Basheeth Naveed, Donnelly Martin, David Smyth, Munish Shandilya
Department of Otorhinolaryngology, Waterford Regional Hospital, Waterford, Ireland.
Laryngoscope. 2015 Dec;125(12):2677-84. doi: 10.1002/lary.25358. Epub 2015 May 9.
OBJECTIVES/HYPOTHESIS: Functional and cosmetic deformities are common after nasal injuries and at times necessitate advanced surgery to reverse the effects of trauma. This study was designed to study the factors related to nasal injury and patient parameters in influencing the acute management of nasal injuries and its outcome.
Prospective study.
Nasal injuries from County Waterford in Southeast Ireland were referred to a new Cost-Neutral Nasal Fracture Clinic. The first 400 patients from this prospective audit, referred to Waterford Regional Hospital from August 2009 through December 2010, were included in this study. Twenty-one variables, including satisfaction scores using Visual Analog Scale (VAS), were studied. Data was obtained at each stage of management, from initial assessment in ears, nose, and throat (ENT) casualty to being seen and further reviewed in consultant-based specialty clinic.
Men outnumbered women 72: 28, and the mean age was 26.89 (0.4 years-87 years). Patients presenting time to the ENT casualty after the injury ranged between 1 and 90 days (mean 10.5 days). The interval between injury and intervention was on an average 6.1 days. Accident (41%) and soccer (46%), among the sports group, were predominantly related to nasal injury. The overall satisfaction rate was 77.5% for breathing and 85.6% for cosmesis. One hundred twenty-seven (31.8%) patients were referred to and managed from the septorhinoplasty clinic. Overall, 11% required septorhinoplasty. Patient satisfaction was seen in manipulation performed up to 5 weeks postinjury.
Our databank is the largest prospectively studied series of nasal-fracture management from Ireland. The incidence of nasal fracture in the southeast of Ireland is 0.37%. Age, gender, mode of injury, and type of sport influenced the satisfaction rates in this study. This type of service may not be practical in all ENT departments, but a regional center may be an idea worth considering.
目的/假设：鼻外伤后功能和外观畸形很常见，有时需要进行高级手术来逆转创伤的影响。本研究旨在探讨与鼻外伤相关的因素以及患者参数对鼻外伤急性处理及其结果的影响。
前瞻性研究。
来自爱尔兰东南部沃特福德郡的鼻外伤患者被转诊至一家新的成本中性鼻骨折诊所。本前瞻性审计的前400名患者，从2009年8月至2010年12月被转诊至沃特福德地区医院，纳入本研究。研究了21个变量，包括使用视觉模拟量表（VAS）的满意度评分。在管理的每个阶段获取数据，从耳鼻喉科（ENT）急诊的初始评估到在专科顾问诊所就诊及进一步复查。
男性与女性的比例为72:28，平均年龄为26.89岁（0.4岁 - 87岁）。受伤后患者到耳鼻喉科急诊就诊的时间在1至90天之间（平均10.5天）。受伤与干预之间的间隔平均为6.1天。在运动组中，意外事故（41%）和足球运动（46%）与鼻外伤主要相关。呼吸方面的总体满意率为77.5%，美容方面为85.6%。127名（31.8%）患者被转诊至鼻中隔成形术诊所并接受治疗。总体而言，11%的患者需要鼻中隔成形术。受伤后长达5周进行的手法复位可提高患者满意度。
我们的数据库是爱尔兰最大的关于鼻骨折处理的前瞻性研究系列。爱尔兰东南部鼻骨折的发病率为0.37%。年龄、性别、受伤方式和运动类型影响了本研究中的满意率。这种服务模式可能并非在所有耳鼻喉科部门都可行，但区域中心可能是一个值得考虑的想法。
