Duke-NUS Graduate Medical School, Singapore.
Aesthet Surg J. 2013 May;33(4):505-15. doi: 10.1177/1090820X13484466.
Closed reduction and splinting are generally recommended in the acute management of nasal fractures. Although open reduction is recommended for more severe nasal fractures, immediate functional and cosmetic open rhinoplasty following nasal fractures has not been described for Asian noses.
The authors document their experiences with combining open reduction of acute nasal fractures with simultaneous cosmetic correction of preexisting aesthetic concerns in an Asian population.
Twenty-five Asian patients underwent primary functional and cosmetic open rhinoplasty immediately following acute nasal fracture. Grafts consisted of autologous material, including septum, concha, rib, and deep temporal fascia. Prior to opening the nose, anatomical reduction of the bony vault fractures was performed. Spreader grafts were used to stabilize the fractured or dislocated dorsal septum as well as to straighten the nose. Aesthetic refinement of the nose included lengthening, refining the tip, and increasing tip projection and was performed according to the patients' aesthetic desires. Patient satisfaction was subjectively reported on a 1 to 10 scale.
Mean follow-up was 17 months (range, 10-24 months). Twenty-three patients rated the results of their procedures as 7 or higher. Functionally, all patients were breathing as well or better postoperatively compared with their preinjury functional state. One patient (4%) underwent a secondary filler procedure for a slight dorsal irregularity.
Immediate cosmetic and functional open rhinoplasty is safe, predictable, and effective in Asian patients.
在急性鼻骨骨折的处理中，通常建议进行闭合复位和固定。虽然开放性复位适用于更严重的鼻骨骨折，但对于亚洲人来说，鼻骨骨折后立即进行功能性和美容性的开放式鼻整形术尚未有报道。
作者描述了他们在亚洲人群中，将急性鼻骨骨折的开放性复位与同时矫正先前存在的美学问题相结合的经验。
25 例亚洲患者在急性鼻骨骨折后立即接受了原发性功能性和美容性开放式鼻整形术。移植物包括自体材料，如鼻中隔、鼻甲、肋骨和颞深筋膜。在打开鼻子之前，先进行骨性穹窿骨折的解剖复位。采用鼻中隔扩张器来稳定骨折或脱位的鼻中隔以及使鼻子变直。根据患者的审美需求，对鼻子进行美学细化，包括延长、细化鼻尖、增加鼻尖突出度。患者满意度通过 1 到 10 的评分进行主观报告。
平均随访时间为 17 个月（范围 10-24 个月）。23 例患者将手术结果评为 7 分或更高。在功能方面，所有患者术后的呼吸情况均与受伤前相比有所改善或更好。1 例患者（4%）因轻微的鼻背不平整进行了二次填充手术。
对于亚洲患者来说，即时的美容和功能性开放式鼻整形术是安全、可预测且有效的。
4 级。
