A new approach to nasoseptal fractures: Submucosal endoscopically assisted septoplasty and closed nasal reduction.

Background: Nasal bone fracture is the most common among facial bone fractures. The prevalence of concomitant septal and nasal bone fractures fluctuates between 34% and 96.2%. An adequate management of such fractures is essential to prevent complications such as post-traumatic nasal obstruction and nasoseptal deformities. The purpose of the present study is to introduce the submucosal endoscopically assisted septoplasty (SEAS) as an alternative approach for acute septal lesions and to report our experience and outcomes.
Methods: Retrospective review including patients with nasal fracture in association with septal fracture (nasoseptal fractures) who underwent to submucosal endoscopically assisted septoplasty and closed nasal reduction. The surgical technique is described and a video is presented.
Results: Ninety patients were included; 23% were female and 77% were male, with a mean age of 40 years. All the cases were workplace accidents or commuting accidents. The mean time elapsed between the accident and surgery was 15 days. There were no technique-related intraoperative complications. Three (3.3%) patients suffered a subsequent nasal obstruction and/or deviation of the nasal axis, requiring subsequent secondary open rhinoseptoplasty.
Conclusions: Submucosal endoscopically assisted septoplasty and closed nasal reduction for the treatment of nasoseptal fractures is a novel approach that reduces the rate of secondary rhinoseptoplasty as compared to other authors' reports. The technique described is reproducible, cost-effective and has very encouraging outcomes.
Level of Evidence: IV Therapeutic.
(Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)