Preliminary Three-Dimensional Volumetric Analysis of New Technique of
Open Septal Reduction using Polydioxanone Plates for Nasoseptal Fracture
Objectives: In this study, we designed a new technique for open septal
reduction using a polydioxanone (PDS) plate and compared it with closed
reduction. Design, Setting, Participants: This study included nineteen
consecutive patients with nasoseptal fracture: ten receiving open
reduction with a PDS plate (PDS group) and nine undergoing closed
reduction (CR group). Open septal reduction was performed after closed
reduction for nasal bone fracture. A mucoperichondrial flap was
unilaterally elevated, and the deviated septal cartilage was reduced.
The PDS plate was inserted horizontally above the vomerine suture.
Surgical outcome was analyzed with three-dimensional volumetry and with
a quality-of-life scale for nasal obstruction (NOSE scale). Results:
Complications included one case of septal perforation in the CR group
and one case of PDS exposure and septal hematoma in the PDS group. In
the 3D volumetric analysis of the PDS group, the median value of the
nasal cavity change significantly differed between 1.14 mL
(interquartile range; 0.46 to 2.4) at the preoperative CT scan and 0.33
mL (interquartile range; -0.22 to 1.29) at the postoperative CT scan
(**p = 0.0039). The NOSE scale revealed significant improvement in nasal
obstruction postsurgically (median value, 42.5 to 7.5; *p = 0.0139) in
the PDS group. Conclusion: PDS plates potentially present a new concept
of open septal reduction in terms of septal reinforcement compared with
the subtractive approach of open septal reduction.