J Rhinol.  2021 Nov;28(3):175-179. 10.18787/jr.2021.00352.

Complications After Inadequate Treatment of Nasal Bone Fracture Combined With Septal Fracture: A Case Report

• Yang SK
• Hong SN

• KMID: 2522788
• DOI: http://doi.org/10.18787/jr.2021.00352

Abstract

In treating a nasal bone, an incomplete nasal bone reduction can result in nasal deformity, both aesthetic and functional, requiring a secondary operation. A 60-year-old female with a traumatic comminuted nasal bone fracture with septal fracture was initially treated with closed reduction, which later resulted in a saddle nose and a completely occluded nasal cavity. Later, the patient underwent a revision operation of extracorporeal septorhinoplasty with rib cartilage graft, and the postoperative course was uneventful. Herein, we present a case of complications occurring after inadequate treatment of septal fracture. Physicians should thoroughly evaluate the extent of the nasal bone fracture, including the integrity of the nasal septum, and manage accordingly.

Keyword

Nasal bone fracture; Septal fracture; Closed reduction; Complication; Rhinoplasty; Extracorporeal septoplasty

Figure

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  Fig. 1. Initial CT after trauma (A: axial, B, C: coronal). Bilateral comminuted nasal bone fracture, extending to frontal process of right maxilla and nasal septum (arrow), is evident.

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  Fig. 2. Endoscopic finding of the nasal cavity after the initial reduction. A: Endoscopy of right nasal cavity with residual anterior septum (asterisk). B: Endoscopy of left nasal cavity (arrowhead), which is completely obliterated. Right nasal cavity (arrow) is visualized from the left nostril via the septal perforation.

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  Fig. 3. Pre-operative CT (A: axial, B: coronal). The left nasal cavity is totally blocked (asterisk). Severely deviated nasal septum (arrow).

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  Fig. 4. Operation findings. A: Intra-operative photo of the septal cartilage (arrows). Visualization of the left nasal cavity after dissection (asterisk). B: Rhinoplasty worksheet describing the design of neoseptum with rib cartilage. C: Intraoperative photo of the anterior septal angle reconstructed by columellar strut and extended spreader graft with rib cartilage.

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  Fig. 5. Post-operative endoscopy (A: right, B: left) showing the correction of the deformities, allowing the visualization of both nasal cavities.

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  Fig. 6. Pre-operative and post-operative facial photos (A, C: pre, B, D: post) showing the correction of the saddle nose.

Reference

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