Skip to main content
SpringerLink
Log in

Traumatologie der Nase

Moderne Konzepte

Traumatology of the nose

Modern concepts

  • Leitthema
  • Published:
Journal für Ästhetische Chirurgie Aims and scope

Zusammenfassung

Die Nase als prominentestes Element des Gesichtes wird überdurchschnittlich oft traumatisiert. Eine exakte Beurteilung einer traumatisierten Nase, eine angemessene Diagnostik und die Entscheidung zu einer adäquaten Frühbehandlung tragen dazu bei, bleibende Formstörungen zu verhindern. Die gesamte Palette der bekannten Techniken der Rhinoplastik ermöglicht weitreichende Korrekturmaßnahmen. In die Planung intensiver Korrekturmaßnahmen sollten technische Varianten wie mehrfache Osteotomien und die Abtragung überschüssiger Knochensequester oder Narben einbezogen werden. Außerdem ist die Auswahl eines geeigneten Materials zur Auffüllung von Defekten wichtig.

Abstract

The nose is the most prominent feature of the face and therefore suffers from trauma more often than the average. An exact assessment of the trauma to the nose, appropriate diagnostics and the decision for an adequate timely treatment contribute to avoidance of permanent disfiguration. The complete range of known techniques for rhinoplasty enables far-reaching corrective measures. The planning of intensive corrective measures should include technical variations, such as multiple osteotomies and the removal of superfluous bone sequestra or scar tissue. In addition, the selection of a suitable filling material for defects is important.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6a,b
Abb. 7

Literatur

  1. Al-Moraissi EA, Ellis E 3rd (2015) Local versus general anesthesia for the management of nasal bone fractures: a systematic review and meta-analysis. J Oral Maxillofac Surg 73(4):606–615

    Article  PubMed  Google Scholar 

  2. Behrbohm H, Kaschke O (1998) Elevatorium für Frakturen des Os nasale und des Arcus zygomaticus. Laryngol Rhinol Otol (Stuttg) 77:52–53

    Article  CAS  Google Scholar 

  3. Cook JA, McRae DR, Irving RM, Dowie LN (1990) A randomized comparison of manipulation of the fractured nose under local and general anaesthesia. Clin Otolaryngol 15:343

    Article  CAS  PubMed  Google Scholar 

  4. Fry HJH (1966) Interlocked stresses in human nasal septal cartilage. Br J Plast Surg 19:276

    Article  CAS  PubMed  Google Scholar 

  5. Green KM (2001) Reduction of nasal fractures under local anaesthetic. Rhinology 39:43–46

    CAS  PubMed  Google Scholar 

  6. Gunter JP, Rohrich RJ (1988) Management of the deviated nose: the importance of septal reconstruction. Clin Plast Surg 15:43

    CAS  PubMed  Google Scholar 

  7. Hoffmann JF (1998) Naso-orbital-ethmoid complex fracture management. Facial Plast Surg 14:67–81

    Article  CAS  PubMed  Google Scholar 

  8. Holt GR (1999) Biomechanics of nasal septal trauma. Otolaryngol Clin North Am 32:15–19

    Article  Google Scholar 

  9. Holt GR (1978) Immediate open reduction of nasal septal injuries. Ear Nose Throat J 57:344–354

    Google Scholar 

  10. Hong HS, Cha JG, Paik SH, Park SJ, Park JS, Kim DH, Lee HK (2007) High-resolution sonography for nasal fracture in children. AJR Am J Roentgenol 188(1):W86–W92

    Article  PubMed  Google Scholar 

  11. Illum P (1991) Legal aspects in nasal fractures. Rhinology 29:263–266

    CAS  PubMed  Google Scholar 

  12. Jackson IT (1989) Classification and treatment of orbitozygomatic and orbitoethmoid fractures. The place of bone grafting and plate fixation. Clin Plast Surg 16(1):77–91

    CAS  PubMed  Google Scholar 

  13. Kaschke O (2004) Trauma der Nase. In: Behrbohm H, Tardy ME (Hrsg) Funktionell-ästhetische Chirurgie der Nase-Septorhinoplastik. Thieme, Stuttgart, S 216–227

    Google Scholar 

  14. Logan M, O’Driscoll K, Masterson J (1994) The utility of nasal bone radiographs in nasal trauma. Clin Radiol 49:192

    Article  CAS  PubMed  Google Scholar 

  15. Marcks R, Pirsig W (1977) Spätergebnisse der Nasenbeinfrakturen bei Erwachsenen. HNO 25:187–1192

    CAS  PubMed  Google Scholar 

  16. Markowitz BL, Manson PN (1989) Panfacial fractures: organization of treatment. Clin Plast Surg 16:105–114

    CAS  PubMed  Google Scholar 

  17. Meleca RJ, Mathog RH (1995) Diagnosis and treatment of naso-orbital fractures. In: Mathog RH, Arden RL, Marks SC (Hrsg) Trauma of the nose and paranasal sinuses. Thieme, Stuttgart, S 65–98

    Google Scholar 

  18. Murray JAM, Maran AGD, MacKenzie IJ, Raab G (1984) Open vs. closed reduction of the fractured nose. Arch Otolaryngol 110:797–802

    Article  CAS  PubMed  Google Scholar 

  19. OWolff J, Sándor GK, Pyysalo M, Miettinen A, Koivumäki AV, Kainulainen VT (2013) Late reconstruction of orbital and naso-orbital deformities. Oral Maxillofac Surg Clin North Am 25(4):683–695

    Article  Google Scholar 

  20. Papadopoulos H, Salib NK (2009) Management of naso-orbital-ethmoidal fractures. Oral Maxillofac Surg Clin North Am 21(2):221–225

    Article  PubMed  Google Scholar 

  21. Paskert JP, Manson PN (1989) The bimanual examination for assessing instability in naso-orbito-ethmoidal injuries. Plast Reconstr Surg 83:165–167

    Article  CAS  PubMed  Google Scholar 

  22. Perkins SW, Dayan SH, Sklarew EC, Hamilton M, Bussell GS (2000) The incidence of sports-related facial trauma in children. Ear Nose Throat J 79:632–638

    CAS  PubMed  Google Scholar 

  23. Pirsig W, Lehmann I (1975) The influence of trauma on the growing septal cartilage. Rhinology 13:39–46

    CAS  PubMed  Google Scholar 

  24. Potter JK, Muzaffar AR, Ellis E, Rohrich RJ, Hackney FL (2006) Aesthetic management of the nasal component of naso-orbital ethmoid fractures. Plast Reconstr Surg 117(1):10e–18e

    Article  PubMed  Google Scholar 

  25. Renner GJ (1991) Management of nasal fractures. Otolaryngol Clin North Am 24:195–213

    CAS  PubMed  Google Scholar 

  26. Rohrich RJ, Adams WP (2000) Nasal fracture management: minimizing secondary nasal deformities. Plast Reconstr Surg 106:266–273

    Article  CAS  PubMed  Google Scholar 

  27. Simmen D (1998) Nasenfrakturen-Indikationen zur offenen Reposition. Laryngol Rhinol Otol (Stuttg) 77:388–393

    Article  CAS  Google Scholar 

  28. Smith D, Mathog RH (1995) Diagnosis and management of acute nasal fracture. In: Mathog RH, Arden RL, Marks SC (Hrsg) Trauma of the nose and paranasal sinuses. Thieme, Stuttgart, S 21–38

    Google Scholar 

  29. Stucker FJ, Bryarly RC, Shockley WW (1984) Management of nasal trauma in children. Arch Otolaryngol 110:190–192

    Article  PubMed  Google Scholar 

  30. Tardy ME (1997) Cartilage autograft reconstruction. In: Tardy ME (Hrsg) Rhinoplasty: the art and the science, Bd. 2. WB Saunders, Philadelphia, S 648–723

    Google Scholar 

  31. Tardy ME (1997) Narrowing the nose. In: Tardy ME (Hrsg) Rhinoplasty: the art and the science, Bd. 1. W.B. Saunders, Philadelphia, S 326–373

    Google Scholar 

  32. Tebbetts JB (1998) Osteotomies. In: Tebbetts JB (Hrsg) Primary rhinoplasty: a new approach to the logic and the techniques. Mosby, St. Louis, S 225–260

    Google Scholar 

  33. Thiede O, Krömer JH, Rudack C, Stoll W, Osada N, Schmäl F (2005) Comparison of ultrasonography and conventional radiography in the diagnosis of nasal fractures. Arch Otolaryngol Head Neck Surg 131(5):434–439

    Article  PubMed  Google Scholar 

  34. Velidedeoğlu H, Demir Z, Sahin U, Kurtay A, Erol OO (2005) Block and surgicel-wrapped diced solvent-preserved costal cartilage homograft application for nasal augmentation. Plast Reconstr Surg 115(7):2081–2093

    Article  PubMed  Google Scholar 

  35. Verwoerd CDA, Verwoerd HL, Meeuwis CA (1989) Stress and wound healing of the cartilaginous nasal septum. Acta Otolaryngol 107:441–445

    Article  CAS  PubMed  Google Scholar 

  36. Verwoerd CDA (1992) Present day treatment of nasal fractures: closed versus open reduction. Facial Plast Surg 8:220

    Article  CAS  PubMed  Google Scholar 

  37. Vora NM, Fedok FG (2000) Management of the central nasal support complex in naso-orbital ethmoid fractures. Facial Plast Surg 16:181–191

    Article  CAS  PubMed  Google Scholar 

  38. Wright RJ, Murakami CS, Ambro BT (2011) Pediatric nasal injuries and management. Facial Plast Surg 27(5):483–490

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Abt. Hals-Nasen-Ohrenheilkunde, Plastische Gesichts- und Halschirurgie, Sankt Gertrauden Krankenhaus, Paretzer Str. 12, 10713, Berlin, Deutschland

    O. Kaschke

Authors
  1. O. Kaschke
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to O. Kaschke.

Ethics declarations

Interessenkonflikt

O. Kaschke gibt an, dass kein Interessenkonflikt besteht. Der Beitrag wurde erarbeitet in Zusammenarbeit mit dem Privat-Institut für medizinische Weiterbildung und Entwicklung auf dem Gebiet der Hals-Nasen-Ohrenheilkunde e.V. (http://www.imwe-berlin.de)

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Im Falle von nicht mündigen Patienten liegt die Einwilligung eines Erziehungsberechtigten oder des gesetzlich bestellten Betreuers vor.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kaschke, O. Traumatologie der Nase. J Ästhet Chir 10, 26–34 (2017). https://doi.org/10.1007/s12631-016-0076-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12631-016-0076-x

Schlüsselwörter

Keywords

Search

Navigation