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      Satisfacción estética y funcional tras reducción cerrada de fracturas nasales: implementación de la escala NOSE Translated title: Aesthetic and functional satisfaction after closed reduction of nasal fractures: implementation of the NOSE scale

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          Abstract

          Resumen Introducción y objetivo. La fractura nasal es la lesión facial más común y más del 50 % de todas las fracturas faciales en adultos. Debido a que en muchas ocasiones no es diagnosticada y tratada oportunamente, puede generar diferentes grados de limitación funcional y resultados estéticos indeseables. Pocos estudios evalúan la satisfacción de los pacientes tratados con técnica cerrada de reducción de fractura nasal. Nuestro objetivo es valorar la satisfacción funcional y estética posterior a reducción cerrada de fractura de huesos nasales en un hospital de Colombia, mediante la escala de evaluación de síntomas de obstrucción nasal (NOSE, por sus siglas en inglés - nasal obstruction symptom evaluation) y la escala estética subjetiva. Material y método. Estudio observacional analítico prospectivo de pacientes con fractura nasal llevados a reducción cerrada en el Hospital Universitario de Santander, Colombia. Se registraron las puntuaciones de las escalas NOSE y estética subjetiva, antes y 2 meses después de la cirugía. Resultados. Evaluamos 55 pacientes, 90.9% hombres. La mediana de edad fue de 31 años (RIC 24-48). El contexto de lesión principal fue violencia física (40%), seguido de accidente de tránsito (32.7%). Tras el procedimiento, los pacientes presentaron mejoría de obstrucción nasal medida con la escala NOSE (p<0.001); antes de la cirugía el 89% presentaba obstrucción nasal moderada-severa, posteriormente descendió a 14.5%. La escala NOSE mostró fabilidad por consistencia interna con alfa de Cronbach de 0.8317. Tras la cirugía hubo aumento de la satisfacción respecto al aspecto nasal (p<0.001). Conclusiones. En nuestro estudio, el cuestionario NOSE permitió cuantificar la mejora de síntomas de obstrucción nasal en pacientes con reducción cerrada por fractura de huesos nasales. Observamos mejoría de síntomas obstructivos nasales y aumento de satisfacción estética. Nivel de evidencia científica 4c Terapéutico

          Translated abstract

          Abstract Background and objective. Nasal fracture is the most common facial injury, accounting for more than 50% of all facial fractures in adults. Because it is often not diagnosed and treated promptly, it can generate different degrees of functional limitation and undesirable aesthetic results. Few studies evaluate the satisfaction of patients treated with the closed nasal fracture reduction technique. Our objective is to evaluate functional and aesthetic satisfaction after closed reduction of a nasal bone fracture in a hospital in Colombia, using the nasal obstruction symptom evaluation (NOSE) and subjective aesthetic scales. Methods. Prospective analytical observational study of patients with nasal fractures undergoing closed reduction at the University Hospital of Santander, Colombia. The scores of the NOSE scales and subjective aesthetics were recorded, before and 2 months after surgery. Results. We evaluated 55 patients, 90.9% men. Median age 31 years (IQR 24-48). The main injury context was physical violence (40%), followed by traffic accident (32.7%). After the procedure, the patients presented improvement in nasal obstruction measured with the NOSE scale (p<0.001); before surgery, 89% had moderate-severe nasal obstruction, later it decreased to 14.5%. The NOSE scale showed reliability due to internal consistency with Cronbach's alpha of 0.8317. After surgery, there was an increase in satisfaction regarding the nasal appearance (p<0.001). Conclusions. The NOSE questionnaire allows us to quantify the improvement of nasal obstruction symptoms in patients with closed reduction due to nasal bone fracture. Improvement of nasal obstructive symptoms and increased aesthetic satisfaction was observed. Level of evidence 4c Terapeutic

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          Most cited references21

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          Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale.

          The study goal was to validate a disease-specific health status instrument for use in patients with nasal obstruction.Design, settings, and patients The study consisted of a prospective instrument validation conducted at 4 academic medical centers with 32 adults with nasal septal deformity. Prospective instrument validation occurred in 2 stages. Stage 1 was the development of a preliminary (alpha-version) instrument of potential items. Stage 2 was a test of the alpha-version for item performance, internal consistency, and test-retest reliability; construct, discriminant, criterion validity, and responsiveness; and creation of the final instrument. Items with poor performance were eliminated from the alpha-version instrument. In testing the final instrument, test-retest reliability was adequate at 0.702; internal consistency reliability was also adequate at 0.785. Validity was confirmed using correlation and comparison analysis, and response sensitivity was excellent. The Nasal Obstruction Symptom Evaluation Scale is a valid, reliable, and responsive instrument that is brief and easy to complete and has potential use for outcomes studies in adults with nasal obstruction.
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            Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study.

            The aim of this study was to assess the characteristics of maxillofacial fractures in the Piracicaba region of Brazil during a 5-year period and to delineate comparisons with worldwide facial fracture patterns. A descriptive statistical analysis was developed based on data collected using a specifically designed clinical survey of all patients who attended the Division of Oral and Maxillofacial Surgery at the Piracicaba Dental School from 1999 to 2004. Information regarding age, gender, etiology, and type of maxillofacial injury and its associated lesions were evaluated. In addition, treatment modalities and complication rates during patient follow-up were assessed. A total of 1024 patients presenting 1399 maxillofacial fractures were analyzed. Patients' ages ranged from 0 to 88 years (mean age, 28 +/- 16.4 years). The ratio of men to women was 4:1. Most fractures were caused by traffic accidents (45%), followed by assaults (22.6%), falls (17.9%), sports accidents (7.8%), and work accidents (4.5%). The prevalent anatomic regions of facial fractures (in percentages) were the mandible (44.2%), the zygomatic complex (32.5%), and the nasal bones (16.2%). Associated systemic lesions were found in 41.9% of patients, with prevalence for injuries to the upper (24.1%) and lower limbs (15.4%). Patient management was considered to be conservative in 490 patients (47.9%), and surgical therapy was performed in 493 patients (48.1%), of whom 399 (80.9%) were treated with open reduction and rigid internal fixation. Complications occurred in 76 patients (7.4%), mainly due to infection and malocclusion. The findings of this study indicated that epidemiological research of maxillofacial fractures allows the presentation patterns of the most affected individuals and the nature of their lesions to be outlined according to the region evaluated. Furthermore, treatment evaluation and complication rate analysis permits a more realistic interpretation of how patients should be managed.
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              The efficiency of Nose Obstruction Symptom Evaluation (NOSE) scale on patients with nasal septal deviation.

              The aim in this study was to evaluate the efficiency of Nasal Obstruction Symptom Evaluation (NOSE) scale for septoplasty (without turbinate reduction) in comparison with other examination methods. Prospective observational study was undertaken in otolaryngology department of university hospital. NOSE scale for quality of life assessment, visual analog scale for examination findings, acoustic rhinometry and coronal computed tomography were performed before and after septoplasty. The efficiency of NOSE scale to assess for septoplasty results and the correlation between NOSE scores and other techniques was analyzed. Twenty-seven patients underwent septoplasty; there was a very significant improvement in mean NOSE scores of patients (60.2 versus 11.28, p<0.01). There was no correlation between NOSE scores and acoustic rhinometry. Correlation was found between NOSE scores and examination and computed tomography findings (p<0.05). NOSE scale that is well correlated with examination findings and computed tomography, is very useful tool to evaluate the effectiveness of pure septoplasty. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Journal
                cpil
                Cirugía Plástica Ibero-Latinoamericana
                Cir. plást. iberolatinoam.
                Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) (Madrid, Madrid, Spain )
                0376-7892
                1989-2055
                September 2023
                : 49
                : 3
                : 217-224
                Affiliations
                [2] Bucaramanga orgnameUniversidad Industrial de Santander (UIS) Colombia
                [3] Bucaramanga orgnameUniversidad Industrial de Santander (UIS) orgdiv1Hospital Universitario de Santander (HUS) Colombia
                [1] Bucaramanga orgnameUniversidad Industrial de Santander (UIS) orgdiv1Hospital Universitario de Santander (HUS) Colombia
                [4] Bucaramanga orgnameUniversidad de Santander UDES orgdiv1Hospital Universitario de Santander (HUS) Colombia
                Article
                S0376-78922023000300003 S0376-7892(23)04900300003
                10.4321/s0376-78922023000300003
                100faa90-f3b6-48a4-9f66-1e1985a4c861

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 11 August 2023
                : 30 June 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 8
                Product

                SciELO Spain

                Categories
                Estética

                Nasal fractures,Hueso nasal,Obstrucción nasal,Satisfacción paciente,Closed fracture reduction,Nasal bone,Nasal obstruction,Patient satisfaction,Fractura nasal,Reducción cerrada

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