Impact of different fracture types in the pyriform buttress area on nasal airway function

Fractures in the pyriform buttress area adversely affect facial appearance and nasal airway patency. Nasal airway function has received less attention than aesthetic problems in the literature. This retrospective study classified the different fracture types in this area and determined their impact on nasal airway function.

Three-dimensional computed tomography images of patients with fractures in the pyriform buttress area were analyzed to identify the exact fracture pattern. The nasal airway functions were evaluated and compared between patients with different fracture patterns using acoustic rhinometry, rhinomanometry, and the nasal obstruction symptom evaluation scale.

Overall, 47 patients, including 16 with type I fractures (high fracture line; group I), 16 with type II fractures (intermediate fracture line; group II), and 15 with type III fractures (low fracture line; group III), were included in the study. The mean minimal cross-sectional area (MCA), total nasal inspiratory resistance (Tri) and total nasal expiratory resistance (Tre) of group I were 0.51 ± 0.06 cm², 1.67 ± 0.11 kPa L^-1 s^-1, and 1.66 ± 0.12 kPa L^-1 s^-1, respectively; those of group II were 0.48 ± 0.07 cm², 1.89 ± 0.15 kPa L^-1 s^-1, and 1.88 ± 0.14 kPa L^-1 s^-1, respectively; and those of group III were 0.36 ± 0.04 cm², 1.94 ± 0.21 kPa L^-1 s^-1, and 2.01 ± 0.34 kPa L^-1 s^-1, respectively. The nasal obstruction symptom evaluation (NOSE) scale scores for groups I, II, and III were 7.188, 9.813, and 13.27, respectively.

Therefore, the severity of the nasal airway obstruction depends on the displacement of the fractured bones in patients with fractures in the pyriform buttress area. The most profound nasal obstruction occurs in patients with the lowest fracture line.