Treatment of Nasal Bone Fracture with Reverse U-Shaped Silicone Sheet

반전된 U자형 실리콘 시트를 이용한 코뼈골절의 치료

  • Choi, Hwan Jun (Department of Plastic and Reconstructive Surgery, College of Medicine, Soon Chun Hyang University) ;
  • Wee, Syeo Young (Department of Plastic and Reconstructive Surgery, College of Medicine, Soon Chun Hyang University) ;
  • Choi, Chang Yong (Department of Plastic and Reconstructive Surgery, College of Medicine, Soon Chun Hyang University)
  • 최환준 (순천향대학교 의과대학 성형외과학교실) ;
  • 위서영 (순천향대학교 의과대학 성형외과학교실) ;
  • 최창용 (순천향대학교 의과대학 성형외과학교실)
  • Published : 2009.03.15

Abstract

Purpose: The majority of nasal bone fractures have been managed by routine procedure of closed reduction and intranasal packing. However, nasal packing can cause nasal injury, hypoxia and patient's discomfort. And, synechiae formation is a frequently occurred after the nasal surgery. Various methods are used to reduce the incidence of synechiae formation. The purpose of this study was to compare routine procedure and nasal packing with reverse "U" shaped silicone sheet with respect to postoperative nasal synechiae formation and final outcome. Methods: We analyzed the medical records of 100 patients with nasal bone fracture who were operated by closed reduction in the last one year. The silicone sheet was designed in reverse "U" fan - shape and inserted between the middle turbinate and the septal wall. Nasal packing was removed at two days after the operation, and silicone sheet was removed at 10 to 14 days. Results: Synechiae in the middle meatus developed in 2 of 75 patients. Although synechiae between the middle meatus and nasal septum occurred in patients, the patients did not complaint of any olfactory disturbance and nasal obstruction. Conclusion: The reverse "U" fan - shape silicone sheet caused less pain for patients and no significant differences in outcome were found. The results of this study suggest that insertion of silicone sheet between the middle meatus and septum can be a useful method in the prevention of intranasal synechiae formation. The reverse "U" silicone sheet is a good alternative for routine packing methods.

Keywords

References

  1. Yang HE, Park ES, Cha JG, Kim CH, Kim JH, Kim YB: Ultrasound-guided closed reduction of nasal bone fracture. J Korean Soc Plast Reconstr Surg 34: 460, 2007
  2. Min BY, Kim HU, Chu HR, Park CH: A comparative study between K-wire and intranasal packing in nasal bone fracture. Korean J Otolaryngol-Head Neck Surg 45: 1073, 2002
  3. Kim SB, Han SK, Kim WK: Airway improvement after reduction of nasal bone fracture. J Korean Soc Plast Reconstr Surg 32: 49, 2005
  4. Lee SP, Suhk JH, Choi WS, Kim TB, Yang WS: Usefulness of utrasound-guided closed reduction of nasal bone fracture. J Korean Cleft Palate Craniofac Assoc 9: 12, 2008
  5. Choi YS, Jang TY, Kim BM, Choi JS, Kim MW: Repair of nasal septal perforation using silastic sheet. Korean J Otolaryngol 49: 522, 2006
  6. Park SW, Kim YH, Kwon JH, Cho JH: Endoscopic endonasal reconstruction of blowout fracture of the medial orbital wall using a n-shape 1 mm thick silastic sheet and filling up with compressed Merocel(R). Korean J Otolaryngol 47: 75, 2004