Silastic Nasal Septal Splint: A Key Success in the Treatment of Acute Nasal Bone Fractures

Abstract

Objective: Nasal septal splint post manipulation in acute nasal bone fractures treatment can stabilize the septum in perfect position until healing unites which can provide good esthetic and functional long term end results.
Methods: During October 2008-February 2012, there were 530 nasal bone fracture patients (417 male and 113 female ~ratio 4: 1) admitted at Prapokklao Hospital, 375 isolated nasal bone fractures cases and 142 cases associated with other facial bone fractures. The total 517 treated cases were treated as closed reduction (359 cases) and open reduction (158 cases). After manipulation, tailor- made silastic sheets were placed along the correct position of the nasal septum as a fixation splint with sutures, left in place for 7- 10 days before removal.
Results: The success in closed reductions for isolated nasal bone fractures was 95.73 % (359 cases of 375 cases) and the success in open reduction was 100% (158 cases), with follow-up between 3 months to 3 years. Most cases had a good result and only 17 cases had post-traumatic deformities (3.29 %). Surgical corrections: 3- septorhinoplasty, 2- closed reduction after repeated trauma, 2- augmented rhinoplasty with calvarial bone graft, were done, and ten cases denied further treatment.
Conclusion: Nasal septal splint after treatment with appropriate reduction in acute nasal bone fractures could straighten the nasal septum, providing good esthetic and functional long-term end results.