Primary Septoplasty in the Treatment of Nasal Bone Fractures

ABSTRACT

PURPOSE: Most of nasal bone fractures involve the septum; either or both of the ethmoidal perpendicular plate(EPP) and quadrangular cartilage(QC). Unlocked tension from the underlying quadrangular cartilage and poorly reduced bony septum are obstacles to the successful reduction of nasal bone. So we compared the preliminary outcome of septoplasty as a primary treatment with the untreated septum in nasal bone fractures. METHODS: We performed a retrospective study of 215 patients who underwent reduction of nasal fracture from January 2002 to February 2008. We graded patients into four groups according to the amount of deviation and direction of force by CT. Our indication for septoplasty and combined procedures was the deviation of EPP or QC over 50% from the midline. We interviewed part of the patients by telephone regarding the subjective esthetic and functional outcomes. RESULTS: Forty five of 215 patients (21 percent) underwent septoplasty and combined procedures (cartilage graft, etc) after the informed consent. The patients who underwent septoplasty significantly were satisfied with the outcome of esthetic appearance and nasal patency compared with the patients who underwent simple closed reduction despite of having septal deviation over 50 percent from the midline(p<0.05). CONCLUSION: Septal surgery and esthetic consideration shoud be made even in simple nasal reductions. And if CT scans reveal severe deviation of septum, septoplasty should be considered as a primary treatment.