Background and Objective

Nasal bone fracture is the most common facial fracture and its concomitant finding with septal fracture varies from 34% to 96.2%. Its proper management is needed to prevent complications such as nasal obstruction and nasoseptal posttraumatic deformities.

The aim of the paper is to introduce the technique of endoscopic assistance as an alternative for the treatment of acute septal lesions and to compare its results with the traditional approach.

Methods

Retrospective review of nasoseptal fractures cases between January 2010 and April 2014 in which closed nasal reduction and open nasal septoplasty (traditional technique) or closed nasal reduction and sub-mucosal endoscopically assisted septoplasty (SEAS) were performed.

The surgical technique is described and results are presented.

Results

We collected 123 patients: 33 cases with traditional technique and 90 with SEAS. All the cases were workplace accidents or commuting accidents. Both groups were comparable. The average time elapsed between the accident and traditional surgery was 11.4 days and 15 days for SEAS. No intraoperative complications were observed in any of the techniques presented. Five patients (15.15%) treated with traditional technique and 3 patients (3.3%) with SEAS evolved with nasal obstruction and/or deviation of the nasal axis, requiring subsequent secondary open rhinoseptoplasty (statistically significant difference).

Conclusions

The closed nasal reduction and SEAS for the treatment of nasoseptal fractures is an innovation that reduces the rate of secondary rhinoseptoplasty required compared to the traditional technique and the reported in the literature. It’s besides a reliable and low cost technique.

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