Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Eur Arch Otorhinolaryngol. 2024 Mar;281(3):1301-1306. doi: 10.1007/s00405-023-08290-5. Epub 2023 Oct 20.
Fractures in the pyriform buttress area adversely affect facial appearance and nasal airway patency. Nasal airway function has received less attention than aesthetic problems in the literature. This retrospective study classified the different fracture types in this area and determined their impact on nasal airway function.
Three-dimensional computed tomography images of patients with fractures in the pyriform buttress area were analyzed to identify the exact fracture pattern. The nasal airway functions were evaluated and compared between patients with different fracture patterns using acoustic rhinometry, rhinomanometry, and the nasal obstruction symptom evaluation scale.
Overall, 47 patients, including 16 with type I fractures (high fracture line; group I), 16 with type II fractures (intermediate fracture line; group II), and 15 with type III fractures (low fracture line; group III), were included in the study. The mean minimal cross-sectional area (MCA), total nasal inspiratory resistance (Tri) and total nasal expiratory resistance (Tre) of group I were 0.51 ± 0.06 cm, 1.67 ± 0.11 kPa L s, and 1.66 ± 0.12 kPa L s, respectively; those of group II were 0.48 ± 0.07 cm, 1.89 ± 0.15 kPa L s, and 1.88 ± 0.14 kPa L s, respectively; and those of group III were 0.36 ± 0.04 cm, 1.94 ± 0.21 kPa L s, and 2.01 ± 0.34 kPa L s, respectively. The nasal obstruction symptom evaluation (NOSE) scale scores for groups I, II, and III were 7.188, 9.813, and 13.27, respectively.
Therefore, the severity of the nasal airway obstruction depends on the displacement of the fractured bones in patients with fractures in the pyriform buttress area. The most profound nasal obstruction occurs in patients with the lowest fracture line.
梨状窝区骨折会影响面部外观和鼻气道通畅性。鼻气道功能在文献中受到的关注不如美学问题多。本回顾性研究对该区域的不同骨折类型进行分类，并确定其对鼻气道功能的影响。
对梨状窝区骨折患者的三维 CT 图像进行分析，以确定确切的骨折模式。使用鼻声反射计、鼻阻力计和鼻阻塞症状评估量表评估并比较不同骨折模式患者的鼻气道功能。
共有 47 例患者（16 例高骨折线 I 型骨折患者，即 I 组；16 例中骨折线 II 型骨折患者，即 II 组；15 例低骨折线 III 型骨折患者，即 III 组）纳入本研究。I 组最小横截面积（MCA）、总鼻吸气阻力（Tri）和总鼻呼气阻力（Tre）的平均值分别为 0.51±0.06cm、1.67±0.11kPa·Ls 和 1.66±0.12kPa·Ls；II 组分别为 0.48±0.07cm、1.89±0.15kPa·Ls 和 1.88±0.14kPa·Ls；III 组分别为 0.36±0.04cm、1.94±0.21kPa·Ls 和 2.01±0.34kPa·Ls。I、II 和 III 组的鼻阻塞症状评估（NOSE）量表评分分别为 7.188、9.813 和 13.27。
因此，梨状窝区骨折患者鼻气道阻塞的严重程度取决于骨折骨块的移位程度。骨折线最低的患者发生的鼻阻塞最严重。
