Effectiveness of endoscopic intranasal incision reduction for nasal fractures

• Published in: European archives of oto-rhino-laryngology Vol. 279; no. 3; pp. 1341 - 1348
• Main Authors: Yan, Shu, Jiang, Yan, Wang, Yan, Chen, Kaixuan, Yan, Xudong, Sun, Xiaohan, Zhang, Jisheng, Li, Na
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2022
• Subjects: Endoscopy - methods; Head and Neck Surgery; Humans; Medicine; Medicine & Public Health; Nasal Cavity - diagnostic imaging; Nasal Cavity - surgery; Nasal Obstruction - etiology; Nasal Obstruction - surgery; Neurosurgery; Otorhinolaryngology; Retrospective Studies; Rhinology; Rhinomanometry; Rhinometry, Acoustic; Endoscopic intranasal incision reduction; Fractures of the frontal process of the maxilla; Aesthetics; Nasal bone fractures; Nasoseptal fractures
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-021-06878-3

Purpose To report our experience using endoscopic intranasal incision reduction (EIIR) for nasal fractures and to assess effectiveness of the method. Methods 30 patients who underwent EIIR were retrospectively analysed. All the patients were examined by three-dimensional computed tomography (3D CT), acoustic rhinometry and rhinomanometry, preoperatively and postoperatively at 1 month. The visual analogue scale (VAS) was used to assess the preoperative aesthetics and nasal airflow satisfaction and at 1, 3 and 6 months postoperatively. VAS aesthetic satisfaction was also scored by two junior doctors. Results 3D CT showed that the fracture fragments fitted well in 30 patients postoperatively at 1 month. VAS aesthetics and nasal airflow scores were significantly improved postoperatively at 1, 3 and 6 months compared with preoperative scores ( P  < 0.01). The VAS aesthetic scores from the two surgeons were also significantly improved ( P  < 0.01). The minimal cross-sectional area increased from 0.39 ± 0.13 to 0.64 ± 0.13 ( P  < 0.001), the nasal volume increased from 4.65 ± 0.86 to 6.37 ± 0.94 ( P  < 0.001) and the total inspiratory airway resistance of the bilateral nasal cavity median decreased from 0.467 Pa/mL/s to 0.193 Pa/mL/s ( P  < 0.001). There were no technique-related intraoperative complications. Conclusion EIIR was a practical choice, and the aesthetics and nasal airflow were significantly improved in patients with overlapped and displaced bone fragments, patients with fractures of the frontal process of the maxilla (FFPM), patients who underwent failed CR and patients beyond the optimal temporal window.