Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2023; 11(27): 6374-6382
Published online Sep 26, 2023. doi: 10.12998/wjcc.v11.i27.6374
Effectiveness of out-fracture of the inferior turbinate with reduction nasal bone fracture
Se-Young Kim, Ha-Jong Nam, Je-Yeon Byeon, Hwan Jun Choi
Se-Young Kim, Ha-Jong Nam, Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, Gumi-si 39371, South Korea
Je-Yeon Byeon, Hwan Jun Choi, Department of Plastic and Reconstructive Surgery, Soonchunhyang University Cheonan Hospital, Cheonan-si 31151, South Korea
Author contributions: Nam HJ contributed to manuscript writing, visualization, and data collection; Byeon JY contributed to conceptualization, methodology and analysis; Choi HJ contributed to project administration; Kim SY contributed to manuscript review, editing, and supervision; all authors have read and approved the final manuscript.
Supported by the National Research Foundation of Korea Grant funded by the Korea Government (MSIT), No. 2020R1A2C1100891; and Soonchunhyang Research Fund, No. 2023-0048.
Institutional review board statement: The study was approved for exemption by the Institutional Review Board of Soonchunhyang University Hospital (IRB exemption No. 2023-04-028).
Informed consent statement: The patients provided written informed consent for the publication and use of his or her images.
Conflict-of-interest statement: No potential conflict of interest relevant to this article was reported.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hwan Jun Choi, MD, PhD, Professor, Surgeon, Department of Plastic and Reconstructive Surgery, Soonchunhyang University Cheonan Hospital, Suncheonhyang 6-gil 31, Dongnam-gu, Cheonan-si 31151, South Korea. iprskorea@gmail.com
Received: June 6, 2023
Peer-review started: June 6, 2023
First decision: July 17, 2023
Revised: July 28, 2023
Accepted: August 23, 2023
Article in press: August 23, 2023
Published online: September 26, 2023
Processing time: 106 Days and 11.3 Hours
Abstract
BACKGROUND

The nasal bone, being the most protruding bone in the center of the facial bones, is particularly susceptible to damage. Nasal bone fractures can often result in secondary deformation and dysfunction of the nose, including septal fractures. Studies on functional or intra-nasal complications have been rarely reported after nasal bone fracture reduction.

AIM

To evaluate the severity of nasal obstruction and its improvement following nasal bone fracture reduction using inferior turbinoplasty.

METHODS

We conducted a retrospective review of data from 50 patients with symptomatic nasal obstruction between January to December 2010. All patients underwent preoperative Computed tomography evaluation, and symptom changes and nasal cavity volume were analyzed using a visual analog scale and acoustic rhinometry before and after surgery. Closed reduction and out-fracture of both inferior turbinates performed by the same surgeon. Treatment outcomes were assessed by comparing changes in the nasal airway volume measured using acoustic rhinometry before and after surgery. The minimal cross-sectional area (MCA) was also analyzed based on the Stranc classification.

RESULTS

Before reduction, the mean MCA for all cases was 0.59 ± 0.06 cm2, which represented an 11% decrease compared to the average size of a Korean adult (0.65 ± 0.03 cm2). The MCA for frontal impact was 0.60 ± 0.02 cm2 and for lateral impact, it was 0.58 ± 0.03 cm2. After reduction via inferior turbinoplasty, the MCA improved to 0.64 ± 0.04 cm2.

CONCLUSION

This study suggests that turbinoplasty is helpful in addressing nasal obstruction. Out-fracture of the inferior turbinate is an effective and durable technique that can be easily performed to enlarge the nasal airway with minimal morbidity.

Keywords: Acoustic rhinometry; Nasal bone; Fracture; Turbinate

Core Tip: We analyzed subjective symptoms and computed tomography images of patients with nasal bone fractures before and after surgery. Acoustic nasal aeration was examined before and after surgery to determine the effect of the inferior turbinate anatomy on nose function through cross-sectional changes. We reviewed the data of 50 patients with symptomatic nasal obstruction. Treatment outcomes were evaluated by comparing changes in nasal airway volume measured using acoustic rhinometry before surgery. The minimal cross-sectional area was improved up to 0.64 ± 0.04 cm2 after reduction with inferior turbinoplasty. Our results suggest that out-fracture of the inferior turbinate is an effective and durable technique that can be easily performed to enlarge the nasal airway with minimal morbidity.