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Do closed reduction and fracture patterns of the nasal bone affect nasal septum deviation?

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...

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Autores principales: Choi, Jun Ho, Oh, Hyun Myung, Hwang, Jae Ha, Kim, Kwang Seog, Lee, Sam Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Cleft Palate-Craniofacial Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9271658/
https://www.ncbi.nlm.nih.gov/pubmed/35811343
http://dx.doi.org/10.7181/acfs.2022.00661
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author Choi, Jun Ho
Oh, Hyun Myung
Hwang, Jae Ha
Kim, Kwang Seog
Lee, Sam Yong
author_facet Choi, Jun Ho
Oh, Hyun Myung
Hwang, Jae Ha
Kim, Kwang Seog
Lee, Sam Yong
author_sort Choi, Jun Ho
collection PubMed
description 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.
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spelling pubmed-92716582022-07-14 Do closed reduction and fracture patterns of the nasal bone affect nasal septum deviation? Choi, Jun Ho Oh, Hyun Myung Hwang, Jae Ha Kim, Kwang Seog Lee, Sam Yong Arch Craniofac Surg Original Article 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. Korean Cleft Palate-Craniofacial Association 2022-06 2022-06-20 /pmc/articles/PMC9271658/ /pubmed/35811343 http://dx.doi.org/10.7181/acfs.2022.00661 Text en Copyright © 2022 Korean Cleft Palate-Craniofacial Association https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Choi, Jun Ho
Oh, Hyun Myung
Hwang, Jae Ha
Kim, Kwang Seog
Lee, Sam Yong
Do closed reduction and fracture patterns of the nasal bone affect nasal septum deviation?
title Do closed reduction and fracture patterns of the nasal bone affect nasal septum deviation?
title_full Do closed reduction and fracture patterns of the nasal bone affect nasal septum deviation?
title_fullStr Do closed reduction and fracture patterns of the nasal bone affect nasal septum deviation?
title_full_unstemmed Do closed reduction and fracture patterns of the nasal bone affect nasal septum deviation?
title_short Do closed reduction and fracture patterns of the nasal bone affect nasal septum deviation?
title_sort do closed reduction and fracture patterns of the nasal bone affect nasal septum deviation?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9271658/
https://www.ncbi.nlm.nih.gov/pubmed/35811343
http://dx.doi.org/10.7181/acfs.2022.00661
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