Airway Improvement After Reduction of Nasal Bone Fracture

Kim, Sang Bum; Han, Seung Kyu; Kim, Woo Kyung

Abstract

Evaluations and treatments of nasal bone fracture have been mainly focused on aesthetic aspect, but nose has an important role as an airway. The purpose of this study was evaluation of nasal bone fractures in the view of nasal obstruction and its improvement after reduction. Acoustic rhinometry was applied to the 77 nasal bone fractured patients who received closed reduction from August 2002 to July 2003 and received closed reduction. This was tested twice, before and 6 days after reduction, for all 77 patients and additional acoustic rhinometry was also possible in 26 patients after 6 months. The analysis of acoustic rhinometry were based on data of minimal cross-sectional area(MCA) according to fracture sites(one side, both side and tip) and septal displacement. Mean MCA for all cases before reduction was 0.43+/-0.21 cm2, which was 19% decrease compared to normal adult data(0.53+/-0.12 cm2). Depending on fracture sites the MCA were 0.45+/-0.16 cm2 for one side fracture, 0.35+/-0.18 cm2 for both side fracture, and 0.42+/-0.25 cm2 for tip fracture. The patients with septal displacement showed more severe obstruction than ones without septal displacement, 0.26+/-0.26 cm2 and 0.46+/-0.10 cm2, respectively. The MCA was improved up to 0.50+/-0.22 cm2 after reduction and showed slight decrease after 6 month(0.48+/-0.23 cm2). Based on the results of this study, nasal bone fracture really caused airway obstruction(19% decrease). Both side fracture showed more profound decrease than one side fracture and septal displacement was an important parameter which causes nasal obstruction. Closed reduction improved MCA by 14% right after reduction, and 11% after 6 month follow up.