DOI QR코드

DOI QR Code

The Usefulness of Nasal Packing with Vaseline Gauze and Airway Silicone Splint after Closed Reduction of Nasal Bone Fracture

  • Kim, Hyo Young (Department of Plastic Surgery, Kosin University Gospel Hospital, Kosin University School of Medicine) ;
  • Kim, Sin Rak (Department of Plastic Surgery, Kosin University Gospel Hospital, Kosin University School of Medicine) ;
  • Park, Jin Hyung (Department of Plastic Surgery, Kosin University Gospel Hospital, Kosin University School of Medicine) ;
  • Han, Yea Sik (Department of Plastic Surgery, Kosin University Gospel Hospital, Kosin University School of Medicine)
  • Received : 2012.07.02
  • Accepted : 2012.08.22
  • Published : 2012.11.15

Abstract

Background Packing after closed reduction of a nasal bone fracture causes inconvenient nasal obstruction in patients. We packed the superior meatus with Vaseline gauze to support the nasal bone, and packed the middle nasal meatus with a Doyle Combo Splint consisting of an airway tube, a silastic sheet, and an expandable sponge to reduce the inconvenience. In addition, we aimed to objectively identify whether this method not only enables nasal respiration but also sufficiently supports the reduced nasal bone. Methods Nasal ventilation was measured via spirometry 1 day before surgery and compared to 1 day after surgery. To compare support of the reduced nasal bone by the 2 methods, 2 plastic surgeons assessed the displacementon X-rays taken after the surgery and after removing the packing. The extent of nasal obstruction, dry mouth, sleep disturbance, headache, and swallowing difficulty were compared with visual analog scales (VAS) on a pre-discharge survey. Results In the experimental group, the nasal respiration volume 1 day after surgery remained at $71.3%{\pm}6.84%$ on average compared to 1 day prior to surgery. Support of the reduced bone in the experimental group ($2.80{\pm}0.4$) was not significantly different from the control group ($2.88{\pm}0.33$). The VAS scores for all survey items were lower in the experimental group than in the control group, where a lower score indicated a lower level of inconvenience. Conclusions The nasal cavity packing described here maintained objective measures of nasal respiration and supported the reduced bone similar to conventional methods. Maintaining nasal respiration reduced the inconvenience to patients, which demonstrates that this packing method is useful.

Keywords

References

  1. Huizing E, Pirsig W, Wentges R, et al. Unanimity and diversity in nasal surgery. Rhinol Suppl 1989;9:15-23.
  2. Schultz LW. Nasal splints: advantages, disadvantages and author's modifications. Am J Surg 1957;94:897-9. https://doi.org/10.1016/0002-9610(57)90078-8
  3. Rhee SC, Kim JS. A simple method of fabricating nasal packing armed with ventilation tube. J Craniofac Surg 2008;19: 1385-6. https://doi.org/10.1097/SCS.0b013e3181843719
  4. Jung YJ, Choi YW, Nam SH, et al. The usefulness of airway tube Merocel(R) on treatment of nasal bone fracture. J Korean Cleft Palate-Craniofac Assoc 2009;10:14-8.
  5. Son KM, Yang JY, Kim GB, et al. The effect of nasal packing with rolled silastic sheet after closed reduction of nasal bone fracture. J Korean Soc Plast Reconstr Surg 2011;38:602-8.
  6. Kim JY, Kim YH. The usefulness of a bronchodilator after the closed reduction of nasal bone fracture. J Korean Cleft Palate-Craniofac Assoc 2011;12:22-7.
  7. Fairbanks DN. Complications of nasal packing. Otolaryngol Head Neck Surg 1986;94:412-5. https://doi.org/10.1177/019459988609400337
  8. Ogretmenoglu O, Yilmaz T, Rahimi K, et al. The effect on arterial blood gases and heart rate of bilateral nasal packing. Eur Arch Otorhinolaryngol 2002;259:63-6. https://doi.org/10.1007/s00405-001-0422-1
  9. Johannessen N, Jensen PF, Kristensen S, et al. Nasal packing and nocturnal oxygen desaturation. Acta Otolaryngol Suppl 1992;492:6-8.
  10. Park S, Iwasaki Y. Intranasal Kirschner wire splinting of nasal fractures. Plast Reconstr Surg 2000;106:952-3.
  11. Burm JS, Oh SJ. Indirect open reduction through intercartilaginous incision and intranasal Kirschner wire splinting of comminuted nasal fractures. Plast Reconstr Surg 1998; 102:342-9. https://doi.org/10.1097/00006534-199808000-00007
  12. Garth RJ, Brightwell AP. A comparison of packing materials used in nasal surgery. J Laryngol Otol 1994;108:564-6.
  13. Ruddy J, Brain D, Sudesh RR, et al. A prospective trial of Merocel packs. Rhinology 1991;29:281-5.
  14. Acioglu E, Edizer DT, Yigit O, et al. Nasal septal packing: which one? Eur Arch Otorhinolaryngol 2012;269:1777-81. https://doi.org/10.1007/s00405-011-1842-1
  15. Kang SJ, Kim JW. Proposed method for closed reduction of impacted nasal bone fractures using a Kirschner wire and a C-arm. J Oral Maxillofac Surg 2012;70:1393-7. https://doi.org/10.1016/j.joms.2012.02.023
  16. Han DS, Han YS, Park JH. A new approach to the treatment of nasal bone fracture: the clinical usefulness of closed reduction using a C-arm. J Plast Reconstr Aesthet Surg 2011; 64:937-43. https://doi.org/10.1016/j.bjps.2010.12.019

Cited by

  1. Comparison Study of the Use of Absorbable and Nonabsorbable Materials as Internal Splints after Closed Reduction for Nasal Bone Fracture vol.41, pp.4, 2014, https://doi.org/10.5999/aps.2014.41.4.350
  2. A Comparison Between K-Wire Splinting and Intranasal Gauze Packing in Nasal Bone Fracture vol.26, pp.5, 2012, https://doi.org/10.1097/scs.0000000000001850
  3. Comparison Study of the Use of Absorbable Materials as Internal Splints with Airway Silicone Splint and Absorbable Materials as Internal Splints Alone vol.17, pp.4, 2012, https://doi.org/10.7181/acfs.2016.17.4.202
  4. Evaluation of Safety and Efficacy for an Intranasal Airway Device in Nasal Surgery vol.21, pp.1, 2012, https://doi.org/10.1001/jamafacial.2018.0955