• 대한두개안면성형외과학회지
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• 제23권3호
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• pp.119-124
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• 2022

Background: Many severe nasal bone fractures present with septal fractures, causing postoperative septal deviation and negatively affecting the patients' quality of life. However, when a septal fracture is absent, it is difficult to predict whether surgical correction can help minimize nasal septal deviation postoperatively. This study determined whether performing closed reduction on even mildly displaced nasal bone fracture could deter the outcome of septal deviation. Methods: We retrospectively reviewed the data of 116 patients aged 21-72 years who presented at the outpatient clinic and emergency room with fractures of nasal bones only without any involvement of the septum from January 2014 to December 2020. Patients were classified into three fracture type groups: A (unilateral), B (bilateral), and C (comminuted with depression). The degree of septal deviation was calculated by measuring the angle between the apex of the most prominent point and the crista galli in the coronal view on computed tomography images. The difference between the angles of the initial septal deviation and that of the follow-up was calculated and expressed as delta (Δ). Results: Closed reduction tended to decrease the postoperative septal deviation in all fracture types, but the values were significantly meaningful only in type A and B fractures. In the surgical group, with type A as the baseline, type B showed a significantly larger Δ value, but type C was not significantly different, although type C showed a smaller Δ value. In the conservative group, with type A as the baseline, the other fracture types presented significantly lower Δ values. Conclusion: For all fracture types, closed reduction significantly decreased the extent to which the nasal septum likely deviated. Therefore, when a patient is reluctant to undergo closed reduction, physicians should address the possible outcomes and prognosis of untreated nasal bone fractures.

• Archives of Plastic Surgery
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• 제39권5호
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• pp.561-564
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• 2012

Nasal bone fractures are often accompanied by septal fractures or deformity. Posttraumatic nasal deformity is usually caused by septal fractures. Submucosal resection and septoplasty are commonly used surgical techniques for the correction of septal deviation. However, septal perforation or saddle nose deformity is a known complication of submucosal resection. Hence, we chose to perform septoplasty, which is a less invasive procedure, as the primary treatment for nasal bone fractures accompanied by septal fractures. During septoplasty, we used a bioabsorbable mesh as an internal splint. We used the endonasal approach and inserted the mesh bilaterally between the mucoperichondrial flap and the septal cartilage. The treatment outcomes were evaluated by computed tomography (CT) and the nasal obstruction symptom evaluation (NOSE) scale. The CT scans demonstrated a significant improvement in the septal deviation postoperatively. The symptomatic improvement rated by the NOSE scale was greater at 1 month and 6 months after surgery compared to the preoperative status. There were no cases of extrusion or infection of the implant. In cases of moderate or severe septal deviation without dislocation from the vomerine groove on the CT scan, our technique should be considered one of the treatments of choice.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권5호
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• pp.530-534
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• 2007

Nasal fractures are the most common type of facial fractures. Nowdays computed tomography is found to be very helpful in diagnosing nasal fracture, especially in findings the nasal septal fractures. From August 2004 to July 2005, 36 cases of nasal fracture were admited and reviewed to oral and maxillofacial surgery of Ulsan University Hospital, not including other facial bone fracture. Out of 223 cases of facial bone fractures, we treated 47 cases of nasal fractures. We reviewed and examined the 36 patients of nasal fractures 2months postoperative. The results were 28cases of male and 8cases of female. The highest age frequency was in the fourth decades group. The most frequent causes of injury were falling down and fist trauma. The 25(69%) patients were found to have septal fractures, after computed tomography findings. The treatment methods of nasal fracture were closed reduction(13cases), open reduction(20cases), ORIF(1case), non operation(2cases). Complications of nasal deformity were found in 2patients. Septoplasty was performed on 21 patients. Septal fractures in combination with nasal fracture are usually unrecognized and untreated at the time of injury, usually ended in nasal deformities. It is important to find out the exact type of nasal fractures. We will report the results of treatment of nasal fractures with a literature review.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.626-632
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• 2010

Purpose: Nasal bone fractures are often classified as minor injury. However, the incidence of posttraumatic nasal deformity remains alarmingly high. It is because of unnoticed septal fracture. This study was conducted to determine the necessity of septoplasty for patients with nasal bone fracture accompanying grade I septal fractures. Methods: Among 105 patients with nasal bone fractures, 52 who had grade I septal fracture were diagnosed based on physical examination and computed tomography. Patients' age ranged from 14 to 65 years (mean 29.25 years), and 35 were male and 17 female. Patients were divided into 2 groups according to surgical treatment methods: patients who underwent closed reduction only (group 1, n=28) and those who underwent simultaneous closed reduction and septoplasty (group 2, n=24). The treatment outcomes were evaluated by comparing changes in nasal airway volume measured by acoustic rhinometry before the surgery, 3 months and 6 months after the surgery according to the timing of surgical repair and surgical treatment methods. Results: Nasal airway volume increased after the surgery by 17.8% in 3 months after the surgery, 25.2% in 6 months in group 1 and by 22.7% in 3 months, 35.8% in 6 months in group 2. The increase in airway volume after the surgery by 26.3% in 3 months after the surgery, 34.2% in 6 months after the surgery in operation within 1 week after trauma and by 12.1% in 3 months, 22.2% in 6 months after the operation later 1 week after trauma. The difference was statistically significant. Three patients in group 1 complained of intermittent nasal obstruction, two of whom showed a decrease in nasal airway volume by acoustic rhinometry. Conclusion: Most patients with nasal bone fractures accompanying grade I septal fractures have been treated with closed reduction in clinical settings. However, the results of this study suggest that septoplasty be performed after a correct diagnosis of septal fracture is made through comprehensive physical examination and computed tomography. Septoplasty is important to obtain more favorable outcomes and reduce complication.

• 대한두개안면성형외과학회지
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• 제18권1호
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• pp.25-29
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• 2017

Background: Many authors have evaluated the post-reduction result of nasal bone fracture through patient satisfaction or postoperative complications. However, these results are limited because they are subjective. The aim of this study was to correlate an objective operation result with patient satisfaction and postoperative complications according to the type of nasal bone fractures. Methods: Our study included 313 patients who had isolated nasal bone fractures and had undergone a closed reduction. Postoperative outcomes were evaluated objectively using computed tomographic (CT) images, while patient satisfaction was evaluated one month after the operation. The correlation of the operation result with patient satisfaction was then evaluated. Results: The correlation between the operation result and patient satisfaction was highest for the lateral impact group type I (LI) type of fracture and lowest for the comminuted fracture group (C) type of fracture. However, there were no statistically significant differences in correlation between the overall result and patient satisfaction by fracture type. The complication rate of lateral impact group type II (LII), C, and frontal impact group type I (FI) fractures were statistically significantly higher than that of frontal impact group type II (FII) and LI fractures. There were no statistically significant relationships between the prevalence of complications and septal fracture or deviation according to the fracture type. In the total group, however, there was a statistically significant difference in complication rate by septal fracture. Conclusion: We found that the CT outcomes correlated with patient satisfaction. The complication rate of LII, C, and FI fractures were statistically significantly higher than that of FII and LI fractures. Septal fracture/deviation increased the postoperative complication in the total group.

• 대한두개안면성형외과학회지
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• 제23권1호
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• pp.29-33
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• 2022

Background: There have been many reports of nasal bone fractures in adults, but there are few clinical reports of them in adolescents, although adolescence is the main growth period of the nasal bone. In addition, previous studies have tended to classify and describe child and adolescent nasal fractures in the same category. The aim of this study was to identify the clinical aspects of nasal fractures in adolescents, and to evaluate the characteristics of nasal fractures in the growth period. Methods: Our institution's database was reviewed to extract data on adolescent patients between the age of 13 to 18 who had isolated nasal bone fractures from March 2012 to February 2020. The study excluded patients with other facial fractures, previous facial fractures, or congenital deformities. Results: This study included 243 boys and 26 girls. Interpersonal violence and sports-related accidents accounted for 85 and 79 cases, respectively. There were 128 frontal impact injuries and 132 lateral impact injuries, and 97 patients had accompanying septal fractures. An accompanying septal fracture was present in 36.06% of all patients, but in 51.20% of those who underwent surgery. Conclusion: The prevalence of adolescent nasal fractures was significantly higher in boys, to a greater extent than observed for pediatric or adult fractures. The main causes of fractures were interpersonal violence and sports-related accidents. An explanation for these results is that adolescent boys are more prone to have violent accidents or companionship with active sports than other age or sex groups, leading to substantially more fractures.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.775-782
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• 2011

Purpose: Nasal bone fracture is most common facial bone fracture. The cause of fractures is mainly trauma such as fighting, automobile accident and fall down, and it commonly involves young males. Very frequently nasal bone fractures are associated with other facial injuries such as orbital bone fracture, maxillary bone fracture and nasal septal deformities. Because of various dynamic directions of power are involved, phenomenon of fractures are also various and treatment cannot be simple. Methods: We studied and analyzed retrospectively 452 cases nasal bone fractures from January 2008 to December 2010. Diagnosis were made with physical examination, Nasal bone X-rays, Facial bone CT and 3D facial bone CT. Four surgeons are involved in treatments of these patients and applied different procedure along patient's condition and deformity. We analyzed the cause of nasal bone fractures, deformities, associate injuries and applied surgical technique, and patient's satisfaction rate. In this study, old nasal bone fractures were excluded. Results: Young male group was most commonly sustained nasal bone fracture and physical violence was most common cause of injury. 64 of 452 patient was involved associate injuries of face. Closed reduction were applied 246 cases and C-arm quide reduction were 167 cases and in 20 cases lateral osteotomy were applied. Approximately, more than 80% of the Patients were satisfied with the outcomes. Conclusion: Diagnosis and treatment of nasal bone fractures are considered simple but because of various deformity and associate injuries, treatment is not always simple and universal. Time to time, we face unsatisfied patient after treatment of nasal bone fractures. For obtaining satisfactory result, cause of injury and state of deformities and associate injuries such as nasal septal deformity should be evaluated properly and proper treatment should be applied.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.7-14
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• 2020

Background: It is difficult to completely fix nasal bone fractures with closed reduction, as it is often accompanied by septal cartilage damage, and this often results in postoperative secondary deformities. Thus, patients are often reluctant to undergo closed reduction surgery. The present study aimed to evaluate aesthetic and functional satisfaction, as well as satisfaction with and complications of closed reduction, according to nasal bone fracture type. Methods: The subjects were patients who underwent closed reduction under general anesthesia from January 2017 to December 2018. Based on the modified Murray classification, patients were classified into five groups according to the fracture site, septal fracture, and deviation. A total of 211 patients were sent a web-based survey on postoperative satisfaction and complications, as well as intention for revision and cosmetic surgery. Sixty-one patients (28.9%) responded. Results: There were no significant differences in aesthetic and functional satisfaction or satisfaction with closed reduction according to the fracture type, site, or severity. Postoperative functional complications developed in 14 of 61 patients (22.95%). With 10 out of 24 (41.67%) patients (p = 0.044), the bilateral fracture with septal fracture or prominent septal deviation type had a higher incidence of complications than the other types. Conclusion: The incidence of complications is higher for bilateral fracture with septal fracture or prominent septal deviation compared to the other nasal bone fracture types. Therefore, long-term follow-up after closed reduction surgery for this fracture type can aid in establishing additional postoperative treatment plans and improving patient satisfaction.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.3-6
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• 2020

Nowadays, the incidence of nasal bone fracture is increasing because of social complexity with frequent social activity, and reduction of fractures is relatively simple and can be corrected in short operation time. However, the postoperative results are known to be less satisfied with higher complication rates relatively. These problems could have resulted from inaccurate recognition and interpretation of fracture aspect, inaccurate planning of operation resulting in under or overcorrection, ignoring septal management, complication related nasal packings with removal, postoperative management, and patient satisfaction with complication.

• 대한두개안면성형외과학회지
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• 제24권6호
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• pp.273-277
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• 2023

Background: The clinical characteristics of pediatric nasal fractures can vary depending on the child's age, social activities, and environment. Therefore, this study aimed to analyze these characteristics in different age groups. Methods: We retrospectively reviewed of a series of patients aged under 12 years who received treatment between 2013 and 2021. The initial study design involved dividing the patients into four age groups, corresponding to different developmental ages, but there were no cases in infants aged 0 to 1 year. Therefore, the patients were divided into three groups: group I, between 2 and 5; group II, between 6 and 9; and group III, between 10 and 12 years of age. The following parameters were evaluated: sex, age, etiology, fracture type and severity, and the incidence of septal injuries. Results: In total, 98 patients were included in this study. In group III, the ratio of boys to girls was 3.88:1, exceeding the overall ratio of 1.97:1. The most common cause varied with age: slipping down in group I, bumping accidents in group II, and sports accidents in group III. Concomitant septal injuries were present in 4.17% of patients in group I, 5.71% of patients in group II, and 28.21% of patients in group III. Conclusion: Increasing age was accompanied by a greater tendency for male predominance and a higher prevalence of sports-related causes and septal injuries. Violence was infrequent but started to become a contributing factor during school age. These varying environmental factors across age groups can offer valuable insights into the epidemiology and clinical characteristics of pediatric nasal bone fractures.