Transnasal tension suture of external nasal splints: A reliable, novel technique

• Published in: American journal of otolaryngology Vol. 43; no. 6; p. 103585
• Main Authors: Kreutz-Rodrigues, Lucas, Bakri, Karim, Gibreel, Waleed, Lettieri, Salvatore C.
• Format: Journal Article
• Language: English
• Published: Maryland Heights Elsevier Inc 01.11.2022; Elsevier Limited
• Subjects: Adhesives; Bones; Closed reduction; Complications; Fractures; Nasal fracture; Necrosis; Patients; Polypropylene; Reduction; Rhinoplasty; Splints; Sutures; Trauma; Nasal fracture; Rhinoplasty
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2022.103585

We routinely apply external nasal splints after closed nasal reduction or rhinoplasty and secure the splint by transnasal suturing. We seek to describe our technique and review our experience. A retrospective chart review was performed to review patients who had an external nasal splint secured by transnasal suturing. The technique consists of steristrips applied across the dorsum and nasal bones. The Aquaplast is molded to the nose and a 2-0 polypropylene suture on a straightened tapered needle or a Keith needle is passed through the splint, the nasal sidewalls and septum, through the splint on the contralateral side, and back again in a horizontal mattress fashion. The suture is tied down to maintain the desired shape of the splint. The splint is removed in the first postoperative followup (10–14 days). Mean patient age was 31.5 years, 82 male and 18 female patients were reviewed, 67 % of splints were placed for closed reduction of acute nasal trauma, and 33 % placed after elective rhinoplasty for late correction of functional and cosmetic traumatic deformity. No splints were inadvertently removed by patients prior to followup. Splints were removed an average of 12 days postoperatively, and mean followup was 27 weeks. There were no complications related to transnasal suturing of the splint, such as skin ulceration, pressure necrosis, identifiable scarring related to the suture entry points or breathing difficulty attributable to internal nasal valve narrowing. Transnasal suturing is a safe and reliable method for fixation of an external nasal splint.