Objective:To compare the outcomes of simultaneous versus staged nasal bone reduction and septoplasty in the treatment of traumatic nasal bone fractures with associated septal fractures. Methods:Patients with traumatic nasal bone fractures, with or without septal fractures, were recruited from two hospitals and divided into three groups. Group A underwent simultaneous nasal bone reduction and septoplasty, Group B underwent staged nasal bone reduction and septoplasty, and Group C underwent nasal bone reduction only. Nasal appearance scores and nasal congestion Visual Analogue Scale （VAS） scores were measured preoperatively, at 2 weeks postoperatively, and at 3 months postoperatively. For Group B, scores were also recorded at 2 weeks and 3 months after the second-stage surgery. Differences were analyzed using statistical software. Results:Two weeks post-surgery, the nasal appearance scores significantly decreased in all three groups compared to preoperative scores （P< 0.01）, with no statistically significant differences between the groups （P= 0.43, 0.71, 0.58）. In Group A, the VAS score for nasal congestion decreased significantly following simultaneous surgery （P<0.01）. In Group B, there were no significant differences in nasal congestion VAS scores between pre-surgery and post-first-stage, nor between three months post-first-stage and two weeks post-first-stage （P= 0.61, 0.13）. However, the VAS scores significantly decreased after the second-stage surgery compared to pre-surgery, and three months post-second-stage surgery compared to three months post-first-stage surgery （P<0.01）. The VAS scores for nasal congestion at two weeks post-surgery in Group A were lower than those in Group B after the first-stage surgery （P<0.01）. The incidence rates of nasal adhesions post-surgery in Groups A, B, and C were 0%, 6.9%, and 4.3%, respectively. Conclusion:For traumatic nasal bone fractures with associated septal fractures, performing simultaneous nasal bone reduction and septoplasty under general anesthesia using endoscopy is more time-efficient compared to staged surgery, and it results in a lower occurrence rate of post-surgical nasal adhesions.
Humans ; Nasal Bone/surgery* ; Nasal Septum/injuries* ; Treatment Outcome ; Rhinoplasty/methods* ; Male ; Female ; Adult ; Skull Fractures/surgery* ; Fractures, Bone/surgery* ; Middle Aged ; Adolescent

Klippel-Feil syndrome is characterized by congenital fusion of two or more cervical vertebrae, a low hair line at the back of the head, restricted neck mobility, and other congenital anomalies. We report a 16-year-old young man with Klippel-Feil syndrome, Sprengel deformity of the right scapula, thoracic kyphoscoliosis, and mandibular prognathism with an anterior open bite. He was treated with orthodontic treatment and maxillofacial surgery. An anticipated difficult airway due to a short neck with restricted neck movements and extrinsic restrictive lung disease due to severe thoracic kyphoscoliosis increased his anesthesia risk. Due to his deviated nasal septum and contralateral inferior turbinate hypertrophy, we chose awake fiber optic orotracheal intubation followed by submental intubation. Considering the cervical vertebral fusion, he was carefully positioned during surgery to avoid potential spinal injury. He recovered well and his postoperative course was uneventful.
Adolescent ; Anesthesia ; Cervical Vertebrae ; Congenital Abnormalities ; Female ; Genioplasty ; Hair ; Head ; Humans ; Hypertrophy ; Intubation ; Klippel-Feil Syndrome ; Lung Diseases ; Mandible ; Nasal Septum ; Neck ; Open Bite ; Orthognathic Surgery ; Osteotomy ; Prognathism ; Scapula ; Spinal Injuries ; Surgery, Oral ; Turbinates

OBJECTIVE: To investigate the classification and distribution of external nasal fracture, and its influence to the nasal septum. METHOD: We randomly chose 60 patients who received nasal CT scan because of nasal trauma and diagnosed as external nasal fracture. We reviewed their CT data in PACS system with computer. RESULT: Of the 60 cases of nasal trauma, 90 sides got external nasal fracture, among which 58 sides (64.4%) had only nasal bone fracture, 16 sides (17.8%) had only maxillary frontal process fracture, and 16 sides (17.8%) had both. Half of these 60 patients got unilateral external nasal fracture, among whom 14 patients (46.7%) had traumatic nasal septum deviation meanwhile. The other 30 patients suffered from bilateral external nasal fracture, among whom 26 patients (86.7%) had traumatic nasal septum deviation. The difference between these two groups was statistically significant (P < 0.01). Moreover, 24 patients got fracture of either nasal bone or maxillary frontal process, 11 of whom (45.8%) got traumatic nasal septum deviation at the same time. The other 36 patients suffered fracture of both these two bones, 29 of whom (80.6%) had traumatic nasal septum deviation. The difference between these two groups was statistically significant (P < 0.01). We classified the nasal bone fracture as below: 16 patients with only unilateral external nasal fracture belonged to Type I, of whom 15 patients (25.0%) were type Ia with nasal bone or maxillary frontal process fracture and 1 patient (1.7%) fell into type Ib with fracture occurred on both of these two bones at the same side. Four patients suffered bilateral external nasal fracture belonged to type II, among whom 2 patients (3.3%) belonged to type IIa with nasal bone or maxillary frontal process fracture and 2 patients fell into type IIb with fracture of both of these two bones at different sides. The other 40 patients (66.7%) belonged to Tpye III, who suffered external nasal fracture accompanied with traumatic nasal septum deviation. CONCLUSION Traumatic nasal septum deviation was extremely concomitant in patients with external nasal fracture. It will be better to perform external nasal reconstructive surgery and plasty of nasal septum deviation by using the endoscope within 1 month for the patients whose symptom were serious or who cared a lot about the appearance.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Fractures, Bone ; classification ; diagnostic imaging ; pathology ; Humans ; Male ; Middle Aged ; Nasal Bone ; injuries ; Nasal Septum ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To investigate the feasibility and the efficacy of endoscopic three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction for traumatic nasal septum deviation. METHOD: Clinical data of 45 cases with traumatic nasal septum deviation treated were retrospectively analysed. These patients were performed with three lines tension relaxing septorhinoplasty and nasal bone fracture correction under endoscopy 5 to 14 days after injury. RESULT: All patients were followed up for more than six months. They all achieved significant efficacy and no complications occurred. CONCLUSION Endoscopic three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction can achieve satisfactory curative effect and can effectively prevent the occurrence of complications.
Adult ; Endoscopy ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Nasal Bone ; injuries ; surgery ; Nasal Septum ; injuries ; surgery ; Nose Deformities, Acquired ; surgery ; Retrospective Studies ; Rhinoplasty ; methods ; Treatment Outcome ; Young Adult

Adult ; Calculi ; complications ; Foreign Bodies ; complications ; Humans ; Male ; Nasal Cavity ; injuries ; Nasal Septum ; injuries ; Palate, Hard ; injuries

BACKGROUND AND OBJECTIVES: Accurate diagnosis of nasal fracture is difficult in many cases. Some reports showed that threedimensional facial computed tomography (3-D facial CT) is more effective than conventional facial computed tomography (conventional CT) in the diagnosis of nasal fracture. The purpose of this study is to prospectively evaluate the effectiveness of 3-D facial CT in diagnosis of nasal fracture. MATERIALS AND METHODS: From July 1, 2006 to January 31, 2007, 85 patients (83 men and 2 women, ranging in age from 29 to 46 years) visited the Armed Forces Capital Hospital within 2 weeks from nasal trauma. All patients prospectively underwent physical examination, lateral nasal bone view, Water's view, conventional CT, and 3-D CT. If any of definite crepitus on physical examination, or if definite fracture line on simple X-ray, or on conventional CT or on 3-D CT was found according to Hwang's criteria, that patient was confirmed to have nasal bone fracture. The diagnostic values of conventional CT and 3-D CT methods were analyzed by Pearson's chi-square test. RESULTS: Out of 85 trauma patients, 71 patients were diagnosed as having nasal bone fractures with the most common causes being, in the order of frequency of oc-currence, sports injuries and with other causes of blows, military training, works, and traffic accident. 28 patients showed nasal septal displace-ment or fracture. Conventional CT and 3-D CT were equally effective and had diagnosed 70 out of 71 fractures (98.6% of positive predictive value) and determined to be more effective than simple X-ray which had diagnosed only 50 fractures (70.4% of positive predictive value)(p=0.000). In the evaluation of nasal septum, conventional CT was proved to be more effective than 3-D CT since it diagnosed all 28 nasal deviation or fractures cases (100%) whereas 3-D CT diagonosed only 23 cases out of 28 (82.1%)(p=0.000). CONCLUSION: 3-D CT is not more effective than conventional CT in the diagnosis of nasal bone fracture. Moreover, conventional CT is better than 3-D CT in the diagnosis of nasal septal displacement or septal fracture.
Accidents, Traffic ; Arm ; Athletic Injuries ; Displacement (Psychology) ; Female ; Humans ; Male ; Military Personnel ; Nasal Bone ; Nasal Septum ; Physical Examination ; Prospective Studies

OBJECTIVE: To prevent the perforation of nasal septum due to button battery lodging in nose. METHOD: In 34 cases of nasal button battery, 28 were removed under general anesthesia and 6 under local anesthesia. The general treatment of nasal douching and local dressing were done after operation. RESULT: Only 1 case of perforation were found in 25 cases undertaken general treatment after operation, and perforation were found in all 9 cases with no general treatment. CONCLUSION Nasal douching and local dressing after battery removing can alleviate the mucosal erosion and decrease the sequels of nasal button battery.
Child, Preschool ; Female ; Foreign Bodies ; etiology ; Humans ; Infant ; Male ; Nasal Cavity ; Nasal Septum ; injuries ; Retrospective Studies

OBJECTIVE: To evaluate the repairing effect of ] diethylstilbestrol injection in mucosa injury of nasal septum. METHOD: 11 cases with perforation of nasal septum were made about 1-2 mm new wound surface around perforation, the cotton piece infiltrated by diethylstilbestrol injection was closed directly to the surface of perforation when the diameter of perforations not more than 8mm, xenoma and auto ethmoid bone were used before using cotton piece infiltrated by diethylstilbestrol injection when the diameter of perforations more than 8mm. RESULT: Eleven cases of perforation were cured, the symptoms disappear gradually. There is no reperforation during follow-up six months. There is no adverse effect. CONCLUSION The application of ] diethylstilbestrol injection was easy in operation and observation. The price of ] diethylstilbestrol injection was inexpensive,and it is no adverse effect. Curative effect is significant. It is a good method to be used to repair perforation of nasal septum.
Adult ; Diethylstilbestrol ; administration & dosage ; therapeutic use ; Female ; Humans ; Intraoperative Complications ; prevention & control ; Male ; Middle Aged ; Nasal Septum ; injuries ; Rhinoplasty ; methods ; Treatment Outcome ; Young Adult

Adult ; Endoscopy ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Nasal Septum ; injuries ; surgery ; Periosteum ; transplantation

A retrospective study on 273 patients who suffer from vomer trauma were conducted at ENT from Jan 2001 to Dec 2003. The result showed that: the number of patients in the following year often higher in the previous year, most of them are Kinh ethnic. Most of patients who suffered from fracture on vomer operated within 10 days so the result are good, no after effect and complication later. The simple nose bone fracture is higher than multiple trauma, rate in males is 5 times higher than in females. The rate for female in 2003 is higher than in 2002. The number of patients in the provincial level hospitals is higher than in the urban level hospitals. Reason: highest is traffic accident, then fighting accidents and lowest is labor accident. The bone nose fracture caused by fighting in the following year is higher than previous year. In 2002, the traffic accident lessen significantly to compare with 2001 but in 2003, there is an increase of traffic accident cases.
Nasal Septum ; Wounds and Injuries ; Epidemiology