Raghvi A, Priya K, Rajasekaran S, Prabakaran S, Navin R B Namasivaya, Balaji D, Gowthame K
Department of ENT, Chettinad Academy of Research and Education, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu 603103 India.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):2998-3006. doi: 10.1007/s12070-023-03894-z. Epub 2023 Jun 2.
This study was conducted to evaluate the outcomes of closed reduction of different types of nasal bone fractures depending on time between onset of injury and reduction and comparing the outcomes of early closed reduction (within 6 h) of nasal bone fracture with late closed reduction (after 2 weeks). A hospital based Prospective cohort type of study was conducted among cases of nasal bone fracture attending the outpatient department of Otorhinolaryngology at Chettinad Hospital and Research Institute, Chennai during the months of August 2021 to January 2022. A total of 54 participants were included in the study. Primary outcome was to assess the effectiveness of closed reduction of different types of nasal bone fractures postoperatively. The second objective was to compare the outcomes of early closed reduction (within 6 h) of nasal bone fracture with late closed reduction (after 2 weeks). Using chi square test, the association of factors such as age, sex, mode of injury, external framework deformity, type of fracture and treatment was analyzed with outcome measures such as post op degree of deviation, arch irregularity, malalignment, bony irregularity, bony displacement, olfactory disturbances and result. We analyzed the sample data statistically and measured the outcomes which showed that post operatively after undergoing closed reduction, some degree of deviation was present in 17(31.48./.), arch irregularity present in 12(22.2./.), malalignment in 11(20.37./.), bony irregularity in 24(44.44./.), bony displacement in 19(35.19./.), olfactory disturbances in 2(3.70./.). Comparing the outcome factors between early and late reduction, we found that the outcome was better in early closed reduction when compared with late closed reduction. Among the 54 patients studied, the results of closed reduction were found to be excellent in 27(50./.), Fair in 16(29.63./.), Good in 10(18.52./.) and poor in 1(1.85./.) We could thus conclude from this study that early closed reduction of nasal bone fracture gave better results than a late closed reduction in terms of post operative deformity, arch irregularity, malalignment, bony irregularity, bony displacement and olfactory disturbances.
本研究旨在评估不同类型鼻骨骨折闭合复位的效果，具体取决于损伤发生与复位之间的时间间隔，并比较鼻骨骨折早期闭合复位（6小时内）与晚期闭合复位（2周后）的效果。2021年8月至2022年1月期间，在金奈切蒂纳德医院和研究所耳鼻喉科门诊就诊的鼻骨骨折病例中，开展了一项基于医院的前瞻性队列研究。该研究共纳入54名参与者。主要结局是评估不同类型鼻骨骨折闭合复位术后的有效性。第二个目标是比较鼻骨骨折早期闭合复位（6小时内）与晚期闭合复位（2周后）的效果。使用卡方检验，分析年龄、性别、损伤方式、外部框架畸形、骨折类型和治疗等因素与术后偏斜程度、弓状不规则、错位、骨质不规则、骨移位、嗅觉障碍和结果等结局指标之间的关联。我们对样本数据进行了统计分析并测量了结局，结果显示，闭合复位术后，17例（31.48%）存在一定程度的偏斜，12例（22.2%）存在弓状不规则，11例（20.37%）存在错位，24例（44.44%）存在骨质不规则，19例（35.19%）存在骨移位，2例（3.70%）存在嗅觉障碍。比较早期和晚期复位的结局因素，我们发现早期闭合复位的效果优于晚期闭合复位。在研究的54例患者中，闭合复位结果优秀的有27例（50%），一般的有16例（29.63%），良好的有10例（18.52%），差的有1例（1.85%）。因此，我们可以从本研究得出结论，就术后畸形、弓状不规则、错位、骨质不规则、骨移位和嗅觉障碍而言，鼻骨骨折早期闭合复位的效果优于晚期闭合复位。
