An evaluation of the use of nasal bones imaging in primary care in Malta

Abstract

Introduction: Fractures of the nasal bones are one of the commonest injuries sustained in facial trauma. The purpose of this study was to evaluate the use of nasal bone x-rays in the public primary care department in Malta and whether this has an impact on subsequent follow-up of patients presenting with nasal trauma. --Method: This was a retrospective cross-sectional observational study. Data of all nasal x-rays requested in primary health care during the year 2018 was gathered. Data input and analysis was carried out using Microsoft Excel®2016. -- Results: A total of 212 nasal bone x-rays were taken in primary care over the one-year study period, amounting to 65% of the total number of nasal x-rays taken in the public health sector in Malta. The majority of the patients were males. The most frequent age group was 21 to 30 years. The highest number of nasal bone x-ray requests (37.7%) was for unspecified trauma, followed by trauma secondary to a fall (25.9%), and trauma secondary to fights or assaults (16.5%). The majority(67%) of x-rays were reported as normal. Thirty point two per cent of all patients who had a nasal bone x-ray taken were referred to the Accident and Emergency (A&E) Department on the same day and 28.3% had Ear, Nose & Throat (END Outpatients follow-up. -- Conclusion: A substantial number of nasal bone x-rays are performed in the primary health care department in Malta on a yearly basis. Only a slight majority of those referred to ENT had an abnormal x-ray report, in keeping with data from previous studies highlighting the limitations of nasal x-rays in planning further management.