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
ARTICLE HIGHLIGHTS
Research background

Among facial bones, the nasal bone is located at the center of the facial bones. It is the most protruding and thus, the weakest bone. It has a high frequency of damage, which often leads to secondary deformation, as well as dysfunction of the nose due to fracture and dislocation of the septum. The current practices have had little consideration towards anatomical structures such as the nasal cavities, which often involve airway obstruction and olfactory disturbances due to fractures or efforts to objectify patient's subjective or temporary symptoms.

Research motivation

In order to improve functional problems, inferior turbinate outward osteotomy and septal curvature have been mainly performed in the field of otolaryngology, while studies involving such structures have been rare in the field of plastic surgery. Therefore, our study investigated the effect of the anatomical structure of the inferior turbinate on the function of the nose in nasal bone fractures through the changes of the nasal cavity, determined by subjects’ pre- and post-operative symptoms, computed tomography (CT) analysis, and pre- and postoperative acoustic nasal airway examination.

Research objectives

The article demonstrates a satisfactory result in the appearance and function of the nose, subjective and objective, after inferior turbinate outward osteotomy and a concurrent closed reduction in patients with nasal bone fractures.

Research methods

From January to December 2010, pre-operative radiological examination and acoustic rhinometry were performed on nasal bone fracture patients with nasal obstruction symptoms prior to receiving closed reduction. Questionnaires on the patients’ symptoms were conducted before surgery, and two weeks, four weeks, and eight weeks after surgery. Nasal bone fractures were classified according to the Stranc classification system using CT performed for diagnosis and nasal obstruction was objectively measured using an acoustic rhinometry. 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 fracture classification.

Research results

The mean MCA for all cases before reduction was 0.59 ± 0.06 cm2, which was a 11% decrease compared to that in the average of a Korean adult (0.65 ± 0.03 cm2). The MCA were 0.60 ± 0.02 cm2 for frontal impact, and 0.58 ± 0.03 cm2 for lateral impact. The MCA improved up to 0.64 ± 0.04 cm2 after reduction with inferior turbinoplasty.

Research conclusions

The results of this study suggest that out-fracture of the inferior turbinoplasty is more helpful to prove nasal obstruction.

Research perspectives

Our study proved that a simple and easy inferior turbinate outward osteotomy is more advantageous in improving the symptoms of nasal obstruction at an early stage. Out-fracture of the inferior turbinate is an effective and durable technique, which can be performed easily to enlarge the nasal airway with minimal morbidity.