method was used in 76 nasal bone fracture cases from July 2011 to March 2013, and we could obtain clear images of the entire nasal bone and surrounding bones. However, in some images, there were artifacts and blurred areas. The patterns of blurring were classified and their causes were analyzed. Results: The 6 patterns of artifacts and blurred images were (1) Blurred side wall of the nasal bone in 68 cases, (2) air bubbles in the water in 68 cases, (3) unclear deep portions by attenuation in 23 cases, (4) distorted images caused by shaking of the probe in 44 cases, (5) parallel shadows due to multiple reflections in 18 cases, and (6) mysterious shadows caused by side lobes of the ultrasound beams in 55 cases. Almost all of them could be avoided by adding some small changes of techniques. Conclusions: Our methods can provide whole clear images of the nasal bone and surrounding bones in 1 field. Almost all the artifacts and blurred images which occurred during the performance of our methods could be avoided by adding some small changes, for example, tilting the probe, pouring the water slowly, and moving the probe closer to the nose. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright (C) 2017 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.

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