Clin Exp Otorhinolaryngol.  2018 Mar;11(1):46-51. 10.21053/ceo.2017.00346.

Corrective Septorhinoplasty in Acute Nasal Bone Fractures

• Kim J
• Jung HJ
• Shim WS

• KMID: 2407792
• DOI: http://doi.org/10.21053/ceo.2017.00346

Abstract

OBJECTIVES
Closed reduction is generally recommended for acute nasal bone fractures, and rhinoplasty is considered in cases with an unsatisfactory outcome. However, concomitant rhinoplasty with fracture reduction might achieve better surgical outcomes. This study investigated the surgical techniques and outcomes in patients who underwent rhinoplasty and fracture reduction concomitantly, during the acute stage of nasal bone fracture.
METHODS
Forty-five patients who underwent concomitant rhinoplasty and fracture reduction were enrolled. Nasal bone fractures were classified into three major types (type I, simple fracture; type II, fracture line that mimics nasal osteotomy; and type III, comminuted fracture) based on computed tomography images and preoperative facial images. Two independent otolaryngology-head and neck surgeons evaluated the surgical outcomes and telephone based survey were made to evaluate patients satisfaction.
RESULTS
Among 45 patients, there were 39 males and 6 females. Type I was the commonest type of fracture with 18 patients (40%), while the most frequently used surgical technique for corrective surgery was dorsal augmentation with 44 patients (97.8%). The mean visual analogue scale satisfaction score of the surgeons and patients were 7.62 and 8, respectively, with no significant differences between fracture types.
CONCLUSION
Concomitant rhinoplasty with fracture reduction can be performed for acute nasal bone fracture patients, and it might lead to better aesthetic outcomes.

Keyword

Nasal Bone; Bone Fractures; Rhinoplasty

MeSH Terms

Female
Fractures, Bone
Humans
Male
Nasal Bone*
Neck
Osteotomy
Rhinoplasty
Surgeons
Telephone

Figure

• 

  Fig. 1. Types of nasal bone fractures. Blue line indicates an ideal shape and location of the nasal bone. (A) Aesthetically ideal bony pyramid. (B) Type I, minimally displaced nasal bone fracture, which remains within the blue line. (C) Type IIb, a broad based nose, with unaffected bone outside the blue line and the fractured bone inside the blue line. (D) Type IIh, a hump nose with intact bone above the blue line and fractured bone inside the blue line. (E) Type III, comminuted fracture with a septal fracture where all components collapse away from the blue line. Arrows indicate directions of displacement of fracture site in favorable way.

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  Fig. 2. Facial photographs and computed tomography (CT) image of case 1. (A) Preoperative facial bone CT shows a broad base bony pyramid with left nasal bone fracture. The fracture line mimics a lateral osteotomy. (B) Preoperative facial photograph shows a right side broad base nose. (C) Postoperative facial photograph shows a well-corrected broad base nose.

• 

  Fig. 3. Facial photographs and three-dimensionally reconstructed computed tomography (CT) image of case 2. (A) Preoperative three-dimensionally reconstructed CT image shows a hump nose with left nasal bone fracture. The fracture lines mimic a medial and lateral osteotomies. (B, C) Preoperative facial photographs show a hump nose with right side deviation. (D, E) Postoperative facial photograph shows a well-corrected hump nose.

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