A novel use of photo messaging in the assessment of nasal fractures

Abstract

We evaluated a new method of assessing patients referred to the otolaryngology department with nasal injury. Patients possessing a mobile phone with built-in camera took an image of their face and sent it to the department for assessment. A decision was then made as to whether the patient needed further consultation or treatment. This method of nasal fracture assessment might avoid unnecessary referrals to the department. A prospective single blinded study was carried out. Twenty-five patients with a nasal injury took photographs of their face using a mobile phone camera. These images were reviewed and assessment made about whether a nasal fracture was present. The patient was then clinically assessed, the clinical examination being the 'gold standard' method of assessment. There was little agreement between photographic and clinical assessment. Sixty-two percent of patients who were clinically assessed to have a nasal fracture requiring manipulation were not picked up on assessment of their image. The greatest agreement with clinical assessment was the patient's own opinion as to whether there was new deviation of their nasal bone.