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急性鼻骨骨折的鼻部美容整复术。

Cosmetic rhinoseptoplasty in acute nasal bone fracture.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea.

出版信息

Otolaryngol Head Neck Surg. 2013 Aug;149(2):212-8. doi: 10.1177/0194599813487493. Epub 2013 May 6.

Abstract

OBJECTIVE

Traditionally, rhinoseptoplasty for nasal bone fracture is only considered after an unsatisfactory outcome from initial closed reduction. However, better surgical outcomes may be achieved if rhinoseptoplasty is performed at the same time as the nasal bone fracture reduction. This study investigated the surgical outcomes of patients who underwent rhinoseptoplasty concomitantly with nasal bone fracture reduction according to their computed tomography image-based nasal bone fracture classifications.

STUDY DESIGN

Case series with chart review.

SETTING

Academic tertiary care medical center.

SUBJECTS AND METHODS

Fifty-six patients who underwent rhinoseptoplasty concomitantly with nasal bone fracture reduction were enrolled in this study. Nasal bone fractures were classified into 6 types by computed tomography scans. Two independent facial plastic surgeons evaluated the outcomes 6 months postoperatively using a visual analog scale. The nasal tip projection and rotation were measured using the pre- and postoperative profile views.

RESULTS

The satisfaction scores of type I, IIo, and IIIo fractures without septal fracture were significantly higher than those of type II, III, and IV fractures with septal fractures. Among the patients, 82.1% underwent lower vault surgery. The nasal tip projection and rotation were increased after surgery in patients without septal fractures, whereas the tip rotation was elevated but the projection was unchanged postoperatively in patients with septal fractures.

CONCLUSION

Rhinoseptoplasty for acute nasal bone fractures can be performed at the same time as nasal bone fracture reduction. However, nasal bone fracture with septal fracture should be managed carefully.

摘要

目的

传统上,只有在初次闭合复位后效果不佳时,才考虑对鼻骨骨折进行鼻整形术。然而,如果在进行鼻骨骨折复位的同时进行鼻整形术,可能会获得更好的手术效果。本研究根据基于计算机断层扫描图像的鼻骨骨折分类,调查了同时进行鼻整形术和鼻骨骨折复位的患者的手术效果。

研究设计

病例系列,病历回顾。

设置

学术三级保健医疗中心。

受试者和方法

本研究纳入了 56 例同时进行鼻整形术和鼻骨骨折复位的患者。通过计算机断层扫描将鼻骨骨折分为 6 型。两名独立的面部整形医生在术后 6 个月使用视觉模拟量表评估结果。使用术前和术后的侧位像测量鼻尖突出度和旋转度。

结果

无鼻中隔骨折的 I 型、IIo 型和 IIIo 型骨折患者的满意度评分明显高于有鼻中隔骨折的 II 型、III 型和 IV 型骨折患者。在这些患者中,82.1%进行了下鼻甲手术。无鼻中隔骨折的患者术后鼻尖突出度和旋转度增加,而有鼻中隔骨折的患者术后鼻尖旋转度升高但突出度不变。

结论

对于急性鼻骨骨折,可以同时进行鼻整形术和鼻骨骨折复位。然而,对于伴有鼻中隔骨折的鼻骨骨折,应谨慎处理。

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