Resolution Comparison of a Standoff Gel Pad Versus a Liquid Gel Barrier for Nasal Bone Fracture Sonography - A Standardized Crossover Study

Q: What was the main purpose of comparing the standoff gel pad with the liquid gel barrier?

To determine whether a semisolid standoff gel pad provides superior image contrast and signal stability compared with a liquid gel barrier during intraoperative nasal bone fracture sonography.

Q: How was the study designed and who participated?

It was a prospective, single-center, within-subject crossover study including 30 adults with isolated nasal bone fractures scheduled for closed reduction.

Q: Which imaging metrics improved with the standoff gel pad and by how much?

The standoff gel pad increased cortical interface CNR and improved both bone and soft-tissue SNRs versus the liquid gel barrier under fixed B-mode presets.

Sep 30, 2026

Uploaded by Jake

High-frequency ultrasonography increasingly supports closed reduction in nasal bone fractures, yet near-field image quality over the curved nasal dorsum depends on the acoustic coupling medium. This prospective, single-center, within-subject crossover study compared a 7 mm semisolid standoff gel pad (PAD) with a custom 7 mm liquid gel barrier (LGB) in 30 adults. PAD produced significantly higher near-field contrast-to-noise ratio and bone and soft-tissue signal-to-noise ratios under standardized intraoperative B-mode settings, suggesting a practical coupling approach.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

1. Introduction

2. Materials and Methods

2.1. Study Objective and Design

2.2. Participants

Article Resolution Comparison of a Standoff Gel Pad Versus a Liquid Gel Barrier for Nasal Bone Fracture Sonography: A Standardized Crossover Study Dong Gyu Kim and Kyung Ah Lee * Academic Editor: Konstantinos Seretis Received: 15 November 2025 Revised: 17 December 2025 Accepted: 21 December 2025 Published: 26 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. Department of Plastic and Reconstructive Surgery, Inje University Haeundae Paik Hospital, Busan 48108, Republic of Korea * Correspondence: [dlruddk01@gmail.com](dlruddk01@gmail.com); Tel.: +82-51-797-2380 Abstract Background: High-frequency ultrasonography (US) is increasingly used to guide closed reduction in nasal bone fractures, but near-field resolution over the curved nasal dorsum depends critically on the acoustic coupling medium. We aimed to determine whether a semisolid standoff gel pad (PAD) provides superior image contrast and signal stability compared with a liquid gel barrier (LGB) during intraoperative nasal bone fracture sonography. Methods: In this prospective, single-center, within-subject crossover study, 30 adults with isolated nasal bone fractures underwent intraoperative high-frequency US of the nasal dorsum under two coupling conditions differing only by the medium used: a 7 mm hydrogel standoff pad (PAD) and a custom-made 7 mm liquid gel barrier (LGB) . All scans were acquired on the same platform using fixed B-mode presets (10 MHz, 4.0 cm depth, single focal zone at the cortex) . Rectangular regions of interest (ROIs) were placed on the cortical interface (bone ROI) and adjacent soft tissue (soft-tissue ROI) at matched depth. For each subject and condition, contrast-to-noise ratio (CNR) and two signal-to-noise ratios (SNR_bone, SNR_soft) were derived from ROI gray-level statistics and compared using paired t-tests. Results: The PAD yielded a significantly higher CNR at the cortical interface compared to the LGB (3.46 ± 0.17 vs. 2.50 ± 0.19; mean paired difference 0.96, 95% CI 0.88–1.04; p < 0.0001) . SNR_bone was also higher with PAD (4.31 ± 0.35 vs. 3.63 ± 0.34; difference 0.68, 95% CI 0.52–0.83; p < 0.0001) . Using the soft-tissue ROI as the noise reference (SNR_soft), PAD again outperformed LGB (7.64 ± 0.73 vs. 6.68 ± 0.78; difference 0.96, 95% CI 0.59–1.33; p = 0.000012) . Conclusions: Compared with a liquid gel barrier of similar thickness, a semi-solid standoff gel pad provides higher near-field CNR and SNR at the nasal cortical interface under standardized intraoperative conditions. These quantitative differences support the use of a gel pad as a practical coupling medium for real-time ultrasound guidance during closed reduction in nasal bone fractures, although the impact on clinical outcomes remains to be determined. Keywords: nasal bone fracture; ultrasonography; contrast-to-noise ratio; signal-to-noise ratios 1. Introduction Nasal bone fracture is the most common facial fracture. Closed reduction benefits from real-time visualization of cortical discontinuities and step-offs. High-resolution ultrasonography (US) provides such guidance without ionizing radiation and shows diagnostic utility in both pediatric and adult populations [1–5] . On the curved nasal dorsum, near-field performance depends on the acoustic medium at the probe–skin interface. Micro-air interfaces and unstable contact diminish contrast and obscure thin cortical lines. Water-bath coupling can provide wide-field views but is vulnerable to bubbles, meniscus curvature, and motion during manipulation, limiting intraoperative practicality [6] . From an acoustic standpoint, soft-tissue–air boundaries reflect most incident energy; uninterrupted, air-free coupling is therefore essential. Bench studies favor gel-based media for transmissivity and impedance matching compared with wa

FAQs

What was the main purpose of comparing the standoff gel pad with the liquid gel barrier?

To determine whether a semisolid standoff gel pad provides superior image contrast and signal stability compared with a liquid gel barrier during intraoperative nasal bone fracture sonography.

How was the study designed and who participated?

It was a prospective, single-center, within-subject crossover study including 30 adults with isolated nasal bone fractures scheduled for closed reduction.

Which imaging metrics improved with the standoff gel pad and by how much?

The standoff gel pad increased cortical interface CNR and improved both bone and soft-tissue SNRs versus the liquid gel barrier under fixed B-mode presets.

Sep 30, 2026

Uploaded by Jake