Trujillo Oscar, Lee Clara
Department of Otolaryngology-Head & Neck Surgery, Columbia University Irving Medical Center, 180 Fort Washington Avenue HP8, New York, NY 10032, USA.
Department of Otolaryngology-Head & Neck Surgery, Columbia University Irving Medical Center, 180 Fort Washington Avenue HP8, New York, NY 10032, USA.
Otolaryngol Clin North Am. 2023 Dec;56(6):1089-1099. doi: 10.1016/j.otc.2023.05.004. Epub 2023 Jun 21.
Nasal fractures are very common. The literature describes early intervention (<14 days) with closed techniques as cost-effective, minimizing the need for possible secondary surgeries and improved early patient satisfaction. However, the authors observe a measurably high rate of subsequent open treatment after closed treatment, particularly where there is significant septal involvement in the fracture. Moreover, delayed intervention (>3 months) with an open approach has many advantages over early closed technique, including lower revision rate, improved ability for rigid fixation and support, and the ability to correct severe dorsal or caudal L-strut deformities, nasal valve issues, and severe nasal bony deviation/deformities.
鼻骨骨折非常常见。文献表明，采用闭合技术进行早期干预（<14天）具有成本效益，可将二次手术的需求降至最低，并提高患者早期满意度。然而，作者观察到，闭合治疗后进行后续开放治疗的比例相当高，尤其是骨折累及鼻中隔的情况。此外，采用开放手术进行延迟干预（>3个月）比早期闭合技术有许多优势，包括翻修率更低、刚性固定和支撑能力更强，以及能够矫正严重的背侧或尾侧L形支柱畸形、鼻瓣膜问题和严重的鼻骨偏斜/畸形。
