ĐÁNH GIÁ VÁCH NGĂN TRONG GÃY XƯƠNG CHÍNH MŨI: ĐẶC ĐIỂM LÂM SÀNG, HÌNH ẢNH HỌC VÀ XỬ TRÍ BAN ĐẦU TẠI BỆNH VIỆN NHÂN DÂN GIA ĐỊNH

Abstract

Background: Nasal septal abnormality recorded in the context of nasal bone fracture (NBF) may be overlooked in the acute phase. Without pre-injury data, septal deviation should be interpreted cautiously because it may have pre-existed before trauma.

Objectives: To describe the prevalence, clinical and imaging characteristics, and initial management of septal abnormality recorded in the context of NBF, and to explore clinical features suggesting the need for active septal assessment.

Methods: This descriptive cross-sectional retrospective study analyzed 30 adult NBF patients treated at the Department of Otolaryngology, Gia Dinh People’s Hospital, from November 2022 to July 2023. Patients were classified into the septal abnormality group (VN+, n=9) and non-septal abnormality group (VN-, n=21). Categorical variables were compared using two-sided Fisher’s exact test.

Results: Septal abnormality was recorded in 9/30 patients (30%), all presenting as septal deviation; no complete septal fracture/collapse or septal hematoma was documented. The VN+ group had higher rates of nasal obstruction and overall nasal collapse than the VN- group (both 77.8% vs 28.6%; p=0.020). Nasal endoscopy and maxillofacial CT scan documented septal abnormality in all VN+ cases, whereas plain radiography suggested abnormality in only 2/9 cases. All VN+ patients underwent septal reduction with Asch forceps before closed nasal bone fracture reduction in the same surgical session.

Conclusions: Septal abnormality was recorded in 30% of NBF patients and was associated with higher rates of nasal obstruction and nasal collapse. These findings suggest that patients with NBF presenting with nasal obstruction or nasal collapse should undergo active septal assessment using intranasal examination, nasal endoscopy, and maxillofacial CT scan when appropriate.