Nasal bone clip: a novel approach to nasal bone fixation.

BACKGROUND: Nasal bone fracture is a common injury, but its repair can be unexpectedly difficult. To date, intranasal gauze packing has been used to support the nasal bone in position and to maintain contact between the mucosa of the septum and the cartilage. This gauze packing, however, has a tendency to shift, resulting in an inflammatory response characterized by a foul odor until removal, which detracts from the comfort of the patient. We developed a novel device, the nasal bone clip (NBC), which provides a satisfactory nasal airway and improved comfort. METHODS: A 1.2-mm Kirschner wire and a small piece of hydrocolloid wound dressing are used. The single wire is bent into a double-curved shape, after which each of the 2 tips is curled with pliers. The end of the wire in the nasal passage is covered with a piece of wound dressing to protect the mucosa. After reduction, the external portion of the wire is inserted on the surface of the splint. RESULTS: The NBC was applied in 14 cases: 12 instances of fresh fractures and 2 of old fractures; there were 8 men and 6 women; their mean age was 19.9 years. Complications were not observed; moreover, no patients exhibited problems during the treatment. CONCLUSIONS: The advantages of the NBC are that all materials are available in the operating room or outpatient department, it is low cost, it is readily installable and detachable, it affords superior support for gauze packing, it provides effective external splinting with intranasal support, it never disturbs the nasal airway, and it offers comfort.

Double pennant technique: elongating the helix using rim flaps to correct the constricted ear.

In a Tanzer group 2B or group 3 constricted ear, the short helix must be elongated with additional tissues. To do this, we have developed a new method of surgical repair using 2 pennant-shaped rim flaps. Six constricted ear patients underwent correctional ear plasty using this method. Four of the deformities were Tanzer group 2b and 2 were group 3. Our surgical procedure elongated the patients' helix from 7 to 22 mm, leaving them with smooth curvature and a good color match to the adjoining skin.