Zhao Yu, Zhu Li, Ma Furong
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Apr;28(8):527-30.
To investigate the classification and distribution of external nasal fracture, and its influence to the nasal septum.
We randomly chose 60 patients who received nasal CT scan because of nasal trauma and diagnosed as external nasal fracture. We reviewed their CT data in PACS system with computer.
Of the 60 cases of nasal trauma, 90 sides got external nasal fracture, among which 58 sides (64.4%) had only nasal bone fracture, 16 sides (17.8%) had only maxillary frontal process fracture, and 16 sides (17.8%) had both. Half of these 60 patients got unilateral external nasal fracture, among whom 14 patients (46.7%) had traumatic nasal septum deviation meanwhile. The other 30 patients suffered from bilateral external nasal fracture, among whom 26 patients (86.7%) had traumatic nasal septum deviation. The difference between these two groups was statistically significant (P < 0.01). Moreover, 24 patients got fracture of either nasal bone or maxillary frontal process, 11 of whom (45.8%) got traumatic nasal septum deviation at the same time. The other 36 patients suffered fracture of both these two bones, 29 of whom (80.6%) had traumatic nasal septum deviation. The difference between these two groups was statistically significant (P < 0.01). We classified the nasal bone fracture as below: 16 patients with only unilateral external nasal fracture belonged to Type I, of whom 15 patients (25.0%) were type Ia with nasal bone or maxillary frontal process fracture and 1 patient (1.7%) fell into type Ib with fracture occurred on both of these two bones at the same side. Four patients suffered bilateral external nasal fracture belonged to type II, among whom 2 patients (3.3%) belonged to type IIa with nasal bone or maxillary frontal process fracture and 2 patients fell into type IIb with fracture of both of these two bones at different sides. The other 40 patients (66.7%) belonged to Tpye III, who suffered external nasal fracture accompanied with traumatic nasal septum deviation.
Traumatic nasal septum deviation was extremely concomitant in patients with external nasal fracture. It will be better to perform external nasal reconstructive surgery and plasty of nasal septum deviation by using the endoscope within 1 month for the patients whose symptom were serious or who cared a lot about the appearance.
探讨鼻外骨折的分类与分布及其对鼻中隔的影响。
随机选取60例因鼻外伤行鼻CT扫描且诊断为鼻外骨折的患者，在PACS系统中用计算机回顾其CT资料。
60例鼻外伤患者中，90侧发生鼻外骨折，其中单纯鼻骨骨折58侧（64.4%），单纯上颌骨额突骨折16侧（17.8%），两者皆有16侧（17.8%）。60例患者中半数为单侧鼻外骨折，其中14例（46.7%）同时伴有外伤性鼻中隔偏曲。另外30例为双侧鼻外骨折，其中26例（86.7%）伴有外伤性鼻中隔偏曲。两组差异有统计学意义（P<0.01）。此外，24例为鼻骨或上颌骨额突骨折，其中11例（45.8%）同时伴有外伤性鼻中隔偏曲。另外36例为这两块骨均骨折，其中29例（80.6%）伴有外伤性鼻中隔偏曲。两组差异有统计学意义（P<0.01）。将鼻骨骨折分类如下：16例单纯单侧鼻外骨折患者属于Ⅰ型，其中15例（25.0%）为Ⅰa型，即鼻骨或上颌骨额突骨折，1例（1.7%）为Ⅰb型，即同侧这两块骨均骨折。4例双侧鼻外骨折患者属于Ⅱ型，其中2例（3.3%）为Ⅱa型，即鼻骨或上颌骨额突骨折，2例为Ⅱb型，即两侧这两块骨均骨折。另外40例（66.7%）属于Ⅲ型，即鼻外骨折伴有外伤性鼻中隔偏曲。
鼻外骨折患者常伴有外伤性鼻中隔偏曲。对于症状严重或对外貌要求较高的患者，最好在1个月内采用鼻内镜行鼻外重建手术及鼻中隔偏曲矫正术。
