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Comparative Study
. 2025 Apr;39(4):338-343.
doi: 10.13201/j.issn.2096-7993.2025.04.009.

[Comparison of the efficacy of simultaneous and staged surgical procedures for traumatic nasal bone fractures with septal fractures]

[Article in Chinese]
Affiliations
Comparative Study

[Comparison of the efficacy of simultaneous and staged surgical procedures for traumatic nasal bone fractures with septal fractures]

[Article in Chinese]
Yi Dong et al. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr.

Abstract

Objective:To compare the outcomes of simultaneous versus staged nasal bone reduction and septoplasty in the treatment of traumatic nasal bone fractures with associated septal fractures. Methods:Patients with traumatic nasal bone fractures, with or without septal fractures, were recruited from two hospitals and divided into three groups. Group A underwent simultaneous nasal bone reduction and septoplasty, Group B underwent staged nasal bone reduction and septoplasty, and Group C underwent nasal bone reduction only. Nasal appearance scores and nasal congestion Visual Analogue Scale (VAS) scores were measured preoperatively, at 2 weeks postoperatively, and at 3 months postoperatively. For Group B, scores were also recorded at 2 weeks and 3 months after the second-stage surgery. Differences were analyzed using statistical software. Results:Two weeks post-surgery, the nasal appearance scores significantly decreased in all three groups compared to preoperative scores (P< 0.01), with no statistically significant differences between the groups (P= 0.43, 0.71, 0.58). In Group A, the VAS score for nasal congestion decreased significantly following simultaneous surgery (P<0.01). In Group B, there were no significant differences in nasal congestion VAS scores between pre-surgery and post-first-stage, nor between three months post-first-stage and two weeks post-first-stage (P= 0.61, 0.13). However, the VAS scores significantly decreased after the second-stage surgery compared to pre-surgery, and three months post-second-stage surgery compared to three months post-first-stage surgery (P<0.01). The VAS scores for nasal congestion at two weeks post-surgery in Group A were lower than those in Group B after the first-stage surgery (P<0.01). The incidence rates of nasal adhesions post-surgery in Groups A, B, and C were 0%, 6.9%, and 4.3%, respectively. Conclusion:For traumatic nasal bone fractures with associated septal fractures, performing simultaneous nasal bone reduction and septoplasty under general anesthesia using endoscopy is more time-efficient compared to staged surgery, and it results in a lower occurrence rate of post-surgical nasal adhesions.

目的:比较同期和分期行鼻骨整复及鼻中隔矫正术,对外伤性鼻骨骨折伴鼻中隔骨折治疗的优劣。 方法:收集来自和田地区人民医院耳鼻咽喉科与北京同仁医院耳鼻咽喉头颈外科的外伤性鼻骨骨折伴或不伴鼻中隔骨折患者,分为3组,A组:同期鼻骨整复和鼻中隔矫正术治疗;B组:分期鼻骨整复和鼻中隔矫正术治疗;C组:单纯鼻骨整复术治疗。记录3组术前、术后2周、术后3个月及B组二期术后2周、术后3个月的鼻外观评分及鼻塞症状的VAS评分。经统计学软件比较上述指标的差异。 结果:3组手术治疗后2周较术前鼻外观评分均降低(P<0.01),且3组间差异均无统计学意义(P=0.43、0.71、0.58)。A组同期术后,鼻塞症状的VAS评分降低(P<0.01)。B组一期术后与术前、一期术后3个月与术后2周比较,鼻塞VAS评分差异均无统计学意义(P=0.61、0.13);B组二期术后较术前、二期术后3个月与一期术后3个月比较,VAS评分均降低(P<0.01)。A组术后2周鼻塞VAS评分,低于B组一期术后(P<0.01)。3组术后鼻腔粘连的发生率分别为0%、6.9%及4.3%。 结论:对于外伤性鼻骨骨折合并鼻中隔骨折的患者,全身麻醉内镜下同期进行鼻骨整复术及鼻中隔矫正术,在时效性上优于分期手术,且术后鼻腔粘连并发症的发生率更低。.

Keywords: nasal bone fracture; nasal trauma; septal fracture; surgical treatment.

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Conflict of interest statement

The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.

Figures

图 1
图 1
鼻骨骨折合并中隔骨折患者手术前后冠状位CT同一层面鼻中隔形态
图 2
图 2
鼻骨骨折合并中隔骨折轴位CT像

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