Usefulness of ultrasonography in the treatment of nasal bone fractures.

BACKGROUND: Ultrasonography has recently been used in assessment and diagnosis of maxillofacial trauma because it is easy and quick to perform, inexpensive, portable, and noninvasive. The aim of this study was to estimate ultrasonography as an intraoperative repositioning control of nasal bone fractures. METHODS: We studied 32 patients with suspected nasal bone fracture. We performed preoperative computed tomography (CT) for evaluation of the type and extent of nasal bone fractures. We also took external photographs for evaluation of external deviation of the nose and nasal deformity. During surgery, we performed real-time ultrasonography-guided closed reduction using a 10 MHz linear transducer. After 1 year, we performed postoperative evaluation with CT and external photography. We classified patients into three groups according to their CT score. RESULTS: Patients were 23 males and 9 females aged 8-39 years. Clinical symptoms were pain, nasal swelling, nasal bleeding, and localized depression at the trauma site. In almost all patients, postoperative external photographs showed a symmetrical nasal dorsum without external deformity, and postoperative CT showed stabilization of bony fragments and good alignment of the nasal bone. Postoperatively, the CT score was 3 (excellent) in 25 patients, 2 (good) in 5 patients, and 1 (fair) in 2 patients. CONCLUSION: We suggest that ultrasonography is very useful for evaluating intraoperative repositioning of nasal bone fractures.

Endoscopic reduction of medial orbital wall fractures using the rolled silastic sheet technique.

BACKGROUND: Endoscopic reduction has become common for reducing medial orbital wall fractures because of its various advantages. Nevertheless, there is no standard method of nasal packing to support the orbital contents to maintain the reduction. We evaluated the outcomes of endoscopic reduction of medial orbital wall fractures using the rolled Silastic sheet technique. METHODS: Seventeen patients who underwent endoscopic reduction of medial orbital wall fractures were analyzed. They were diagnosed using 3-mm facial computed tomography and treated surgically under general anesthesia in our department between February 2006 and March 2008. Postoperatively, they were followed for at least 3 months. RESULTS: The 17 patients comprised 13 men and 4 women ranging in age from 18 to 71 years (mean, 40.8 years). There were no significant intraoperative or postoperative complications. All 17 patients showed complete resolution of their symptoms after surgery. CONCLUSION: The technique using the rolled Silastic sheet for medial orbital wall fractures supports the safety and efficacy of endoscopic reduction.