비중격 골절을 동반한 단순 비골 골절의 치료에 있어 비중격 교정술의 중요성: 비강 통기도 검사를 이용한 평가 = The Importance of Septoplasty in The Treatment of Nasal Bone and Grade I Septal Fracture: Estimation with Acoustic Rhinometry

다국어 초록 (Multilingual Abstract)

Purpose: Nasal bone fractures are often classified as minor injury. However, the incidence of posttraumatic nasal deformity remains alarmingly high. It is because of unnoticed septal fracture. This study was conducted to determine the necessity of septoplasty for patients with nasal bone fracture accompanying grade I septal fractures. Methods: Among 105 patients with nasal bone fractures, 52 who had grade I septal fracture were diagnosed based on physical examination and computed tomography. Patients' age ranged from 14 to 65 years (mean 29.25 years), and 35 were male and 17 female. Patients were divided into 2 groups according to surgical treatment methods: patients who underwent closed reduction only (group 1, n=28) and those who underwent simultaneous closed reduction and septoplasty (group 2, n=24). The treatment outcomes were evaluated by comparing changes in nasal airway volume measured by acoustic rhinometry before the surgery, 3 months and 6 months after the surgery according to the timing of surgical repair and surgical treatment methods. Results: Nasal airway volume increased after the surgery by 17.8% in 3 months after the surgery, 25.2% in 6 months in group 1 and by 22.7% in 3 months, 35.8% in 6 months in group 2. The increase in airway volume after the surgery by 26.3% in 3 months after the surgery, 34.2% in 6 months after the surgery in operation within 1 week after trauma and by 12.1% in 3 months, 22.2% in 6 months after the operation later 1 week after trauma. The difference was statistically significant. Three patients in group 1 complained of intermittent nasal obstruction, two of whom showed a decrease in nasal airway volume by acoustic rhinometry. Conclusion: Most patients with nasal bone fractures accompanying grade I septal fractures have been treated with closed reduction in clinical settings. However, the results of this study suggest that septoplasty be performed after a correct diagnosis of septal fracture is made through comprehensive physical examination and computed tomography. Septoplasty is important to obtain more favorable outcomes and reduce complication.

참고문헌 (Reference)

• 1 김상범, "비골 골절 정복 후 비강 내 기도 폐색의 개선" 대한성형외과학회 32 (32): 49-54, 2005
• 2 Rohrich RJ, "The deviated nose: optimizing result using a simplified classification and algorithmic approach" 110 : 1509-, 2002
• 3 Higuera S, "Stal S: Nasal trauma and the deviated nose" 120 : 64S-, 2007
• 4 Rhee SC, "Septal fracture in simple nasal fracture" 113 : 45-, 2004
• 5 Fattahi T, "Repair of nasal complex fracture and the need for secondary septo-rhinoplasty" 64 : 1785-, 2006
• 6 Fernandes SV, "Nasal fracture: the taming of the shrewd" 114 : 587-, 2004
• 7 Rohrich RJ, "Nasal fracture management: minimizing secondary nasal deformities" 106 : 266-, 2000
• 8 Simmen D, "Nasal fracture - indication for open reposition" 77 : 388-, 1998
• 9 권혁준, "Clinical epidemiologic study of facial bone fracture in Daegu" 대한성형외과학회 34 (34): 365-370, 2007
• 10 Hwang K, "Analysis of nasal bone fracture: a six year study of 503 patient" 117 : 261-, 2006
• 11 Robinson JH, "Airway obstruction following closed reduction of nasal fracture" 114 : 1357-, 2004
• 12 Murray JA, "A pathologic classification of nasal fracture" 17 : 338-, 1986