The Effect of Nasal Packing with Rolled Silastic Sheet after Closed Reduction of Nasal Bone Fracture

비골 골절 교정 후 Rolled Silastic Sheet를 이용한 비강 충진의 효과

  • Son, Kyung-Min (Department of Plastic and Reconstructive Surgery, Chosun University College of Medicine) ;
  • Yang, Jeong-Yeol (Department of Plastic and Reconstructive Surgery, Chosun University College of Medicine) ;
  • Kim, Gyu-Bo (Department of Plastic and Reconstructive Surgery, Chosun University College of Medicine) ;
  • Han, Yun-Ju (Graduate School of Chosun University) ;
  • Cheon, Ji-Seon (Department of Plastic and Reconstructive Surgery, Chosun University College of Medicine)
  • 손경민 (조선대학교 의과대학 성형외과학교실) ;
  • 양정열 (조선대학교 의과대학 성형외과학교실) ;
  • 김규보 (조선대학교 의과대학 성형외과학교실) ;
  • 한윤주 (조선대학교 대학원) ;
  • 천지선 (조선대학교 의과대학 성형외과학교실)
  • Received : 2011.06.07
  • Accepted : 2011.08.03
  • Published : 2011.09.10

Abstract

Purpose: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. Methods: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I (n=92), $Merocel^{(R)}$ was used for nasal packing, for Group II (n=152) vaseline gauze was used, and Rolled silastic sheet (RSS) with vaseline gauze packing (VGP) was used for Group III (n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. Results: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased ($p$ <0.05) and the postoperative complication (deviation) were decreased comparing to vaseline gauze packing and $Merocel^{(R)}$ packing, however, these differences were not statistically significant ($p$ >0.05). Conclusion: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.

Keywords

References

  1. Colton JJ, Beekhuis GJ: Management of nasal fractures. Otolaryngol Clin North Am 19: 73, 1986
  2. Ruddy J, Brain D, Sudesh RR, Anand VT: A prospective trial of Merocel packs. Rhinology 29: 281, 1991
  3. Leek JH: Combine Marocel and Gelfilm as a nasal pack. Laryngoscope 95: 99, 1985 https://doi.org/10.1288/00005537-198501000-00024
  4. SCHULTZ LW: Nasal splints: advantages, disadvantages and author's modifications. Am J Surg 94: 897, 1957 https://doi.org/10.1016/0002-9610(57)90078-8
  5. Korean Society of Plastic Surgery: Facial Bone Fracture. Textbook of Plastic Surgery. 2nd ed, Seoul, Koonja Co., 2009, p 276
  6. McCarthy JG: Plastic surgery. 1st ed, Philadelphia, Saunders, 1990, p 987
  7. Yun BH, Kim JS, Kim DI: Ventilating Tube Method using IV Line During closed reduction of nasal bone fracture. J Korean Cleft Palate Craniofac Assoc 2: 77, 2001
  8. Choi HJ, Wee SY, Choi CY: Treatment of nasal bone fracture with reverse U-shaped silicone sheet. J Korean Soc Plast Reconstr Surg 36: 242, 2009
  9. Manson PN: Facial Fractures. In Mathes SJ: Plastic surgery. 2nd ed, Philadelphia, Saunders Elsvier, 2006, p 201
  10. Rhee SC, Kim YK, Cha JH, Kang SR, Park HS: Septal fracture in simple nasal bone fracture. Plast Reconstr Surg 113: 45, 2004 https://doi.org/10.1097/01.PRS.0000096705.64545.69
  11. Hwang K, You SH, Kim SG, Lee SI: Analysis of nasal bone fractures; a six-year study of 503 patients. J Craniofac Surg 17: 261, 2006 https://doi.org/10.1097/00001665-200603000-00010