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急性鼻中隔骨折单纯闭合复位与一期开放修复的比较。

Comparison of closed reduction alone versus primary open repair of acute nasoseptal fractures.

作者信息

DeFatta Robert J, Ducic Yadranko, Adelson Robert T, Sabatini Peter R

机构信息

Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, USA.

出版信息

J Otolaryngol Head Neck Surg. 2008 Aug;37(4):502-6.

Abstract

OBJECTIVE

Nasoseptal injuries have traditionally been treated via closed reduction. Historically, the high incidence of postreduction deformities has led some surgeons to consider alternative approaches to obtain superior results. Here we compare simple closed reduction versus primary open repair of the nasoseptal fracture.

STUDY DESIGN

This was a prospective study of 40 consecutive patients treated with simple closed reduction of their combined nasal bone and septal fracture versus 40 patients treated with closed reduction of their nasal bone fracture and open treatment of the septum. Group outcomes were then compared.

RESULTS

In the closed reduction group, 60% had significant postoperative septal deviation, whereas only 12.5% suffered from residual septal deformity in the open group. This resulted in a statistically significant reduction (p < .01) of patients requiring a second operation to formally address the septum.

CONCLUSION

By addressing the septum through an open approach, a statistically significant reduction in the number of patients requiring revision rhinoplasty was achieved.

摘要

目的

鼻中隔损伤传统上通过闭合复位进行治疗。从历史上看,复位后畸形的高发生率促使一些外科医生考虑采用替代方法以获得更好的效果。在此,我们比较鼻中隔骨折的单纯闭合复位与一期开放修复。

研究设计

这是一项前瞻性研究,连续纳入40例接受鼻骨和鼻中隔联合骨折单纯闭合复位治疗的患者,与40例接受鼻骨骨折闭合复位及鼻中隔开放治疗的患者。然后比较两组的结果。

结果

在闭合复位组中,60%的患者术后出现明显的鼻中隔偏曲,而开放组中只有12.5%的患者存在鼻中隔残余畸形。这使得需要再次手术以正式处理鼻中隔的患者数量在统计学上显著减少(p < .01)。

结论

通过开放入路处理鼻中隔,需要进行鼻整形修复手术的患者数量在统计学上显著减少。

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