Nasal injuries: Their pathogenesis and treatment

Harrison, Douglas H.

doi:10.1016/0007-1226(79)90063-8

Cited by 73 publications

(64 citation statements)

References 7 publications

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“…Harrison war der erste, der C-f ö rmige Septumfrakturen beschrieb, ohne jede biologische Erkl ä -rung zu geben [38] . Sp ä ter wurde ein ä hnlicher Bruch bei einem 4-j ä hrigen Kind [39] …”

Section: Bevorzugte Frakturlinienunclassified

Rhinochirurgie bei Kindern: Entwicklungsphysiologische und chirurgische Aspekte der wachsenden Nase

Verwoerd

Verwoerd-Verhoef

2010

Laryngo-Rhino-Otol

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The anatomy of the nasal skeleton in newborns and adults are not alike. The complete cartilaginous framework of the neonatal nose becomes partly and gradually ossified during the years of growth and is more vulnerable to trauma in that period. Injury in the early youth may have large consequences for development of a nasal deformity which will increase during growth and reach its peak during and after the adolescent growth spurt. To understand more of the underlying problems of nasal malformations and their treatment (septoplasty) these items became the focus of multiple animal studies in the last 40 years. The effects of surgery on the nasal septum varied considerably, seemingly depending on which experimental animal was used. In review, however, it appeared that the very different techniques of surgery might be even more influential in this respect. Study of one of the larger series of experiments in young rabbits comprised skeletal measurements with statistical analysis and microscopic observations of the tissues. The behaviour of hyaline cartilage of the human nose appeared to be comparable to that of mammals. Cartilage, although resilient, can be easily fractured whereas its tendency to integrated healing is very low, even when the perichondrium has been saved. Also surgical procedures - like in septoplasty - may result in growth disturbances of the nasal skeleton like deviation or nasal spine. Loss of cartilage, as might occur after a septum abscess, is never completely restored despite some cartilage regeneration. In this article the many experimental studies are reviewed and compared. Still there remains a lack of real consensus in the literature concerning the developmental effects of rhinosurgry in children. Based on their observations in animals and a few clinical studies, mostly with small numbers of patients but with a long follow-up, the authors have compiled a list of guidelines to be considered before starting to perform surgery on the growing midface in children.

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Section: Bevorzugte Frakturlinienunclassified

Rhinochirurgie bei Kindern: Entwicklungsphysiologische und chirurgische Aspekte der wachsenden Nase

Verwoerd

Verwoerd-Verhoef

2010

Laryngo-Rhino-Otol

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“…If dealing with nasal skin defects, grafts or flaps should rarely be used, and only be used if they are absolutely necessary in an open trauma wound because the potential risk of infection is significantly increased (12). Columella is a tricky subunit to repair because of the low availability of neighbouring skin (17); in a study by Sherris et al (17), only one of 16 patients with columella defect due to trauma was operated with the use of a local flap.…”

Section: Discussionmentioning

confidence: 99%

“…Harrison (12) experimentally described a recurring pattern of septal fracture and displacement produced in 15 cadavers, giving evidence for the causes of the poor outcome of a simple manipulation (12). A fractured septum should be considered a significant factor, which can unfavourably affect the alignment of the nasal bone during the healing process (13).…”

Section: Discussionmentioning

confidence: 99%

Nasal trauma: Primary reconstruction with open rhinoplasty

Konstantinidis¹,

Malliari²

2011

J Plast Surg

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“…The L or C type is almost always accompanied with moderate to severe septal fractures. 10,11,13 It is recommended that saddletype fracture such as L or C type undergo surgery as early as possible, without waiting for swelling to subside 2 ; otherwise, such fractures should be primarily treated by open reduction. 1,3,5,10,13,14 Septal fracture was reported to be an important cause of secondary deformity.…”

Section: Figurementioning

confidence: 99%

“…10,11,13 It is recommended that saddletype fracture such as L or C type undergo surgery as early as possible, without waiting for swelling to subside 2 ; otherwise, such fractures should be primarily treated by open reduction. 1,3,5,10,13,14 Septal fracture was reported to be an important cause of secondary deformity. 1,10,11,13 Although it is difficult to diagnose fracture of the cartilaginous septum, it is possible to accurately diagnose fracture of the bony septum by CT. Murray et al 10,11 reported that the bony segment is often involved in nasal septum fracture.…”

Section: Figurementioning

confidence: 99%

Pre- and Postoperative X-ray and Computed Tomography Evaluation in Acute Nasal Fracture

Yabe

Ozawa²,

Sakamoto³

et al. 2004

Annals of Plastic Surgery

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Between January 1997 and July 2003, 156 acute nasal fractures were treated by closed reduction in Ishikiri-Seiki Hospital. For all patients, x-ray and computed tomography (CT) taken pre- and postoperatively were used to classify fractures and evaluate postoperative conditions. Acute nasal fractures requiring surgery were classified into the following 5 types. Unilateral type (U), bilateral type (B), frontal type (F), laterofrontal type (L), and comminuted type (C). Postoperative conditions were classified as good, fair, or poor. On statistical analysis, it was found that reduction is easier in the U, F, B, L, and C types in order. Furthermore, it was found that in the U, B, and F types, reduction can be performed after swelling has subsided, but in the L and L+C types, reduction should be performed earlier. On follow-up x-ray and CT, there was no significant difference between the postoperative evaluation and follow-up evaluation. A few overreduced cases improved, but correct reduction was preferable to overreduction. Accurate preoperative understanding of the fracture type and postoperative evaluation by x-ray and CT are necessary to obtain good results and to decrease secondary deformity caused by poor primary reduction.

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Nasal injuries: Their pathogenesis and treatment

Cited by 73 publications

References 7 publications

Rhinochirurgie bei Kindern: Entwicklungsphysiologische und chirurgische Aspekte der wachsenden Nase

Rhinochirurgie bei Kindern: Entwicklungsphysiologische und chirurgische Aspekte der wachsenden Nase

Nasal trauma: Primary reconstruction with open rhinoplasty

Pre- and Postoperative X-ray and Computed Tomography Evaluation in Acute Nasal Fracture

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