鼻部外伤性骨折的诊断和修复（附500例分析报告）

目的：探讨鼻骨、鼻软骨骨折正确的诊断方法和最佳的复位方法．对500例鼻部外伤患者的鼻骨骨折X线侧位和轴位摄片(其中162例同时做CT水平扫描)等资料进行分析．其中350例诊断为双侧鼻骨骨折，单侧鼻骨骨折23例，鼻软骨骨折25例，单纯上领骨额突骨折21例，鼻骨上领骨额突复合骨折16例，鼻骨，上领窦上领骨额突和筛骨垂直板复合骨折6例，鼻骨鼻副窦复合骨折4例，鼻眶骨折9例．均行手术和手法复位．结果：490例复位满意，10例复位不佳．结论：X摄片鼻骨只能诊断双鼻骨同时骨折，而单侧鼻骨骨折，上领骨额突骨折，筛骨垂直板等复杂骨折CT扫描均能清楚显示．可见鼻骨X拍片和鼻骨骨折CT扫描在诊断鼻骨骨折中二者不可缺一．鼻骨骨折和鼻软骨骨折同时要有两位耳科专科医师参与则诊断更加明确．

Diagnosis and repair of nasal bone fracture(report 500 cases)

Objective:to discuss methods of diagnosis and repair for nasal bone fracture. Methods:500 cases of nasal trauma were examined by lateral and frontal X-ray test (horizontal CT-scan was also used in 162 cases of these patients).Results:350 cases were found with bilateral fracture of nasal bone,unilateral fracture,nasal cartilage fractures,simple fracture of frontal process of maxilla,compound fracture of nasal bone and frontal process of maxilla.Compound fracture of nasal bone,maxilla,frontal process of maxilla and perpendicular plate of ethmoid bone,compound fracture of nasal bone and accessory nasal sinuses,fracture of nasal bone and orbit were seen in 23,25,21,16,6,4 and 9 cases respectively.Conclusion:X-ray examination can only find bilateral fracture of nasal bone,but CT-scan can clearly demonstrate unilateral fracture,fracture of frontal process of maxilla,fracture of perpendicular plate of ethmoid bone and compound fracture of nasal bone and soon. In the diagnosis of nasal bone fracture,neither X-ray examination of the nasal bone nor CT-scan of the nasal bone fracture can be missed.It is more accurate for two ear specialists to join in the diagnosis of the nasal bone and cartilage fracture.