The Efficacy of Sequential Intranasal Packing Removal in Overcorrected Nasal Bone Fracture: Evaluation With Computed Tomography.
Journal
The Journal of craniofacial surgery
ISSN: 1536-3732
Titre abrégé: J Craniofac Surg
Pays: United States
ID NLM: 9010410
Informations de publication
Date de publication:
01 Sep 2023
01 Sep 2023
Historique:
received:
30
12
2022
accepted:
11
02
2023
medline:
31
8
2023
pubmed:
23
5
2023
entrez:
23
5
2023
Statut:
ppublish
Résumé
Despite the evolution of new techniques to treat nasal bone fractures, closed reduction with appropriate palpation and inspection is one of the critical basic tools to treat nasal bone fractures properly. Despite its rarity, overcorrection after closed reduction of the nasal bone fracture could happen even with experienced surgeons. This study hypothesized that sequential packing removal is mandatory for optimal outcomes based on the preoperative and postoperative Computed Tomography scans in overcorrected cases. This is the first study to evaluate the efficacy of sequential nasal packing removal assessed by facial CT scans. In this retrospective study, we evaluated the medical records and preoperative and postoperative facial Computed Tomography scans of 163 patients with nasal bone fractures treated with a closed reduction from May 2021 to December 2022. Preoperative and Postoperative CT scan was routinely used to assess the outcome. Merocels were used for intranasal packing. In overcorrected cases based on immediate postoperative CT scan, we routinely removed the intranasal packing on the overcorrected side first immediately. On postoperative day 3, we removed the remaining intranasal packing on the other side. We assessed additional postoperative CT scans on postoperative two to three weeks. With sequential packing removal starting on the day of surgery, all overcorrected cases were successfully corrected clinically and radiologically without noticeable complications. Two representative cases were presented. Sequential nasal packing removal provides significant benefits in overcorrected cases. An immediate postoperative CT scan is also vital to do this procedure. This strategy is advantageous if the fracture is significant and there is a substantial possibility of overcorrection.
Sections du résumé
BACKGROUND
BACKGROUND
Despite the evolution of new techniques to treat nasal bone fractures, closed reduction with appropriate palpation and inspection is one of the critical basic tools to treat nasal bone fractures properly. Despite its rarity, overcorrection after closed reduction of the nasal bone fracture could happen even with experienced surgeons. This study hypothesized that sequential packing removal is mandatory for optimal outcomes based on the preoperative and postoperative Computed Tomography scans in overcorrected cases. This is the first study to evaluate the efficacy of sequential nasal packing removal assessed by facial CT scans.
METHODS
METHODS
In this retrospective study, we evaluated the medical records and preoperative and postoperative facial Computed Tomography scans of 163 patients with nasal bone fractures treated with a closed reduction from May 2021 to December 2022. Preoperative and Postoperative CT scan was routinely used to assess the outcome. Merocels were used for intranasal packing. In overcorrected cases based on immediate postoperative CT scan, we routinely removed the intranasal packing on the overcorrected side first immediately. On postoperative day 3, we removed the remaining intranasal packing on the other side. We assessed additional postoperative CT scans on postoperative two to three weeks.
RESULTS
RESULTS
With sequential packing removal starting on the day of surgery, all overcorrected cases were successfully corrected clinically and radiologically without noticeable complications. Two representative cases were presented.
CONCLUSION
CONCLUSIONS
Sequential nasal packing removal provides significant benefits in overcorrected cases. An immediate postoperative CT scan is also vital to do this procedure. This strategy is advantageous if the fracture is significant and there is a substantial possibility of overcorrection.
Identifiants
pubmed: 37218029
doi: 10.1097/SCS.0000000000009376
pii: 00001665-202309000-00060
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1864-1866Informations de copyright
Copyright © 2023 by Mutaz B. Habal, MD.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Hwang K, Ma SH. Overcorrection of nasal bone fracture reduction can be minimized by packing removal. J Craniofac Surg 2022;33:e364–e5.
Lim H, Kang KR, Koh SH, et al. Postoperative changes after closed reduction of nasal fracture. J Craniofac Surg 2017;28:1649–53.