Dong Yi, Li Shengsheng, Ma Suibin, Han Huijun
Department of Otolaryngology Head and Neck Surgery，Beijing Tongren Hospital，Capital Medical University，Key Laboratory of Otolaryngology Head and Neck Surgery，Ministry of Education，Beijing，100730，China.
Department of Otolaryngology，People's Hospital of Hotan District.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):338-343. doi: 10.13201/j.issn.2096-7993.2025.04.009.
To compare the outcomes of simultaneous versus staged nasal bone reduction and septoplasty in the treatment of traumatic nasal bone fractures with associated septal fractures. Patients with traumatic nasal bone fractures, with or without septal fractures, were recruited from two hospitals and divided into three groups. Group A underwent simultaneous nasal bone reduction and septoplasty, Group B underwent staged nasal bone reduction and septoplasty, and Group C underwent nasal bone reduction only. Nasal appearance scores and nasal congestion Visual Analogue Scale （VAS） scores were measured preoperatively, at 2 weeks postoperatively, and at 3 months postoperatively. For Group B, scores were also recorded at 2 weeks and 3 months after the second-stage surgery. Differences were analyzed using statistical software. Two weeks post-surgery, the nasal appearance scores significantly decreased in all three groups compared to preoperative scores （< 0.01）, with no statistically significant differences between the groups （= 0.43, 0.71, 0.58）. In Group A, the VAS score for nasal congestion decreased significantly following simultaneous surgery （<0.01）. In Group B, there were no significant differences in nasal congestion VAS scores between pre-surgery and post-first-stage, nor between three months post-first-stage and two weeks post-first-stage （= 0.61, 0.13）. However, the VAS scores significantly decreased after the second-stage surgery compared to pre-surgery, and three months post-second-stage surgery compared to three months post-first-stage surgery （<0.01）. The VAS scores for nasal congestion at two weeks post-surgery in Group A were lower than those in Group B after the first-stage surgery （<0.01）. The incidence rates of nasal adhesions post-surgery in Groups A, B, and C were 0%, 6.9%, and 4.3%, respectively. For traumatic nasal bone fractures with associated septal fractures, performing simultaneous nasal bone reduction and septoplasty under general anesthesia using endoscopy is more time-efficient compared to staged surgery, and it results in a lower occurrence rate of post-surgical nasal adhesions.
比较同期与分期鼻骨复位及鼻中隔成形术治疗合并鼻中隔骨折的外伤性鼻骨骨折的疗效。从两家医院招募有或无鼻中隔骨折的外伤性鼻骨骨折患者，并将其分为三组。A组接受同期鼻骨复位及鼻中隔成形术，B组接受分期鼻骨复位及鼻中隔成形术，C组仅接受鼻骨复位。在术前、术后2周和术后3个月测量鼻外观评分和鼻充血视觉模拟量表（VAS）评分。对于B组，在第二阶段手术后2周和3个月也记录评分。使用统计软件分析差异。术后2周，与术前评分相比，所有三组的鼻外观评分均显著降低（<0.01），组间无统计学显著差异（=0.43、0.71、0.58）。在A组中，同期手术后鼻充血的VAS评分显著降低（<0.01）。在B组中，术前与第一阶段术后、第一阶段术后3个月与第一阶段术后2周之间的鼻充血VAS评分无显著差异（=0.61、0.13）。然而，与术前相比，第二阶段手术后VAS评分显著降低，与第一阶段手术后3个月相比，第二阶段手术后3个月VAS评分显著降低（<0.01）。A组术后2周的鼻充血VAS评分低于B组第一阶段手术后的评分（<0.01）。A、B、C三组术后鼻粘连的发生率分别为0%、6.9%和4.3%。对于合并鼻中隔骨折的外伤性鼻骨骨折，与分期手术相比，在全身麻醉下使用内窥镜进行同期鼻骨复位及鼻中隔成形术更节省时间，且术后鼻粘连的发生率更低。
